Okra for Dry Eye, Blepharitis, and MGD Treatment with Dr. Peter Pham
Dr. Peter Pham is a practicing ophthalmologist in the Houston area, and he moved to the United States from Vietnam in 1979. This was shortly after the Vietnam war, and many were fleeing Vietnam at the time. After drifting at sea for a few days, they landed off the coast of malaysia and spent a few months there. There were an incredible amount of people there after a few months. After coming to the U.S. as a refugee, he lived in Michigan, California, and Indiana and went to college and medical school at Washington University in St. Louis. After moving around for a while, he landed in Houston to set up a private practice.
Dr. Pham’s story is truly incredible, and it’s definitely inspiring to know that you can come from such humble beginnings and be anything you want to be. He was inspired to be an eye doctor during medical school. He discovered that he enjoyed working with his hands, and the field of ophthalmology allows him to work with patients both in clinic and in the surgical setting.
Suffering from MGD himself, Dr. Pham tried many things to treat his condition. So many of them were ineffective and he found that the treatments don’t work for everyone. Because of this, he decided to dive into something completely different; okra for dry eye disease.
Why Okra for Dry Eye?
Dry eye disease is an inflammatory process, with most of the issue being an eyelid problem. When the small meibomian glands within the eyelids become clogged due to stagnant oil, this can contribute to inflammation of the eyelids and inflammation of the front of the eyes. This inflammation leads to all of the symptoms of dry eye and meibomian gland dysfunction (MGD), which may include:
Irritated eyes and eyelids
Crustiness of the eyelids and lashes
Loss of eyelashes
Current treatments to address the inflammatory portion of dry eye are limited to topical steroids and antibiotics, NSAIDs, and pharmaceutical medications. Dr. Pham realized there was an entire class of polysaccharides that are effective against inflammation, and this is where he got his inspiration to try it for dry eye. Polysaccharides are nothing more than sugar molecules linked together. So many things in our world are polysaccharides, so we’re surrounded by them every single day. Our cell membranes are a mix of glycoprotein polysaccharides attached to the external membranes of cells.
According to Dr. Pham, we’re missing a very important approach to inflammation, and it has to do with these polysaccharides. The whole goal with using polysaccharides for treatment is to decrease the inflammation as we clean the eyelids and lashes. Okra polysaccharide is known for its anti-inflammatory and antioxidant properties, and it is at the forefront of Dr. Pham’s products.
When you visit Dr. Pham as a patient, he’ll begin your regimen with simple treatments. Many people will need to ease into treatment because there are so many options, and it’s easy to get overwhelmed. He recommends avoiding baby shampoo and using hypochlorous acid, tea tree oil cleansers, or okra-based products.
After hygiene, you need to make sure you’re tackling inflammation at its core. Changing your diet, drinking more water, and living an anti-inflammatory lifestyle are all important factors. It’s important to remember that inflammation is constantly being made and it’s also constantly being cleared. It can be cleared a few different ways:
An active process, where another molecule neutralizes and clears the inflammation
The half life, where it disintegrates over time
A mass effect, meaning moving the inflammation away via something like the tear ducts
You can treat all of the inflammation you want, but if you can’t remove it through the tear ducts you’ll never truly clear it. Oftentimes, there’s decreased tear clearance. All the eyes have to do is decrease the rate of blinking and suddenly the tears are evaporating instead of truly being cleared through the tear ducts or through watering (epiphora).
For example, think of a tea cup. Our bodies are constantly filling up our tea cups with inflammation, and dispelling a bit of it (think about drinking from a tea cup). However, if the tea cup is able to overflow with inflammation, you'll begin to notice symptoms. If you’re not physically moving the inflammation out of the eyes with tear flow, you’re never going to actually get rid of it.
Using the Zest Procedure for Demodex and Biofilm
Another factor in dry eye disease that’s often missed is demodex. It’s impossible to detect at home, and it may be missed by doctors if they’re not looking for it. Demodex mites tend to hide around the eyelashes, and they’re shielded by a shell of crustiness around the lashes.
It’s so important to seek a dry eye specialist to help you determine if you’re suffering from an over infestation of demodex. They cannot only specifically look for it, but they can also give you strategies to help and possibly use in-office treatments to accelerate healing. As we discussed in a previous episode, it’s so important to debride the eyelids regularly.
Biofilm is a toxic substance produced by the bacteria on our eyelids, and this substance is difficult to penetrate with cleansers alone. As it sits on your eyelid margins, it allows demodex to continue to feed on the bacteria and it continues to allow bacteria to become overabundant. By debriding the eyelid margins, you can remove this biofilm and actually have a better chance at healing.
Dr. Pham developed a treatment procedure called Zest, which is an in-office treatment similar to ABMax or BlephEx. This is something that may be offered to you at your doctor’s office, and it’s a great option for debriding the eyelid margins and getting rid of that biofilm. The procedure requires no anesthetic (which we want to avoid anyway, because these disrupt the ocular surface). Zest works incredibly well, and most patients notice immediate improvement in their symptoms. In fact, a small study showed that after performing the Zest procedure, the average Standardized Patient Evaluation of Eye Dryness (SPEED) score went from 11 to almost 0. This is truly amazing!
Dr. Peter Pham is a board-certified ophthalmologist, published researcher, innovator, and entrepreneur. He is the Founder and CEO of Okra Limited and Docferral.com, an online referral and scheduling platform for physicians, dentists, and emergency centers. He is also the Co-Founder of KeepYourSight.org, a telemedicine nonprofit organization dedicated to the prevention of vision loss by deploying an advanced online system for visual field screening for glaucoma, macular degeneration, strokes, and other medical disorders that affect the visual field.
Dr. Pham graduated summa cum laude with a degree in chemistry from Washington University in St. Louis. As an undergraduate student, Dr. Pham developed a novel process for simultaneously delivering large, membrane-impermeable molecules into thousands of live cells. Other available methods at the time used electricity or micropipettes and either caused cellular death or were too inefficient. Dr. Pham went on to complete his medical degree from Washington University School of Medicine, ranked one of the top 10 medical schools in the nation. He completed his ophthalmology residency at the prestigious Doheny Eye Institute in Los Angeles. During his ophthalmology training, Dr. Pham teamed with Dr. Ianchulev to develop the online visual field screening platform that serves as the basis for KeepYourSight.org.
Zocular® products are the result of Dr. Pham’s vision for caring for your most critical sense – your eyes. With his background degree in chemistry, Dr. Pham recognized the soothing and restorative properties of Hibiscus esculentus (aka okra) for the eyes due to its chemical composition and properties. By refining its extract into a transformative formulation with other natural botanicals, Zocular products feel as good as they look.