#204: The 3 Biggest Eye Issues Women Experience with Dr. Rani Bank

Hey beautiful, it's Dr. Tabatha. I want to share something with you that I believe God is doing right now in women's health. We're in the middle of a massive movement and most people don't even know it. Every single day, 6,000 women in the U.S. enter menopause. That's over 2 million women a year, and by 2030, that's more than 1.2 billion women worldwide. So here's the thing, most of these women feel exhausted, bloated, anxious, disconnected from themselves, and the medical system is Doctors are handing out prescriptions and quick fixes, and no one is helping women heal from the root cause of their issues. That's where Fast to Faith coaches come in. As a certified coach, you'll be equipped to help midlife women balance their hormones, heal their gut, regain their energy, and reconnect their faith, the foundation that so many of us have been missing. And from a business standpoint, woo, this is one of the most lucrative untapped opportunities in the entire health coaching world. The global health coaching industry is expected to reach over $33 billion by 2023, and midlife women are the fastest-growing, highest-spending demographic in that space. Most importantly, these women stay with their coaches. They invest deeply because they are desperate for lasting transformation— body, mind, and spirit. So if you've been feeling that pull and that whisper that you're meant to do more, This is it. Now is the time to rise, to serve, and build a purpose-driven business that not only changes other women's lives but transforms your own in the process. Because when you help one woman heal, you help her family, her marriage, her faith, and her future. That's the ripple effect that we're creating with Fast to Faith. So join me, click the link to come watch this webinar. It might be the one thing that really moves the needle for you in this Next season. I can't wait to see you in there. Hi, I'm Dr. Tabatha, the Gutsy Gynecologist. I'm a triple board-certified OB-GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey, and I'm super excited to share my wisdom and unique perspective as it pertains to women's health. After caring for thousands of women, I've come to realize that your gut health determines your gyn health and your overall And it's a super gutsy thing for me to go against conventional gynecology practice to bring you the truth. No more Band-Aid medicine, ladies. We're talking root cause resolution on this show. So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place. And I want to be your gutsy gynecologist. So welcome. My topic today impacts every woman. Okay, you have to hear this episode. There are so many golden nuggets and truth bombs and things that you probably have never heard before because we don't get good training in the conventional medical space about eye health, and there's a lot of misconceptions, misunderstandings, and generalities. And most of all, eye health is so much more in our control than we realize. We impact our eye health for the good or for the bad. And so if you want your eyes to continue working and functioning well so that you can still see clearly, you can read closely, you can drive at night, you can work on your screens, you can do all the things. You have to listen to this episode. This is so important, and I'm really excited about this conversation because I've been struggling with eye changes. And it turns out that eye changes are one of the first things that women notice when they're going through hormonal changes because hormones impact our eye health. You heard that right. When my estrogen dropped, And I was having hot flashes, night sweats, crying, couldn't get off the couch. I also could no longer read up close. I had to like pull my phone 10 feet out in front of me to be able to read the words. And it's all connected. So you need to hear this conversation. Please share this with every woman you know. We all need to understand eye health. eye health as an importance in this country. You know, you go to the dentist twice a year. My guest is going to talk about this. You have all these other preventative things, but we don't typically go see someone about our eyes until we can no longer read or no longer drive at nighttime or something like that, or we have an infection or something. But it's way more than that. And if you have family members who struggle with glaucoma or macular degeneration, or, you know, you feel like, oh my gosh, I am requiring glasses now and I never did, or I'm having dry eyes, what the heck is that about? Or you know that your eyes are strained because you're on the computer too much. We're gonna cover all of it. I'm so excited. This is— this was an awesome episode, and If you're listening, consider hopping over to YouTube on the Gutsy Gynecologist channel because my guest Dr. Ronnie has a 3D model of an eyeball and she's going to like teach us some stuff. It's really incredible, so you might want to see it on YouTube. So click on over there if you need to, or if you're already on YouTube hit the subscribe button, hit the notification button so you know when my new episodes drop. If you hit the subscribe button, that puts out an algorithm that says, I care about this kind of stuff, I want to see more of this. And that helps YouTube train— you, you train YouTube to tell you what you like so you see more of that. So once again, you are in control, but you got to hit the subscribe button, turn on the notifications, all that. Okay, let me just sing Dr. Rani's praises because she's amazing. Like, talk about smart. Holy cow. Dr. Rani Banik, she is America's integrative eye doctor. She's board certified in ophthalmology, which is a medical doctor that has gone on to study the eye. She's fellowship trained in neuro-ophthalmology with additional certifications in integrative and functional medicine. So important, and there's not a lot of her out there. Like, she's kind of a unicorn, kind of like me. Dr. Rani focuses on the root cause of eye diseases and uses integrative strategies for conditions such as thyroid eye disease, macular degeneration, cataracts, dry eye, glaucoma, and other autoimmune diseases of the visual system. Her treatments are based on nutrition, botanicals, lifestyle modification, essential oils, and supplements. Yay, she's speaking our language. I love it. She's kind of like the eye version of me. I, you know, I'm a gynecologist that went to functional medicine. She's an ophthalmologist that went into functional medicine. She owns a private practice based in New York City, and she's an associate professor of Mount Sinai in New York City, where she serves as an educator and researcher. She's the principal investigator of several clinical trials in diseases of the optic nerve and she uses cutting-edge approaches such as nanotechnology and gene therapy. Dr. Rani is frequently featured as an expert in the media, has been interviewed on Good Morning America, CBS, NBC, ABC, The New York Times, The Washington Post, and Fox, among many others. Dr. Rani has been voted as Castle Connolly Top Doctor and New York Magazine's Best Doctor in Ophthalmology Every year since 2017. That's so awesome. So I'm really excited because her new book, Beyond Carrots: Best Foods for Eye Health A to Z, has won praise from, like, the top functional people, okay? Dr. Jeffrey Bland, the father of functional medicine, praises this book. So she's it. She's the legit thing. Okay, in this book, Beyond Carrots focuses on the 30+ nutrients and the 40 foods that provide the best complete nutrition for your eyes. There's a companion cookbook as well that she's going to share with us, and it includes over 160 amazing recipes for your eyes. It's so good. So the links are in the show notes, check them out. I would say don't hesitate to get this book if this at all is like Yes, I need this because I know I do. And she's got a really awesome course that I'm going to do. It's just 4 weeks, but it's going to tackle the top 3 challenges that we women face with our eyes. And we're going to dive into those 3 biggest challenges and everything else under the sun right now. So here we go. Well, welcome, Dr. Vrani, to the Gutsy Gynecologist Show.

Thank you so much, Dr. Tabatha. I've been really looking forward to this for a long time.

I know we keep trying to connect and we both have extremely busy schedules, but you are doing such fantastic things. I knew I had to get you on here because I personally have had eye issues and I just keep hearing from my patients. I think it's a perimenopause thing, isn't it?

It totally is. I mean, certain things happen. Many of them are hormonally related. So many of us go through it. So if you're listening and you're going through some of these changes, you don't really know what's happening, where it's coming from. Just know you're not alone. Millions of women go through the same thing.

Yeah, absolutely. Did you have your own eye issues? Is that how you got into this?

Well, I've been taking care of people with eye issues as they get older for years, but it wasn't until I actually went through it myself. So right now I'm in menopause, but about 6 or 7 years ago, I started to get really bad dry eye, and it was really tough. I couldn't even wear my contacts. And a lot of it is, again, related to hormonal changes during this time of life. And then I had the trouble reading, so I was holding things further and further way to figure out a solution for that. And so having experienced a lot of these things my patients experience, I think it gives me a unique perspective. Like, I know exactly what you're going through. I've been through it.

Yeah, I was shocked when I just felt like it was overnight. One day I could no longer read. I just was shocked at how quick it was. And it was during the time transition where my estrogen had dropped and I was feeling really weepy and depressed and having hot flashes and night sweats. And luckily, I've learned from you and other people in the functional space, like, oh my gosh, I think it's related to hormones. So I would love to talk about this for a minute because I don't think women realize this connection. They're like, oh, I'm just getting old. And how much does age have to do with it? Is it age or is it hormonal shifts? Is it all the above?

So, what I'll say is age plays a part of it. For example, as people get older into their late 40s, 50s, 60s, both men and women do have some vision problems. Like, for example, the reading up close issue. Almost everyone eventually has that symptom at some point in their lives. And, but it, for women, it tends to happen a little bit earlier, and I don't really know why. Like, for example, for me, it started in my early 40s. And for men, you know, I've talked to like, you know, my, my family, I've talked to my patients. It tends to be once they get into their 50s, 60s. So I think that there is a hormonal component there as well. And definitely the other conditions, like for example, we were talking earlier about dry eye, that is almost universal across women above the age of 50. Almost every woman above 50 suffers from dry eye. And you have to think, why is that? And it has to do with our hormones. And yes, men can get it too, but not as severe, not as early. So, you know, with women's dropping estrogen levels and also progesterone and testosterone, there are changes that happen in the glands in the eyelids that don't allow us to secrete healthy tears. And so that's what's leading to dry eye in most people. So it's very, very common in women, super common. And, you know, you mentioned like a lot of people may not realize that connection. Even a lot of doctors don't realize that connection, which is kind of shocking. Like in my, you know, in the world of eye care, both ophthalmologists, optometrists, we're not really taught about all the changes that happen because of hormonal changes during midlife. And so that's something as a functional medicine ophthalmologist that I really want to try to get out there in the world, not just for patients' sake, but also for my colleagues to help them understand really what's going on from a root cause perspective.

Oh my gosh, absolutely. I think that's a really important point because I know as an OB-GYN, Nobody ever taught me that. But just using common sense, realizing that we have estrogen receptors throughout our body and progesterone and testosterone receptors, and that everything else dries up when those hormones go away, right? Our skin becomes dry, we lose collagen, our vagina becomes dry. Everything kind of affects those mucosal glands that are producing secretions for us, and they stop. So I think that's A good point. I also see women when they tend to go through perimenopause and menopause, they're at risk for activating autoimmune conditions. And I've been seeing more and more Sjögren's and other things affecting dry eyes. Are you seeing that as well?

Yes, definitely. We know that in general, women are more prone to autoimmune disease than men. And certain things like Sjögren's can affect vision. Dry eye, dry mouth is typically how it's described. But obviously, it's not just those 2 areas that can be affected. But dryness can be very severe in Sjögren's disease, but also other conditions like rheumatoid arthritis, lupus, thyroid, thyroid conditions like autoimmune thyroid conditions. These can all contribute to dry eyes. So when I evaluate a patient for dry eye, I do look for that root cause. Like, really, where is it coming from? Is it just hormonal, or could there be something layered on top of that? Could there be a hidden autoimmune condition that we really need to look for and address? Because you can't just address one thing. You really have to about the body as a whole and how the eyes tie into that. So, it is important to take a root cause approach, but also to try to bring all the organ systems into account when you're evaluating people with vision issues.

Absolutely.

And again, I think a lot of my colleagues are just, they're just not aware. So, it does require a little bit more digging, maybe some testing that needs to be done, functional medicine testing, et cetera. So, it It's a little bit more like a detective approach that needs to be taken here.

Yeah. So, you're kind of answering my next question. What is the difference between how a conventional ophthalmologist would evaluate and treat dry eye versus a functional ophthalmologist? I think this is a really important thing to understand because conventionally, I'm assuming we're going topically, right? And functionally, we're starting from the inside to work our way out.

Yeah, you're absolutely right. So, conventionally trained eye doctors, they wait for a patient to have the symptom and then they treat it with a Band-Aid. They put a Band-Aid on it, use some drops, lubricate, maybe use like a heat, hot compress. But really, from my perspective, I do look for all of those underlying conditions. I look for autoimmune disease, especially in people with symptoms that don't get better with the drops. People say, I've been using drops for years and I don't feel any better.

Yeah.

function well. I can't see well. My eyes are irritated. They're red. They're burning. So these are all common symptoms of dry eye. But when someone doesn't respond to the conventional therapy, we need to look further. Look, meaning, pun intended, look further. And that's when I do— I do start, you know, I do my full exam, which is a very comprehensive exam looking for other subtle signs. Okay, could it be lupus? Could it be thyroid? Could it be maybe there's an issue with the gut? So we're also— we're learning now. I know this is really a really fascinating topic, the relationship between our gut health and our eye health.

Yeah.

And there's just like all this research that's just starting to be done in this area. But I think really we're going to learn so much in the next 5 years or so about gut, the gut microbiome and dysbiosis and maybe even leaky gut syndrome and how that may be contributing to things like dry eye or other eye conditions also like macular degeneration or glaucoma. So I think it's really important to take that functional medicine approach and really seek answers to questions that haven't been addressed yet.

Yes. So everything begins in the gut, all health, all disease, even your eye health, ladies. That's like so important to really grasp that concept because we have to start evaluating our diet and our lifestyle and what we're putting in our body. And, you know, I love the title of your new book, Beyond Carrots, because really that's Even as a doctor, that's what I believe. Like, you just need to eat some carrots for your eye health. Like, you don't really have to do anything extra. And I would love for you to give my listeners just a few tips on, like, what are they supposed to be paying attention to, you know, as far as diet and lifestyle? Because nutrition is playing a way bigger role than just getting that beta-carotene in, right?

So, yes, so important, Dr. Tabatha. So I just wanted to share a little bit of historical perspective here. We're talking about carrots. It's probably like the biggest urban myth that's been propagated through the years. Our parents told us that, our grandparents told us that. Where did it come from? So it actually came from World War II, where the Germans were coming in, they were bombing England in the nighttime, but the British were able to shoot down the German planes and the Germans couldn't figure out, how are they shooting down our planes? How are they finding out where we are in the middle of the night? And so the British started spreading this propaganda that, oh, our pilots are eating carrots. And so because they're eating so many carrots, they have excellent night vision, and that's what's allowing them to shoot down the German planes. In reality, the British had developed radar technology, and back then it was like brand new. So they knew they had radar.

Oh, really?

They were able to detect these planes, shoot them down. But they started spreading this propaganda that it's carrots. So everybody started eating carrots. Everyone started growing carrots and there was a huge surplus of carrots. So that's where that whole myth came from. And, you know, you mentioned earlier beta-carotene. Carrots have a lot of beta-carotene amongst other foods. And beta-carotene, yes, it's important for our eyes. It gets converted into vitamin A and we need vitamin A to prevent night blindness and to help with dry eye. But in my book, I talk about it's not just one food, one nutrient and optimal vision. It really is the spectrum. It's a whole diversity of nutrients. We think about our eyes. They're very complex. You know, they may seem like a small organ, but they have 40 different parts, and we need to know— we need to—

40?

All 40 different parts. Yeah, I have my eye model here, and this is just the outside. You know, we just see like the outside of the eye here, but if you open it up and look inside, there's all this other stuff going on, and each of these structures has different cell types. So, there's a lot going on in the eye, and And to support all of that, we need nutrients that are going to support our mitochondrial health because the eye uses a lot of energy. It has a very high metabolic rate. So we need nutrients to support mitochondrial health. We need lots of antioxidants, and we also need nutrients to help fight inflammation. So I try to categorize the nutrients into 3 categories. So 30 nutrients, they fall into these categories. And if you want to really promote your eye health, you need to diversify your diet. Don't just eat one thing.

Yeah.

Don't just eat carrots. Don't just eat— a lot of eye doctors will tell you, eat your leafy greens, eat spinach, eat kale, but don't just eat one thing every single day. You need to have a diversity of nutrients. In functional medicine, we always talk about eating the rainbow.

Yeah.

And when it comes to eye health, that is so true. Eat the rainbow, get all those different colors, and that way you don't have to count the nutrients, you don't have to count the foods, but you know that you're supplying your eyes with the full range of everything that they need.

That is really important. And I know for myself personally, I did my DNA, you know, evaluation, and I have a genetic SNP that doesn't convert the beta-carotene I eat into retinol. So, I'm kind of at a disadvantage. Like, I could eat carrots all day long, and it's really not going to support my eye health as much, right? So, I need to be focusing on eating that rainbow.

Yeah.

And I've heard you on other podcasts talk about So, healthy fats and hydration, is that all related to the inflammation that we're trying to calm down?

Yeah, I would say in terms of fats, the omegas are so important to consider when it comes to our eyes. So, DHA, EPA are key for eye health. And actually, here's another fun fact. Did you know that the highest concentration of DHA in the body is actually in the retina? There's, you know, there's also high concentration in the brain, but the highest concentration is in the retina. And the retina constantly turns over its cells. So, we need a constant supply of DHA. So, for the retina to be able to structurally be intact and be healthy. So, we need a good amount of that for retinal support, but also for dry eye. There have been lots of studies that have shown that. There was a women's health study that actually showed that women who ate fish 2 or 3 times a week had significantly decreased rates of dry eye. So, get your, you know, get your omegas, omega-3s. Now, a lot of people oftentimes think Okay, omega-3 is the good type of omega and omega-6 is the bad type. I need to stay away from those omega-6s. But there's one omega-6 in particular which is really actually anti-inflammatory, which is GLA, gamma-linolenic acid.

Yeah.

So I tell my patients, get your omega-3s, focus on that, but also try to get some GLA. And it may not be readily available in diet, so maybe you have to take a supplement that has an omega-6 GLA component to it as well. And on top of that, there is also research that shows that when it comes to vision, omega-7 and omega-9 are also helpful. So it's not just the 3s that you need to get. You need to get that spectrum of different omegas. And, you know, sometimes our diet's not enough when it comes to the omega, so sometimes we need to do a supplement just to fill in those dietary gaps.

Absolutely. And I love eggs as well. So do you find that eggs are really helpful for They are fantastic.

Yes. So, you know, the beautiful color of the yolk, the orange-yellow color of the yolk. The reason it's that color is because it has 2 eye nutrients, lutein and zeaxanthin. And these are so, so important for our vision. These nutrients are deposited into the back of the eye, into the retina, and they fight against blue light. They're like our natural internal blue blockers that many people don't realize. So you don't have to go out and get blue-blocking glasses if you have enough foods with lutein and zeaxanthin, you're supporting your natural internal shields for your eye. And they also help fight against UV light and oxidative stress. So these 2 nutrients are really important. Eggs are a wonderful source of these nutrients. Plus, they provide choline, which is important for metabolic function. And they have— it's a good source of protein. So many other nutrients come from eggs as well. One of my favorites.

Oh, my gosh. So important. The— what are the 3 main eye health challenges that women face over 40? Is it— you talked about the presbyopia, the dry eye, and then what's the third one?

The third one is— I'll group it as eye strain and light sensitivity. So women are, you know, are specifically really— I think in my experience from my patients, this is what I hear. They're very vulnerable to this. You know, we all spend hours on a day of, you know, per day on a screen. Many of us spend like 8, 10, 12 hours a day on a screen, myself included.

Guilty.

Yeah. So if you're doing that, you're not alone. Definitely. It's just our modern life. We're glued to our screens, our monitors. But women in particular are very sensitive to the light that comes from the screen. And again, I don't know exactly why. The research hasn't really looked into it, but my guess is it has to do with hormonal changes, not just age, but hormonal changes. And so women can be very, very uncomfortable looking at a screen, the blue light coming from the screen, the flickering from the screen, and then also the dry eye component of simply looking at a screen for hours a day. So normally we're supposed to blink about 15 to 20 times a minute. When we look at a screen, we're only blinking about 4 or 5 times a minute. And so that can really dry out our eyes. So think about that as well. Just, you know, your habits and how you can maybe change a couple of things to help improve your endurance when on a screen. Just blink more. You'll see that that'll make a huge difference if you make a conscious effort to just blink more when you're on Yeah, I'm thinking about it right now, and now I'm blinking multiple times, and it feels better.

It actually does. So that's interesting that we're blinking less. And I noticed—

Actually, if I could just share one thing, there are these exercises that I recommend which are super easy to do. And basically set your timer every 20 to 30 minutes, have your phone timer go off and do just a couple of quick blinking exercises. So all you have to do is gently close your eyes for 2 seconds. Squeeze really hard for 2 seconds. You get the glands working, the oils being secreted, and then open your eyes and just relax. So if you just do like 2 or 3 rounds of those blinking exercises every half hour or so, it'll really make a big difference when you're on a screen for hours on end all day long.

Oh my gosh, thank you. That's so helpful. You know, I notice when I first wake up in the morning that that's the worst time for my eyes to— they just don't function. I Mornings have to grab the reading glasses just for a little bit until I can see better. Is that because I've just been sleeping all night? And what is the best advice for that? Should I just try to not use the readers? Should I give in? Like, what is the best recommendation? Because I want to keep my eyes strong as long as I can. And there's this Tell me if it's a myth or if it's true that if you wear reader glasses, your eye muscles get weak and then they don't accommodate and they can't continue to, you know, do that close-up looking to be able to read. So what's the best answer for women?

Yeah, that's a great question, Dr. Tabatha. So there is a decline in our accommodative ability as we get older, and there's actually an age-related chart. So people in their 40s, what's their accommodative range? People who are 45, 50, So there's actually a scale that we use. So—

Can I actually stop you for just a second and ask you to explain to women? Because I'm not sure they realize that our eyes function to see things, but we have all these muscles that are moving our focus and helping us look far or look close. And that's what we mean by accommodation, right?

Exactly. So let's take a look inside the eye here.

So if you are not watching on YouTube, if you're just listening, you should go to YouTube on the Good Gynecologist because Dr. Rani's got her show and tell out here.

She's got my handy-dandy eye model. So, um, so this is the front of the eye, and in the very front is the— I just lost it. This is the cornea. It's a dome-shaped structure. It's clear, and this is what gets dry. So it's in the very, very front of the eye, and this is the part that gets Yeah. But behind that is the iris. This is the colored part of the eye. And then behind that is the lens. So this lens sits in the— behind the pupil, the dark part of the eye. And this lens is what changes shape. So for example, if you're looking at something for distance, the lens is going to be flatter. If you're looking at something up close, like if you're reading your phone or, for example, or reading a book, the lens will change shape. It'll become thicker in the middle. So it's a dynamic structure and there's a muscle So, there's a muscle back here. I don't know if you can see it. I'll take this out also. Sorry, there's so many parts in here, but you see this dark brown? This is the muscle that controls the shape of the lens.

Is that the pupillary muscle or something?

What is that called? The pupil, the pupillary sphincter is on the—

Pupillary sphincter. Oh my gosh. Med school 101.

Yeah, exactly, exactly. This is the ciliary muscle back here.

Okay.

And this contracts and relaxes based off of what we're looking at. And so, then it changes the shape of the lens. So, what happens is, as we get older, this whole system starts to become less flexible. It starts to stiffen. And when it stiffens, we can't necessarily change our focus from far away. If you're looking out the window, if you're driving, and then you're all of a sudden looking up close, it takes more effort to try to focus on something up close because everything's just getting stiffer.

Mm-hmm.

And so, that's what's happening. That's what we call loss of accommodation as we get older. And there's a decline starting around age 40, but it kind of plateaus at around 60, 65. So, it's not that it's going to continue getting worse and worse. It kind of reaches its worst point at around 60, 65. And so, what I would say is, you know, for your question about what happens in the morning, what should you do in the morning, I would say the best thing is try to let your eyes first get used to light. Maybe, you know, expose yourself to a little bit of sunlight. Don't look directly at the sun, but let some sunlight get into your eyes. To help set your circadian rhythm for the day, to get that natural boost. And then try to initially look at things in the distance and then gradually look at something kind of intermediate distance and then try to focus on something up close. So you're gradually allowing your eyes to adjust and then for that system to start to kick in rather than right away. Many of us— I do this, I'm guilty of this also. First thing I do is I pick up my phone and I look at my phone, right?

Right.

And I look, I check my emails, I check the weather, et cetera. That may not be the best thing to do. So the best thing to do is just get up, expose yourself to light, and then gradually work your way up to looking at something up close. And you'll notice that it's a little bit easier for you to focus. Or the other thing that can happen when we sleep is that our eyes tend to dry out at night because we're not lubricating. We're not, you know, every time we blink, we're spreading lubrication over the surface of the eye. But when you're sleeping, you're not spreading that tear film. You're not getting that moisture to the surface of the eye. So when you open up in the morning, Your eyes may feel really dry or crusted together or sticky, like they're, they're stuck together. So, if that's what's happening, I would recommend using a little bit of ointment at night just to keep it coated, you know, lubricate at nighttime. And then when you wake up, it'll be much easier to focus and it'll be a lot more comfortable also.

Okay.

Yeah, it is something you can do.

Absolutely. And I know for me, I will drink an entire glass of water as soon as I wake up, just room temperature water. That's the first thing I do. It not only seems to help my, my vision, but my joints and my stomach and everything else. You know, I think we just need to start our day more lubricated, more hydrated, right?

So important. And the other thing I would say is if you're really finding your vision's not great in the morning, the first thing you can add to maybe your morning routine is to do a hot compress, and that will really get those glands working in your eyelids, get the oils flowing. And it's just, it's really relaxing. So it's almost like doing a little spa routine in the morning before you start out your day. So add that to your routine, see if that helps. Also.

Okay, very cool. So, okay, when, when you said that muscle gets stiff, the one that we lose accommodation, we can't necessarily see up close, is that stiffness, do you think, related to inflammation and aging and hormonal changes? That's everything that we had talked about up until this point?

I wish we understood it a little bit better. It's probably not inflammation. It's more likely stiffening due to oxidative stress. That's what I would say. Those structures are so delicate that they're really vulnerable to oxidative stress, like free radicals. So there is research being done in terms of how can we delay that process? What can we do to help support our eyes so that this accommodative loss doesn't happen when people turn 40 or 50 or 60. So we're still, again, we're not quite sure exactly the mechanism, but it's probably more that than inflammation.

Okay, so back to eating the rainbow, because free radicals, the way to get rid of them is with antioxidants in all our brightly colored foods, right? So, okay, well, that makes complete sense.

There's one particular class of antioxidants, I think that they probably just don't get enough recognition, are the bioflavonoids. And there is a particular type of bioflavonoid called anthocyanins. And these are pigmented compounds. They come mainly from berries, so like blueberries, blackberries, raspberries, strawberries, and they help protect the plant from oxidative stress and disease and infection. So when you ingest them, they also support you and protect you against oxidative stress. So there's some early work looking at anthocyanins cyanins from berries helping with our focusing, helping with accommodation, helping to prevent myopia. So that's something I think that is a simple thing we can do to promote our eye health through our diet is to start including more anthocyanins in our diet, specifically berries, colorful berries. The darker the better, I say, but red is fine too, or yellow or orange. They're all great. So I routinely, I'll have like half a cup to 1 cup of berries a day just to keep that support against oxidative of stress.

Oh, that's really good to know. I love that. Sometimes I forget to eat berries, especially in the wintertime when they're not like readily available. So grab your frozen blueberries, right?

Exactly.

Better than nothing. Your frozen blackberries.

Okay. They have lots of nutrient value. So absolutely.

Okay, very good. So let's talk about screens a little bit more because blue blocker glasses are super popular. And I keep getting asked, are they, you know, helpful? Are they making the situation worse? I would love to just get your opinion as an ophthalmologist and a functional ophthalmologist, because you probably didn't even really learn this in med school, is my guess, right?

We did not.

And we didn't have screens back in the day. We didn't just graduate yesterday, right, honey? Yeah, yeah.

We weren't, we weren't as glued to our screens back then. Right.

We had paper and pens and highlighters.

I had one of those. Oh, I'm blanking on the name, but where you could put notes in. It wasn't a phone, but it was like a—

It's like a BlackBerry?

No, it was before the BlackBerry. I'm blanking on the name of it, but I had one of those little handheld note takers. And cell phones were just coming out when I was finishing my training. But we didn't have cameras on our phones. We didn't have text on our phones. We didn't have all that that we have now. So, you know, this technology, the screens and the light that comes from the screens, we know that it can cause health issues. We know for sure it can interfere with our sleep patterns, our circadian rhythm. When it comes to our eyes, we know that it can contribute to eye strain and light sensitivity. The good news is that it doesn't cause any permanent vision loss, which is really reassuring. So, you know, if it really did, there would be a pandemic of vision issues right now, like blindness, if it really caused— Permanent issues, but it's short-term issues that we have to worry about. And so the blue light that comes from the device, it's short wavelength light. It gets absorbed by certain cells in the retina, and then those cells interact with cells in the brain, in our brainstem that trigger light sensitivity. So to counteract that, a lot of people again wear blue blocking glasses. The issue with blue blockers is that first of all, there's no No scientific evidence that blue blockers really work. The issue is that most blue blockers, if you look at them, they look clear or they look like they're a really light yellow tint, right? So they only partially block blue light. So those clearer blue blockers or lighter tinted blue blockers are only blocking about anywhere from 10% to 30% of the blue light. So that's probably why the studies haven't shown that they really work, because they're only partially doing the job.

Mm-hmm.

So if you're going to get blue blockers and, you know, let's say you're working on a screen at night, you're really light sensitive, you have trouble sleeping. Yes, you can get blue blockers, but make sure you're getting blue blockers that are really blocking the blue light. So get blue blockers that are darker tinted, for example, red or like a deep orange or amber color. Those are going to help you, not the lighter ones, because the darker ones will probably block anywhere from 98% to 99% of the blue light. And how do you know if your blue blocker is working for you? Well, it's a very simple thing. You just put them on and you look at your screen and you look at something blue on your screen. And when you're looking at the blue, if you can still see the color blue, you know that that blue blocker is not blocking most of the blue light. It's only blocking a percentage of the blue light. So the deeper tints will completely block that blue tint. So that's a quick test you can do to see if your blue blocker is actually doing what it's claiming to do. But beyond that, I would say that But making sure you're getting enough of those carotenoids, the lutein, the zeaxanthin, is so, so important. And there's a lot of newer research coming out showing that people who have these nutrients in their diet, or maybe they're taking a supplement with lutein, zeaxanthin, they have less eye strain, they have less light sensitivity, they're getting fewer headaches from being on screens all day. So a simple thing you can do is just boost your intake of these nutrients.

Awesome. Oh my gosh. That's so good to know. And yeah, I don't think people are wearing the right blue blockers because I've seen them on Zoom calls and things, you know, and they're not amber colored or dark at all. So that makes total sense that you want that red filter in there. Okay.

And, you know, they may help with sleep. That's, you know, it's very likely it could help with sleep. But if you're, you know, using them for vision purposes, it's probably not helping.

Okay, good to know. Good, good, good. Oh my gosh, so much good information. What else did we miss on eye health for women? Because I feel like we covered a lot.

One thing I would say is that there are many eye diseases that happen as we get older, and many of these eye diseases are more common in women, like glaucoma, like macular degeneration. The thing is, these conditions, they don't have any symptoms in the early stages. Like, you would not know that you have early-stage macular degeneration. You would not know that that you're at risk for glaucoma because there are no symptoms until it gets very advanced. And then when it gets advanced, it's too late. There's not much we can do to reverse the damage that's been done. So, because of these silent stealers of sight or thieves of sight, it's really important to get your eye checkups. A lot of people, they don't realize that they should be getting an eye exam every year after the age of 40. And, you know, people say, oh, I don't, you know, my vision's fine, I don't need to go see the eye doctor. But it's not just to go to get checked for glasses, it's to get checked for all of these other things that that could potentially cause vision issues down the road. So, I always tell everyone, get the word out, have people, you know, we all go to the dentist twice a year, we get our routine health screening, we get our blood work done, some of us get our colonoscopies, our mammograms, our general health screening tests, but think about doing your eye exam also as part of that regular health screening because it can pick up eye conditions, but it can also pick up over 200 medical conditions. And I was just on a podcast the other day when I was sharing this, and the host was just really kind of blown away. Like, I had no idea that the eyes could be such an insight into our health. Like, we oftentimes hear that our eyes are a window to the soul, but they're really a window to our overall health. We can pick up so much. We can pick up diabetes and cancers and autoimmune diseases and so many things through an eye exam. So get that annual eye checkup. Yeah.

Oh my gosh, that's such an important point. I'm so glad you brought that up. Let's talk about the eye exam. And you're right, like, we don't talk about that as a preventative ongoing thing that we should do. We just wait until we can't read or can't see driving. So, explain the difference between an optometrist exam and an ophthalmologist exam. Is— are you going to get evaluated for macular degeneration and glaucoma if you go to an optometrist?

So, the answer is very similar exams are done. The key thing is you have to ask for a dilated exam. Now, I know everyone hates to be dilated. It's when the drops put in, your pupils get really big. It's hard to see. You're blurry for a couple of hours. You're kind of out of commission. You're light sensitive. But it is so important because that dilated exam allows us to see— I'll just show my eye model again. So, this here is the back of the eye, and it's the retina. And it's like, it's a sphere, really. So, when you look through, when we look through the pupil and we do an undilated exam, we're only seeing about 10% of the retina. This is about all we get to see through an undilated pupil. But when the pupil's nice and big, we can see the full 360 degrees. And this is really the key to your health is what's going on in the retina as well as the optic nerve. So, again, we can pick up high blood pressure, we can pick up diabetes, I've diagnosed people with cardiac arrhythmias based off of their eye exam, their dilated exam, because there are things that can happen. We can pick up changes in the blood vessels in the back of the eye, in the retina, from these medical conditions. A lot of them are cardiovascular conditions, but also, even like I was saying earlier, even cancers can show up in the back of the eye. Like, I've diagnosed people with breast cancer or lung cancer based off of an eye exam. So, it's really important. And so, I know it's an inconvenience. You don't want to get your eyes dilated, but please, please, please, for your overall health, try to do it at least once a year.

Oh my gosh, I'm going to schedule mine today. Like, I'm thinking it has been a while. And you'll remember, or you'll know if you've had your eyes dilated because they give you those crazy— they look like a pair of shades that, like, roll and you can't see and they don't stay on your face. So, you might want to have somebody drive you to your eye exam. Them, or you just hang out there or have some good glasses with you so you can see when you leave. But you'll know if you've been dilated. And I'm going to get mine done because that's really good information. And I think women need to pay more attention to this. I know, like, I have aunts who are struggling with macular degeneration, and it's like you're losing your vision, and it sounds like it's unnecessary, right? There's so many things that we can do to prevent it. So we have to get your eye beyond carrots. We have Like, start looking at our diet and getting that supplementation in because there are so many preventative things we can do, right?

Absolutely. And in terms of macular degeneration, diet alone can help prevent 40% of cases of advanced— 40%, more than anything else. And then, you know, for people who have advanced macular degeneration, the treatment is getting injections into your eye every Mm-hmm. And that is not fun. I mean, I'll tell you, it saves a lot of vision. You know, millions of people have benefited. But getting an injection of a drug into your eye is not ideal if you can prevent it. So why not prevent it using the right dietary strategies and the right lifestyle strategies? And it's just something that I really want to elevate awareness for, even amongst my colleagues. I gave a talk just last week to my colleagues in ophthalmology. I gave a grand rounds. And they were just blown away. They're like, how come we never really learn about this?

Yeah.

That 80% of macular degeneration can be prevented using diet alone. And so my next book is actually gonna be on macular degeneration. It'll be called Beyond Leafy Greens. And so I do talk about like, there are all these things people can do for macular degeneration. So it's not just your genes, it's not just your, you know, what your quote unquote fate is. It's not your fate. It's really what you choose to do fortify your eyes.

Well, you are like a pioneer. You're at the forefront of this functional ophthalmology movement. It's so awesome what you're doing. And I love that you are going in, you're teaching conventional ophthalmologists. They need to know, like, we didn't learn this in medical school. And so, you know, I tell patients all the time, don't even be mad at your doctor. They just don't know what they don't know. And so you want to seek out somebody who who has gone on and done functional training, integrative training, any kind of extra training in health and nutrition and prevention. And so you just recently created a new course that women can do, right? I'm super excited about this because it, it's like the 3 biggest things that we've been talking about, and this is affecting so many women. So they can now get help and they don't have to see you individually, Yeah.

And that's exactly why I created the course, is because I can only see so many patients.

Right.

But I want to get this information out to the masses and help people not just in New York, but all around the country, all around the world. So the course is called Ageless Eyes by Dr. Rani. And through the course, you learn all the things you can do to help keep your eyes youthful from the inside out. And so we do talk about— there are different modules. One module is all about dry eye. You, you never was told, you were never told about dry eye from your eye doctor. I go into a lot of depth and use a lot of functional medicine strategies, diet, lifestyle, etc. The next module is on presbyopia, which is the issue reading up close, and I share all the different options you have for addressing that, not just over-the-counter reading glasses, but there's a lot of other things people can do. And then the next module is eye strain and light sensitivity. And then I have 2 bonus modules which people are really, really excited about, which is the Youthful Solution, which is helping to manage the cosmetic changes that happen around our eyes as we get older. For example, dark circles under the eyes, fine lines, creases, eye bags, eyelid sags. And then I have a whole module on nutrition also. So it's really packaged into a 4-week course. And I really love giving this course because it's, it's just so amazing to see my students when they realize, oh my goodness, like the light goes on and you can see Oh, wow. This was unbelievable. I didn't know this. And simple things you can do to promote your eye health that we all should be doing. We really should be doing this. And we only have 2 eyes. They have to last us a lifetime. And for most people, I always ask my patients, of the 5 senses, which sense do you think is your most valuable? And the vast majority of people do say vision.

Wow.

So then the next step is, what can we do to help support that and keep our eyes healthy going forward.

Yeah, I think we take it for granted, like our eyes are just going to work until, you know, we pass away. And it's just not the case, especially for women. So I love all of this. I can't wait to do the class, especially the circles, all the stuff, you know, around the look of the eye as well, because there's a lot of procedures out there nowadays, creams, potions, shots, And they can actually affect the eye and the function of the eye, right? So I, I'm a little nervous about that. I've done aesthetics training, you know, fillers, Botox, all this stuff. And I see people doing things that make me nervous. And it's like, you're getting close to the arteries around those eyes. And I really, you know, we need to understand that we could be affecting the function of the eye.

Yeah.

With our cosmetics as well. Absolutely.

Yeah, absolutely. I mean, you know, many people are turning to all of those procedures and the most important thing is to go to somebody who has a lot of experience.

Yes.

And so they know the anatomy. And I've seen complications. I've definitely seen complications of fillers and Botox, etc., and surgeries too that really unfortunately didn't go very well. So what I would say is try to address it naturally first. Using holistic methods, using, you know, simple, almost like DIY hacks first. And there's a lot of things people can do to make their eyes look more youthful rather than, you know, going straight to a surgery, a surgical procedure or an injectable or something like that. So lots of options.

Yeah. Are there any procedures that you just wish weren't available that people wouldn't do that you would never do because of what you've seen?

That's a great question. I wouldn't say there is something that absolutely shouldn't be done as long as it's done by somebody with experience. Like, I've seen eyelid procedures where if somebody has hooded eyelids, they have extra skin here, too much is taken off, and then their eyes are wide open. They can't blink properly. They end up with horrible dry eyes, severe dry eyes. So again, it's just important to go to somebody who has experience and has an understanding of the anatomy. So they're going to do the right amount of surgery for you or the procedure for you, not just as a standard cookie-cutter approach, but really optimize it for you and your anatomy.

Oh, my goodness. Yeah. And I think of filler under for the dark circles. That's getting close to—

Yeah, I've actually seen filler migrate. So some people, they have filler under their eyes here. I've seen it migrate behind the eye socket and cause inflammation. There was one patient, actually, she went to multiple eye doctors before she saw me, and they thought that she had all this inflammation behind the eye socket. They did MRIs and all this inflammation. They put her on steroids, wasn't going away. Then they were starting to think, oh, this must be some kind of cancer, maybe some kind of lymphoma or something like that behind the eye socket. And it ended up just being filler that had migrated from under her skin back into the eye socket and was causing all of this inflammation. Once it gets there, it's very hard to get it out. I mean, filler disperses and it's extremely difficult to get it all out. But she was happy to know she didn't have cancer. But the other diagnosis wasn't ideal either because it's really hard to treat when something happens like that.

Right, exactly. So don't go for whatever's on sale. I know I see that all the time. These medical spas will have big sales and Botox and filler for super cheap, like really the person and make sure they have lots of experience. They're doing this on a regular basis because, yeah, you could end up needing to see Dr. Rani for something bad, and that wouldn't happen.

I hope that doesn't happen. You were talking earlier about all the blood vessels. I've actually seen cases where a nonlicensed person— this is horrible that this happened in a back office somewhere— injected filler. It went into the artery and it caused blindness, but also strokes because it kind of backed into the blood vessels, into the back of the eye, into the brain. So it's not without risk. Just really, again, as you said, vet your person if you're going to be doing any of these procedures.

Absolutely. Oh, my goodness. Okay. But before you go and do all of that, do the course because you're going to address all that and we're going to take care of our eyes naturally. I love I love this so much. So thank you for that. We'll make sure it's in the show notes. Where else should people follow you and get your book Beyond Carrots? Everybody needs to read this, honestly, and they need to give it to their mothers because I'm guessing a lot of women listening are thinking, oh my gosh, that sounds like my mom.

Yeah, absolutely. It's for everyone, for older people, younger people, kids even. So the best way to reach me is through my website, drRonnieBanik.com. I'm also very I'm very active on Instagram. So if any of you are on Instagram, I share a lot of tips related to vision health. And I also do a lot with migraine as well. That's another one of my areas of interest.

We're going to have to have you back.

Absolutely. Yeah. I love talking because I have migraine as well. So that's where my interest came from. And that's actually how I got into functional medicine, trying to heal my own migraines through more holistic approaches rather than medications. And so I'm a huge advocate of using a functional medicine approach for migraine.

So you can find out about that.

And also, in terms of my book, it's on Amazon. So if you're interested, you can find it on Amazon. I have a cookbook to go along with it as well. So the cookbook is Dr. Rani's Visionary Kitchen. And so I have over 200 recipes that will help support your eyes with all those great nutrients.

Oh, awesome. I will have all those links in the show notes. Thank you so much. Like, you are a wealth of knowledge. This is really important stuff that we are not thinking about. And oh my goodness, it impacts women more than men. And when those hormones shift, that's really when you start noticing stuff. So this was a great conversation. And now we're going to have to get you back for migraines because I can already hear the comments. Oh my gosh, I want to hear about migraines. So let's make sure we do that soon. But thank you so much. I'm so excited to do your course. Of course.

Yay.

Absolutely.

I'm excited to have you there, Dr. Tabatha. It's a lot of fun. It's a nice community. We have contests, we have prizes, so it's a fun community event.

Awesome. All right, see you soon.

Okay, thank you. Bye-bye.

Oh, I loved that episode. So much important information. I'm personally going to become more invested in my eye health because I have been struggling so much. You know, I am on this computer way longer than I should be. Some mornings I'm starting really early. This morning I got up at 4 AM, and so that's a long day to be looking at screens. And I'm so glad that she mentioned eating the rainbow and getting in those vital nutrients, and really that we probably need to supplement as well because we're just not getting it in. And we could have talked about gut health more, we should have, but you guys know about gut health. I talk about this all the time. It's super important that you're actually being able to digest your food and get the nutrients from the foods that you're eating. So if you are eating those berries and those vegetables and all those things, is your stomach actually able to give you the Nutrients out of it, so supplementation is necessary for gosh almost everyone honestly. And I loved what she said about the mitochondria in the eye. So that is one of the biggest places that your body requires energy or ATP. So we think of energy as like coming from caffeine. Or stimulants or something like that, but our body makes energy called ATP. If you've ever heard me talk about this, I talk about this extensively in my book, Fast to Faith. But you want to support your mitochondria to be able to produce that ATP because that's how they do their processes. And so your eyeballs, that is what they require to be able to do their job. And I I just want to remind everybody that my product Energy Lift— I'll show you guys here— super, super helpful. That is mitochondrial support in a capsule. Energy Lift helps you make ATP. It has those nutrients that your eyes need: the choline, the riboflavin, the thiamine, the vitamin A. There's vitamin A in there. Like I mentioned, I don't get any vitamin A from eating carrots because of my genes. And so I need to take vitamin A, and it has NAC, which helps with the oxidation process and cleaning up those bad free radicals. So much helpful stuff in Energy Lift for your eyes. So if you're already on it, good for you, you're supporting your eye health. Now consider checking out her class and understanding like what else you can do for your, your dry eyes, your difficulty reading and accommodating, and your, um, your blue light issues, your devices. And then she's got those bonuses that I'm really excited about where she's gonna help with bags under the eyes, wrinkles, creases, all the stuff. So yay! I hope you found this so valuable. Below, please let me know. I want to hear from you. I, I only want to do what is beneficial to you. So if you're like, that was a total waste of time, just send me an email. You can send me an email at info@drtabatha.com. If you felt like it was amazing, I would love a 5-star review. It takes about 30 seconds. You throw that review on there, say something nice, and then other women who are searching for answers, they come across the podcast, they'll look at those reviews and say, okay, let me give it a listen. So you could actually be helping another woman out if you leave a review today. So awesome. Go have an amazing week. I am here for you. You just let me know what else you want to hear about. See you soon.