Dr. Rudrani Banik is a board-certified neuro ophthalmologist and functional medicine doctor specializing in conditions affecting vision and the connection between the eye and the brain.  She focuses on the root causes of eye disease and uses strategies based on nutrition, botanicals, lifestyle modification, and supplements. Dr. Banik was a very popular speaker at the recent Renewal Summit, and we are thrilled to showcase her unique expertise, which provides actionable, relevant information for women concerned about maintaining their vision and overall health as they navigate midlife changes. We’re excited to present a series of interviews with her on eye health as we age.

VISION HEALTH AND AGING

Q: What specific changes do women experience in their vision and eye health as they age?

A: As women transition through perimenopause and menopause, they often experience eye changes that impact the quality and comfort of their vision. Though certain eye issues seem to develop overnight or with the passing of a birthday, in reality, these vision changes progress slowly over years to decades. The most common eye issues that affect women are due to a combination of oxidative stress, hormonal shifts, changes in protein structure, and inflammation.

One of the earliest eye issues in women typically begins in one’s 40s to 50s, and is known as presbyopia, or difficulty seeing up close. Presbyopia is the result of stiffening of proteins in the eye’s natural lens. The lens is normally a dynamic structure responsible for focusing at various distances; when the lens loses its flexibility, the eye cannot focus on near objects.

With age, women are also at higher risk of developing dry eye syndrome, cataracts, glaucoma, and age-related macular degeneration (AMD). Studies show that women account for two-thirds of all cases of blindness and visual impairment, due in part to these age-related changes.

Q: Research shows that 61% of perimenopausal women and menopausal women experience dry eye syndrome. What can women do to maintain a healthy tear film?

As an integrative ophthalmologist, I advocate for addressing the root cause of eye issues like dry eye, rather than just using artificial tears or lubricating drops, which simply put a band-aid on the problem. Maintaining a healthy tear film is the foundation for dry eye management and involves several factors: lipid layer production from the oil-secreting meibomian glands in the eyelids, aqueous (water) production from the lacrimal glands, and mucin from goblet cells on the conjunctival surface of the eye.

For women in midlife, addressing dry eye at its root cause starts with supporting the tear film via ocular nutrition. Omega-3 fatty acids (especially DHA and EPA from marine sources such as fatty fish), antioxidants (like vitamins C and E), and anti-inflammatory nutrients, such as curcumin from turmeric, have been shown to help. Adequate systemic hydration is also a vital, yet underrated strategy to manage dry eye.

Just as dental hygiene is important for healthy teeth and gums, eyelid hygiene is essential for a healthy tear film. This is especially true if blepharitis (eyelid inflammation) or Demodex mites (parasites that live at the base of the eyelashes) are present.

I typically recommend the following daily eyelid hygiene regimen:

1. Apply warm compresses to the eyelids for 5 to 10 minutes a day to open any clogged oil glands.
2. Use eyelid cleansing wipes to clear off any debris on the eyelids and lashes, and
3. Spray dilute hypochlorous acid on the eyelids to support the ocular surface microbiome and fight eyelid inflammation and mite infestation.
4. A full-spectrum omega supplement including omega 3s (DHA and EPA), 6 (GLA), 7, and 9 – omegas all shown to be clinically helpful for dry eye.

To find the trusted brands and products I recommend to my patients and use myself as part of my eyelid regimen, please visit the Dry Eye Bundle in my online store.

For advanced cases of dry eye that are refractory to these initial approaches, I offer my patients advanced therapies, such as:

• An in-office procedure called LipiFlow to open up and reset the meibomian glands and/or
• Compounded topical hormonal formulations to the eyelids to support meibomian gland function

RUDRANI BANIK, M.D. is a Board-certified Ophthalmologist, fellowship-trained Neuro-Ophthalmologist, and Functional Medicine expert. She is fully trained in ophthalmic surgery and Botox, and she has a special interest in treating Headache and Migraine. Dr. Banik manages a wide spectrum of conditions affecting vision, as well as the complex connections between the eye and brain. She is the author of Beyond the Carrot. Visit her website.