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. In this fourth in a series on eye health as we age Anne Akers interviews Dr. Banik on migraines and neuro-ophthalmology.

Q: Research shows that migraines evolve with age and hormonal changes. How do these shifts affect the connection between the eyes and brain, particularly regarding photophobia and visual symptoms?

A: Let me first take this opportunity to emphasize that migraine is not just a headache. Rather, it is a highly complex neurologic disorder that often involves electrical changes in the brain, alterations in blood flow, and inflammation.

There is also a hormonal component- there are estrogen receptors deep within the brain in an area called the brainstem, where migraine is believed to originate. As estrogen levels fluctuate throughout stages of life, particularly during menarche, pregnancy, perimenopause, and menopause, women may experience changes in migraine frequency, duration, and symptoms.

Migraine often affects the visual pathways in the brain. Many patients with migraine report increased light sensitivity (photophobia), visual aura (episodes of flashing or shimmering lights), blurry vision, double vision, or dry eye.

These types of migraine symptoms reflect the eye-brain connection: cortical hyperexcitability, neurotransmitter imbalance, and changes in cerebral blood flow all contribute. Some women in mid-life develop visual disturbances or vestibular migraine that are misdiagnosed as eye disease or inner ear issues, when in reality, the root cause is neurological.

Q: What role does nutrition play in managing migraines and vision health, and how do you integrate dietary interventions with traditional treatments?

A: Nutrition is central to my migraine management approach. Specific nutrients like magnesium, riboflavin (vitamin B2), CoQ10, and vitamin D have strong evidence supporting their role in reducing migraine frequency and severity.

I also look at food sensitivities as possible migraine triggers. I’ve guided many of my migraine patients to eliminate common triggers such as aged cheeses or fermented foods that are high in tyramine, red wine high in sulfites, processed meats high in nitrates and nitrites, and artificial sweeteners.

A diet rich in anti-inflammatory foods—like leafy greens, berries, turmeric, and omega-3s—can significantly reduce the inflammatory load. Adequate hydration is also essential in migraine to support healthy blood flow to the brain and also remove toxins from the body.

Caffeine needs particular mention, as it is a double-edged sword when it comes to migraine management. In patients who normally don’t have much caffeine on a daily basis, a single caffeinated beverage can arrest an attack. However, for those who have a high intake of caffeine regularly, too much caffeine will predispose them to more frequent migraine attacks.

I integrate these dietary interventions alongside medications when needed, but aim to minimize pharmaceutical dependency. I formulated the Migraine Bundle in my Ageless by Dr. Rani line to provide an anti-migraine nutrient foundation for migraine sufferers. I have seen this supplement bundle, when taken for at least 3 months, play a pivotal role in reducing migraine attacks and even chronic migraine, which some women experience daily.

Q: Can you explain the connection between stress, sleep disruption, and vision problems that women experience during midlife transitions?

A: Stress and sleep disturbances are among the most overlooked contributors to eye and brain symptoms. Cortisol dysregulation can raise intraocular pressure and worsen dry eye. Poor sleep impacts glymphatic clearance in the brain and retina, which is critical for reducing waste and inflammation. Women in midlife often juggle caregiving, careers, and their hormonal transitions, making sleep and stress management a key focus. I recommend incorporating mind-body practices like yoga, meditation, essential oils, and regular movement—all of which support parasympathetic balance and, by extension, eye-brain health.

Q: How do you incorporate essential oils, meditation, and movement into your treatment protocols for vision and brain health?

A: Essential oils like peppermint, lavender, and frankincense, when applied topically or inhaled in a diluted form, can be extremely effective for calming the nervous system.

Meditation and breathwork reduce inflammation and improve vascular tone. Movement, particularly yoga and walking, enhances lymphatic drainage and supports the glymphatic system, which is essential for clearing toxins from the brain and eyes.

Rudrani Banik, M.D.

Dr. Rudrani Banik 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.