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Informed Aging
A podcast about health, help, and hard decisions for older adults.
Informed Aging
Episode 86: A Clearer View: How Aging and Screens Affect Our Eyes
Dr. Rani Banik, Integrative Neuro-Ophthalmologist
The Eye Health Summit, a free, global event taking place on May 1–7, coincides with National Healthy Vision Month. https://theeyehealthsummit.com/
Dr. Rudrani Banik, MD, is a board-certified ophthalmologist specializing in an integrative approach to vision health and author of, “Beyond Carrots: Best Foods For Eye Health A to Z,” and “Dr Rani's Visionary Kitchen.” She is also a fellowship-trained neuro-ophthalmologist. Banik is the founder of EnVision Health NYC, a concierge practice specializing in eye health, neurological conditions, and migraine headaches. She is associate professor of ophthalmology at Icahn School of Medicine at Mount Sinai and co-director of the neuro-ophthalmology service. Banik is a member of the American Board of Ophthalmology’s Exam Development Committee and contributes to setting the standards for board certification.
https://www.facebook.com/EnVisionHealthNYC
https://www.instagram.com/dr.ranibanik
Welcome to Informed Aging, a podcast about health help and hard decisions for older adults. I'm Robin Rountree a former family caregiver. I have worked in the home care industry and now work for the Alzheimer's and Dementia Resource Center. The thoughts and opinions expressed belong to me and my guest, not to our wonderful employers and sponsors.
Before making any significant changes in your life or your person's life, please consult your own experts. Today our guest is Integrative neuro-ophthalmologist, Dr. Rani Banik. Now, she's fabulous. She's here to share some simple ways to protect our eyes as we keep looking at screens all day.
Also to tell us what happens to our eyes as we get older. She's got a great free eye health summit coming up. I'm gonna give you the link real quick. It'll also be in the podcast [00:01:00] notes, but it's www.theeyehealthsummit.com. Stay tuned. We're gonna be looking into our eyes. [00:02:00]
Robin Rountree: We are back with Dr. Rani Banik and wow, what a title she has got -- an integrative neuro-ophthalmologist. Okay. Not only that, the founder and medical director of Envision Health, NYC. And a bestselling author of Beyond Carrots, and we're all about the eye health today.
But tell me what is an integrative neuro-ophthalmologist. That is a mouthful.
Dr Rani Banik, MD: Sure. So first I'll explain what a neuro-ophthalmologist is. So, I have a subspecialty where I deal with the connections between the brain and the eyes. Many people don't realize that we actually don't see with our eyes, we see with our brain. So there's a lot of [00:03:00] processing that goes on there. And there are many neurologic conditions that can have vision issues such as.
Strokes, brain tumors, multiple sclerosis, concussion, et cetera. So I manage all of that. and then integrative, because I really bring together the best of both worlds, the traditional western type of medicine, which is based in diagnosis and medications and surgery with a more holistic approach, which really has a focus for my practice on nutrition and lifestyle for eye health.
And sometimes we use other modalities as well. certain herbs, supplements, et cetera.
Robin Rountree: Fantastic. So I wanna get into the nutrition side, but first we're all looking at our screens way too much. Seven to nine hours a day, I think is one average that I've heard, and of know that's not good for our eyes, but how bad is it for our eyes?
Dr Rani Banik, MD: Yeah, well, you know, it's, it's a fact of modern day living, right? There's one study that said actually almost 11 hours a day is kind of the average for, for adults [00:04:00] in the us, which is mind boggling.
But, but the good news is. That,, all this screen time, yes, it can strain our eyes, but it doesn't cause any permanent damage. And if it did cause permanent damage, we'd have an epidemic of blindness based on how much time we all spend on our screen. So that's the good news. and, but it can cause, you know, the not so good news is that sometimes all this screen time can cause.
Some symptoms that we call digital eye strain. And that includes, and many of your listeners have probably experienced this, blurry vision, trouble focusing up close, light sensitivity, sometimes even, dry eye headaches, neck and shoulder strain. So all of this is part of digital eye syndrome, which is really, really common, but.
There are so many amazing ways to combat it that are really so easy to do, and so, you know, simple and natural, even a child could do it. So, we can talk a little bit about what those things are that I recommend.
Robin Rountree: So I know that I've seen a lot about blue light glasses. Is that the easy [00:05:00] fix?
Dr Rani Banik, MD: Actually, no. So here's, here's something really, really interesting. you know, when, when I really went into the research on blue light glasses, there have been a couple of studies. None of the studies have shown that they actually work.
Robin Rountree: Oh,
Dr Rani Banik, MD: So keep that in mind. Like you, you know, you may get, you know, offered Blue Lockers when you go to get your glasses made, et cetera, blue locking tint, et cetera.
There is no study to show that it actually helps. and I think the truth is that most of the tints that these blue lockers are, they're really light tins. Like sometimes they look clear or they look like a. Slight yellowish kind of a color. They don't really do much. They only block about 10 to 30% of the blue light.
So if you wanted to get blue blockers, which again, I'm not a big fan of, but if you really wanted to get them, I would get the really dark ones, like the deep red or amber, orange colored ones. 'cause they probably block about 98 to 99% of the blue light.
Robin Rountree: Alright, so it's not the glasses. What's, what's the secret?
Dr Rani Banik, MD: Yeah, so I always give my patients five [00:06:00] tips. So let's go through what they are. Number one is the 20 20 20 rule, and many people think of 2020 as perfect vision, but this is a simple tip that you can incorporate into your screen time, which is. Set your timer for 20 minutes and every 20 minutes, take a 20 second break and look at something.
Don't look at your screen. Look at something far off in the distance, maybe 20 feet away, whether you're looking at the wall, something on the wall or across the room or out a window that's even better. Look at some, you know, nature out the window, but that 20 second break of looking at something 20 feet away will help to relax your eye muscles, and it will really reduce the strain on your eyes when we're focusing up close for so long.
It's a really simple thing to do. You just have to remember how to do it.
Robin Rountree: Yeah. 20 seconds relaxes your, your eye muscle. That's
Dr Rani Banik, MD: That's all you need. Yeah. 20 seconds of, or you can just close your eyes and not look at your screen for 20 seconds even. That will help you to reset and it'll improve your endurance when you're on a screen.
Robin Rountree: All right. Tip number two, bring [00:07:00] it.
Dr Rani Banik, MD: Blinking. So, you know, we think of blinking as, you know, such a simple thing. It's automatic, we don't really pay much attention to it, but, I'll give you some in interesting, tidbits here. So, normally people blink about 20 times a minute. But when you're on a screen, when people are looking at a screen so intently, they're only blinking about three to five times a minute.
And what that does is when we're not blinking enough, our tears just evaporate off the surface of our eyes and it leads to dry eye, which is also part of digital eye strain. So simply by blinking more like being mindful about blinking and also blinking a little bit more forcefully when we do remember to blink.
So, you know, kind of give yourself a couple of good blinks there, and it'll help the tears to coat the surface of your eye and gets that whole action going to lubricate the surface of your eye. and also along with blinking, remember to stay hydrated to prevent dry eye. And Omegas help too for dry eye.
So there's a lot of evidence that shows that omega threes through diet and even supplementation can be really beneficial for [00:08:00] dry eye. So do all of that to prevent dryness. That's part of digital eye strain.
Robin Rountree: All right, so far these are not complicated things. We've got our 20 20, 20 blink more. I think we can handle that. What's next?
Dr Rani Banik, MD: Okay. The third thing is, you mentioned earlier, blue light exposure. we get a lot of blue light mainly from the sun, but our screens also emit a lot of blue light, which is basically on the short end of the spectrum, and it can lead to symptoms like eye strain and light sensitivity, et cetera. So just limit the blue light coming from your devices.
There are some great. Screen filter apps that are built in to most devices that people can apply, or you can get other apps that not just reduce the blue light, they decrease the screen brightness and they decrease the flicker rate, which is also sometimes very bothersome to patients because their screens flicker on and off very quickly.
And this whole topic of blue light. This is so important because it can affect our sleep. there's some early studies to show that it may cause behavioral issues in kids. so, you know, we really need to be mindful [00:09:00] of our screen time. And actually this is a big topic that's coming up in the Eye health summit that, that I'm hosting, next month.
The first week of May, the Eye Health Summit, it's an online summit. It's a conference anyone can join. It's free, completely free to join. And I've invited 35 experts in eyecare to talk about various eye issues and how to manage them.
Robin Rountree: We will have a link to that in the show notes. I think that's gonna, I love that it's free and you've got so many experts coming in.
Okay, tip number four.
Dr Rani Banik, MD: Okay, so this is gonna be an interesting one. that tip number four is to simply get outdoors more often and on a, if you can, on a daily basis. And why is this important? Well, number one, it takes us away from our screens, but also studies have shown that. Now this is really important in kids that children, when they spend time outdoors at least two hours a day outdoors, that can reduce the risk of myopia progression.
Now, myopia is nearsightedness. It's the medical term [00:10:00] for nearsightedness and myopia is becoming an epidemic. So it's estimated that by the year 2050. 50% of the world will be myopic. And we think it has to do with, you know, being focused on our screens all the time for hours and hours a day that we're causing our muscles to work.
And it causes the eye to get longer and it causes myopia. So again, encourage kids to get outdoors, spend time outdoors, but adults should do it too because we can all benefit from the sunshine and exposing our eyes to natural light to help. Also, circadian rhythms, to help set our circadian rhythms.
Robin Rountree: How do, how do we set those circadian rhythms so that you're talking about we've gotta get enough sleep to rest our eyes.
Dr Rani Banik, MD: Yeah, so you know, there's a natural cycle of melatonin produced by the body. Melatonin is a hormone that regulates sleep or allows us to fall asleep. And so, you know, the best practice, I think would be in the morning to get some exposure of your eyes to early morning sunshine. So let's say before 10:00 AM is to get out there, get a few, at [00:11:00] least a few minutes of exposure, sunshine too.
Get your melatonin levels to go down because now you're awake, you're about to start the day, start a fresh new day. and then towards the end of the day, what you also wanna do is you don't wanna expose your eyes to too much blue light because that will, inhibit the secretion of melatonin. Again, melatonin helps us to fall asleep.
So if you're on your device, you know, late into the night, which I'm sure you know, I'm guilty of this sometimes as well, many of us do this, we're, you know, in our bed with looking at our phones or watching television late into the night that could interfere with falling asleep. So, the guideline, and again, this is very difficult to do in today's modern age, but the guideline I would give is try to limit your exposure to screens in blue light two hours before bedtime,
Robin Rountree: Ooh.
Dr Rani Banik, MD: two hours before, or at least use those filters, you know, use, The blue blocking filters on your devices.
Robin Rountree: Okay, so maybe read my book, not on my phone, but on an actual page because that's better for my eyes.[00:12:00]
Dr Rani Banik, MD: That is an amazing, yeah, that's an amazing tip. it's, it's better for us to just read like, like we used to, right.
Robin Rountree: Right.
Dr Rani Banik, MD: than on a device, you know, we spend enough time on devices, so pick up a, a nice book or a magazine and, and read like we used to.
Robin Rountree: All right. Did we cover all five tips?
Dr Rani Banik, MD: We have one more left.
Robin Rountree: Oh,
glad you
Dr Rani Banik, MD: yeah.
Robin Rountree: track.
Dr Rani Banik, MD: We have one more left. And, so to combat this digital eye strain, there is something that is proven, it's scientifically proven to help with digital ice strain. And it is also simple, it's nutrition. And many people don't realize that there are certain eye health nutrients found in foods that can get deposited into the back of the eye.
These are compounds, called, you may have heard of them before. They're called lutein and zeaxanthin, but basically these are two pigmented compounds. Our bodies can't make them, so we need to get them from diet or from supplements, and they get deposited into the back of the eye and they act like our natural [00:13:00] shields.
So they're shielding our eyes from blue light and UV light. And also protecting against conditions like macular degeneration. So get enough of the foods that have these compounds in them in your diet. And the foods are, I would say number one, leafy greens. Actually number one, two, and three would be leafy greens.
Robin Rountree: Got it!
Dr Rani Banik, MD: there really high levels of lutein and zeaxanthin so, spinach, kale, collared greens, all are great. Also, if you're not a big fan of leafy greens or maybe you have an oxalate sensitivity, you can eat other foods, that are yellow or orange in color. 'cause they probably have high levels of lutein and zeaxanthin.
So, for example, bell peppers. Many people choose green bell peppers, but actually the kind I prefer, are the orange and yellow ones, because that color is because of the lutein and zeaxanthin., and so you can get it that way. Also, egg yolks for people who eat eggs.
the beautiful orange yellow color of the egg yolk is actually from lutein and zeaxanthin. So simple way to get your dietary intake. And there's some spices too that have lutein and zeaxanthin.. For [00:14:00] example, paprika and cayenne pepper are good sources. So there's lots of ways to get them in. If you're, if you are not getting enough of these foods, then it's always really good to take an eye health supplement that has them, because we don't wanna develop eye problems as we get older.
Like, we don't wanna develop macular degeneration. And you can prevent it by having enough lutein and zeaxanthin, through diet and supplements. So simple things you can do. but again, a lot of people don't know these things. That's what the eye health summit is all about, to empower people with this knowledge.
And I'll just say another, another quick thing here. Most people don't know that they should be going to see their eye doctor on a regular basis.
Robin Rountree: Mm.
Dr Rani Banik, MD: so it's recommended that anyone over the age of 40 should go see an eye doctor once a year. So we all go to the dentist twice a year to get our cleanings.
We go to, you know, get our annual health checkups, we get our annual labs done, we get our colonoscopies, mammograms, et cetera. We don't really think about our eyes, but it is super important to get that eye exam once a [00:15:00] yearbecause we can find so many things on an eye exam that may be vision threatening or even life threatening.
And it's good to get that dilated exam. Like I've diagnosed diabetes based off of an eye exam. I've diagnosed high blood pressure brain tumors. I can diagnose off of an eye exam or even other types of tumors like melanoma. So it's really important to get that annual eye health checkup and, you know, be proactive.
Don't just wait for something to happen, just take care of it before it happens.
Robin Rountree: Okay, so the name of the podcast is Informed Aging. what's happening to our eyes as we age , and what can we do to help?
Dr Rani Banik, MD: Yeah, so there are so many things that happen as we get older. I tell my patients, if you are, if you're fortunate to live long enough, you're gonna have three things guaranteed. Three things are gonna happen to your eyes.
Robin Rountree: Okay.
Number one is presbyopia, and that's a, the medical term for not being able to focus up close.
Dr Rani Banik, MD: Many people probably, you know. They noticed at the age of 40 [00:16:00] or so, they have trouble focusing. They may have to use reading glasses. That's called presbyopia, and it happens to all of us. And why does it happen? It's because we have a lens inside of our eye that normally is dynamic. It can change shape, but as we get older, the lens becomes more stiff and it just can't focus up close anymore.
And when it can't change shape and focus up close anymore, we can't see, you know, we can't read fine print. We can't read a newspaper. You can't read labels. It's very difficult. So that's a normal aging change that happens,
Robin Rountree: . So I've already checked that one off my list. I definitely need my readers from time to time. What, what
Dr Rani Banik, MD: Yeah,
Robin Rountree: I expect?
Dr Rani Banik, MD: So the other thing unfortunately that happens to all of us when we get older, and this is a little bit later, not forties, but usually by late fifties, early sixties, is cataract. And what a cataract is is, you know, that lens I was describing that changes the shape that helps us to focus that lens is when we're young, it's.
Transparent, it's clear and it lets light come into the back of [00:17:00] the eye. But as we get older, it becomes a little bit opacified and it really, what happens is it becomes susceptible to oxidative stress and it opacifies and it doesn't let enough light get in. And so the, the lens itself can change. Instead of being transparent, it will change to like a yellowish color.
And in the most advanced cases of cataract, it can look white or even brown. but. It happens to all of us, unfortunately. if we live long enough, it's going to happen, but I will say that just because one may have a cataract, it doesn't mean that you need to do anything about it. So a lot of people, they get frightened.
They hear, oh my goodness, I have a cataract. You know, my eye doctor said I have a cataract. What should I do? Should I have surgery? No, there is no reason to rush into anything unless it's affecting the quality of your vision. So I always, you know, when, when I, if I diagnose a patient with a cataract, I always ask them, what are the top five things you love to do every day?
You know, what are the top [00:18:00] five activities or visual activities you love to do? So it's read, usually reading, being on my computer, driving, cooking, working, seeing faces, you know, talking to my friends and family. Those are usually the top things people love to do. And if you can. Do them well enough because your vision is blurry.
like if you can't drive anymore or drive at night because your vision is blurry, you're having glare and halos, then maybe you can consider doing something about the cataract. but again, as an integrative healthcare provider, I don't tell my patients to rush into anything. Only when it's ready.
Robin Rountree: . What is the third thing that happens to our wonderful eyes as we get older?
Dr Rani Banik, MD: So people are not gonna like this, but it's the cosmetic changes that happen to us, right? So many people develop those fine lines, wrinkles here, and then the dark circles. Some people have really dark circles under their eyes, and then their eyelids, they lose their elasticity, so their eyelids can become heavy or droopy.
Or you can develop puffiness or bags that kind of [00:19:00] overhang over your eyes. So you can't see. See, well, that does happen, unfortunately. it happens to us, but there are lots of great solutions and you know, in some patients it does impact their vision because if they have heavy eyelids, they can't open their eyes and they can't see.
so there are some great solutions for that, those types of changes. And also, you know. No one likes to have dark circles under their eyes. They always look tired. People may, you know, comment, oh, you look really tired. Did you not get enough sleep? sometimes it's genetic, but sometimes it happens with age.
And there are some great solutions. And again, I have two speakers on the eye health summit talking about age related cosmetic changes around the eyes and all the different options you can pursue. both natural as well as procedural to help manage those types of things.
Robin Rountree: And let's talk about glaucoma. That's something we hear about. and usually in older adults, what exactly is that?
Dr Rani Banik, MD: Yeah, that's a great question. So glaucoma is a condition where the nerve in the back of the eye gets damaged, and this is the nerve that connects the back of the [00:20:00] eye to the brain. So it's collecting all the signals that you know, that come in through our eyes, and it's sending those signals to the brain.
So if that nerve gets damaged, people can have loss of vision. Now, interestingly, with glaucoma, usually in the initial phases, there are no symptoms at all. It's a completely silent disease, so you may have glaucoma and have no idea that you have it. And this is another reason why you should go see the eye doctor once a year because they can pick it up on their exam.
But basically. People's central vision initially is spared, but they may have pockets of their peripheral vision that get blurry or go missing, and that's why people may not realize it because slowly they may be losing their peripheral vision until they only have their central vision left, and then they may be bumping into things, you know, just not really able to navigate well, especially in dim lighting.
So, so if you experienced anything like that, definitely get it checked out. Make sure it's not something serious like glaucoma. so the nerve gets damaged, usually in [00:21:00] glaucoma. Not always, but usually, glaucoma is associated with high eye pressure and many people. You know, there are different pressures we can check on the body.
We can check our blood pressure, we can check our brain pressure, we can check our eye pressure. So eye pressure is one of the kind of the vital signs on an eye exam.
It's one of the key metrics that we use in the eye exam to see whether you're at risk for glaucoma. Or if you have glaucoma, you know, we usually try to lower that pressure down.
Robin Rountree: All right, and macular degeneration. AMD. What's going on with that? I'm hearing it more and more on, uh, commercials on tv.
Yes,
Dr Rani Banik, MD: it is all over tv and the reason is because there are some really amazing drugs that have been FDA approved, and that's why the drug companies are promoting their drugs. But I'm a big believer that, and I'll explain what macular degeneration is, but that you can prevent vision loss from macular degeneration by incorporating the right dietary patterns.
And the right lifestyle [00:22:00] habits, and that's been studied, that has been shown that you know, if you eat the right types of foods, you can decrease your risk of losing vision from macular degeneration by over 40%,
Robin Rountree: Wow.
40%
Dr Rani Banik, MD: risk reduction by simply incorporating certain foods in your diet and avoiding other foods.
But, let me answer your question, what macular degeneration is, so it's a condition that affects the retina in the back of the eye. And what happens is that there are waste products that are not cleared. So you get these little waste deposits underneath the retina and, Eventually those waste deposits grow in size and number and they cause inflammation, and then they cause leaking of blood vessels.
Now you would think that blood vessels are a good thing, but when they leak, that's not a good thing, and I like to call this leaky eye syndrome. This is the prototypical leaky eye syndrome is macular degeneration where blood and fluid and proteins and fats leak into the retina where they're not supposed to be.
And that's when people can [00:23:00] experience severe vision loss and it can cause blindness. So it, the good news is macular degeneration doesn't happen overnight. It happens very, very slowly over years and decades. So you have time. You have a window of opportunity to institute some lifestyle changes, nutrition changes, healthier eye habits to decrease your risk of AMD, and also go see your doctor because again, in the initial phases, it's completely silent.
Just like glaucoma. You may have no idea that you have it unless you get your eyes checked out.
Robin Rountree: Wow. Well, I'm so glad that they have some drugs for treatment, but also that prevention piece is so important. I'd rather have my orange and yellow peppers with my breakfast than go And they put a needle in your eye, right?
Dr Rani Banik, MD: Yes, these, the drug, the advertisements people may see on tv, these are injections that go into the eye and unfortunately they need to give, [00:24:00] be given frequently. So every month, people, there are thousands, if not millions of people around the world who unfortunately have advanced stages of macular degeneration, and they're reliant on these monthly eye injections to save their sight.
On the other hand. You can prevent it from happening, right? So you have to think about, you know, okay, which am I gonna choose and am I gonna choose the monthly eye injections, or I'm gonna choose the prevention?
Robin Rountree: Right.
Dr Rani Banik, MD: again, we talk about this. Yeah, exactly. And this is again, we have sessions, multiple sessions on this, on the Eye Health Summit about prevention through, some amazing experts talking about, like a holistic optometrist, integrative optometrists talking about, these issues.
So you can learn a lot. and, and save your eyes. You know, one of the themes that we, we have in the Eye Health summit is an ounce of prevention is worth a pound of cure. so that saying, we've probably all heard it, it was first said by Benjamin Franklin. but, you know, just do things now so that you can save your sight for the decades ahead, like [00:25:00] years and decades ahead.
You don't wanna just, you don't wanna wait for something to happen.
Robin Rountree: Right, right. Thank you so much for your time. I just have a question about this wonderful free eye health summit. Again, we will have the link in the show notes is that you have to watch it at that time or will can you like watch the recordings at another time?
Dr Rani Banik, MD: Yeah, that's a great question. So it's a hybrid, summit. So we have prerecorded talks that will be released every day. So each of the talks will be available for 24 hours, then they expire, and then the next day's talks come up. So you have 24 hours to watch the talks, each of the talks.
and then we have live sessions. So I'm really excited about this because we have live sessions in, the evening, 6:00 PM Eastern. So depending on where you are, which time zone you're at, you can calculate that. But live sessions with myself and experts, so not just me, but experts. And we're gonna be taking questions from the audience, answering their questions, helping guide them.
And yeah, I think it's gonna be an enlightening eye-opening [00:26:00] experience and you can learn so much so.
Robin Rountree: Fantastic. Thank you so much for your time and I wish you a lifetime of great vision and now I've got some tips that I may have the same.
Dr Rani Banik, MD: Thank you so much, Robin. I really appreciate it. Take care.
Robin Rountree: Please make sure to subscribe to our podcast Informed Aging and tell your family and friends about us. If you'd like to support the work that we do at the Alzheimer's and Dementia Resource Center, please go to adrc cares.org/donate. You can find us on facebook.com/informed Aging. Today's episode was recorded at ARC's Podcast Studio.
That's it for now. We are looking forward to our next visit.