How Dysbiosis and Nutrient Deficiencies Impair Eye Health and Cause Everything from Dry Eye to Vision Problems with Dr. Travis Zigler

Today we speak with ophthalmologist Dr. Travis Zigler regarding all things eye health.  Dr. Zigler details how dysbiosis in the eye and nutrient deficiencies impair eye health and cause everything from dry eye to vision problems.

Dr. R’s Fast Facts

Dry Eye

  • A multifactorial disease that can be caused by:
    • Dysfunction of oil glands (meibomian glands)
      • When oil glands cease to excrete oil onto the eye, it causes the eye to feel dry and irritated, which creates inflammation
    • Treatments/therapies to keep eyelids healthy
      • Keeping the eye clean is very important
      • Soap w/ tea tree oil can be used to kill demodex mites that live on the eyelashes
      • Chloric acid spray can be used to control overgrowth of bacteria
        • Overgrowth of mites or bacteria can cause inflammation
      • Eating healthy fats like omega 3-6 for healthy oil glands
      • Warm compress also helps get the oil glands working well
        • Warm (dry) rice in a sock, place it on the eye – helps to make the oil more liquid, massage the area to get the oils moving

Vision Problems

  • We are becoming more nearsighted as a society
  • Playing outside might help decrease nearsightedness
  • Vision therapy/therapist – training the muscles inside the eye to focus better
    • Mainly used for children who have the inability to focus or cross their eyes
    • There are quite a few diseases that cause this, the most common is Convergence Insufficiency
      • Other common diseases – Convergence Excess (over-crossed eyes), Accommodative Insufficiency
    • Not many doctors look for binocular issues
      • These conditions can sometimes present like ADD or ADHD because the child literally has issues with binocular focus
    • In-office therapy has the best results
      • There is a computer program you can do at home as well

Macular Degeneration

  • The Macula is your central vision
  • What causes macular degeneration?
    • Number one cause is age
      • Some signs in the 60s, often in the 70s and 80s
    • Number 2 – genetics
    • Number 3 – smoking (smokers have a 4x greater risk of developing MD) and diet
    • Vitamin deficiencies can be common; phytochemicals (leafy greens), vitamin A, C, and E
      • Free radicals cause damage to the macular tissue
  • Treatments
    • Green smoothies are great
    • Take a macular degeneration formula – Eye Love Ocular Health Formula
    • Sufficient vitamin A, C, E are the most important in this condition

Glaucoma

  • Not much is known about what causes Glaucoma
  • Treated by lowering the pressure in the eye
  • Diet and overall health are important, typically appears in unhealthy patients

Cataracts

  • Not abnormal to have some cataract formation
  • Around the age of 40, the lenses become so thick you have trouble focusing (bending it)
    • 50s – vision starts to become blurry with distance and reading
    • 60s to 70s – vision starts to become cloudy
  • Any preventative measures?
    • Antioxidants can help prevent it from getting worse
    • Overall health – eat less processed food and sugar, eat more leafy greens

Stigmatism

  • 80% of people have astigmatism of some kind, it is considered very normal depending on the severity of it
  • What causes it?
    • The front curvature of your eye isn’t shaped perfectly round
    • When light comes into the eye it gets focused on two points instead of one
    • Therapies like contact lenses and glasses help focus the two points into one
  • Preventative measures
    • Orthokeratology or CRT
      • Special night-time contact lenses can then help all the next day
      • Has been shown to reduce the progression of nearsightedness by 50%
      • A lot of doctors are not aware of this

General Eye Care Advice

  • Get your yearly eye exams

Where to find more about Dr. Travis Zigler’s free live events, products, website, and book

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Prelude … 00:00:39
Episode Intro … 00:01:39
Common Eye Issues … 00:03:00
Dry Eye … 00:04:20
Treatments for Dry Eye … 00:06:00
Vision Problems … 00:11:00
Why Our Eyes Get Tired … 00:14:35
Vision Therapy … 00:15:38
Macular Degeneration … 00:19:30
Glaucoma … 00:23:30
(click gray Topics bar above to expand and see full outline/time stamp)
Cataracts … 00:24:47
Astigmatism … 00:27:44
New Literature on Eye Care … 00:30:00
Importance of Annual Eye Exam … 00:33:00
Episode Wrap-up … 00:35:08

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How Dysbiosis and Nutrient Deficiencies Impair Eye Health and Cause Everything from Dry Eye to Vision Problems with Dr. Travis Zigler

Episode Intro

Dr. Michael Ruscio: Hey, everyone. Welcome to Dr. Ruscio Radio. This is Dr. Ruscio. I am here today with Dr. Travis Zigler. And we are talking all about the eyes, which we haven’t really talked about before. So I’m very hopeful that this will be a show that will give us some information on eye health, which certainly is important because we all want to have good vision. But maybe it doesn’t get quite the attention that it should deserve. So, Travis, thanks for taking the time to be here today.

Dr. Travis Zigler: Yeah, thanks for having me on. Pretty excited to be here.

DrMR: Yeah, excited to have you. Excited to talk about this a little bit more. Tell us just briefly your background and your training. And then we’ll jump into the topic.

DrTZ: Yeah, so I went to Ohio State University. I started there in 2003. Went there for undergrad and then optometry school as well. And optometry school is a four-year program after you graduate. And I graduated from there in 2010. I worked with my uncle and another doctor for about five years. And it was a good time, good learning experience because my uncle does a lot of unique things in his practice.

And there was always something missing, though. And I wanted to do my own thing. So my wife and I moved down here and started two clinics of our own here in South Carolina. So that’s where we are now. We actually just sold one clinic. And we’re getting ready to sell our second clinic because we’re focusing more on online eye care.

Common Eye Issues

DrMR: Gotcha. So with eye care, of course that can encompass a whole myriad of different conditions. I know dry eye is an area that you have particular focus on. What are some of the more common eye imbalances or disorders or conditions that people should be aware of or may affect people that we can talk about today?

DrTZ: There are a lot out there, as you probably could imagine. But we could talk anything from cataracts to glaucoma to macular degeneration. Of course, dry eye is what we specialize in. And then I’d love to even talk about nearsightedness, farsightedness, astigmatism. A lot of people think that when they get diagnosed with astigmatism, their life is over. So we can clear up some myths around that. And then just general how to keep your eyes healthy—we can talk about that, too.

DrMR: All right. So let’s start off with dry eyes. And I should just clarify here for the audience. I’m sure this is no surprise, but I certainly don’t know a ton about the eye. I come across bits and pieces in my reading. There have been a number of trials I’ve seen published regarding dry eye showing that fish oil has actually been shown to be a successful therapy for dry eyes in a number of clinical trials.  So I’m assuming that’s something that comes up. But let’s jump into dry eye.

Dry Eye

DrTZ: Yeah, so dry eye is pretty much a multi-factorial disease, meaning it’s caused by a lot of different things. You have oil glands in your eyelids. It can be caused from a dysfunction of those oil glands. Those are called Meibomian glands.

And so if you have Meibomian gland dysfunction, that’s where those oil glands aren’t secreting oil onto your eye. Therefore, that oil, what it’s used for is it’s used to keep your eye comfortable. And so if you don’t have that comfortable oil on your eye, then your eye is going to feel dry and irritated. And it’s actually going to create more watery tears. And then you’re going to get more tears streaming down your cheeks. And a lot of people will come in with watery eyes. And really, they just have dryness.

And then in turn, that will cause inflammation of the eyes. Inflammation is the telltale sign of dryness. And that’s what we’re mainly treating with the kind of therapies we go over. And whenever you hear somebody talk about dry eye drops, you’re treating that inflammation on the eye itself.

And so dry eye is mainly this thing where your glands aren’t working well in your eyelids. And so we work on getting your eyelids healthy first and then secondarily treating the inflammation on your eye as needed after you get your eyelids healthy. Does that make sense?

DrMR: Yeah. Yeah, it completely makes sense. And thank you for clarifying, because I could see one very easily thinking, “My eyes are watery but irritated. Therefore, my eyes aren’t really dry because they seem like they’re too wet.”

But you make a good point, which is there’s this water lubrication, which would be a tear. And there’s this oil-based lubrication. And a deficiency in the oil lubrication could create what looks like too much moisture,  but actually is not moist enough in a sense.

DrTZ: Yeah, you got it. That’s a good summary.

DrMR: That makes a lot of sense. So what are some of the therapies or the techniques you’re using to treat the eyelids as you say?

Treatments for Dry Eye

DrTZ: So with the eyelids themselves, you just need to keep them clean. And in our eyelids—I’m going to gross out some of your listeners here. But actually in the eyelash follicles, we have mites that live there called Demodex mites. And these Demodex mites can be killed with tea tree oil.

With our company, we actually made a bar of soap that contains natural ingredients and it has tea tree oil in it. So if you wash your face daily with this soap, and especially your eyelids, making sure not to get it in your eye, then you’re actually going to kill those Demodex mites.

And what those Demodex mites do is they cause inflammation on the eyelid itself. And that inflammation then in turn makes the glands not work as properly.

There’s also bacteria that live on our eyelids naturally. And if that bacteria becomes overgrown, that’s called blepharitis. And that can actually be cause of inflammation on the eyelid itself, decreasing the oil glands.

And then if you’re not eating a healthy enough diet, if you’re not eating healthy fats, then the oil glands themselves will not produce a good oil. And that bad oil will turn into more of a solidified oil and therefore won’t get out of the glands as well.

And therefore, we have to treat those three different components because we all have a form of the oil glands dysfunctioning. We all have some of those eyelash mites. It’s just how many. And then we all have bacteria. It’s just how much.

And so we do a combination with our company of the omega-3s, like you talk about. We don’t have an omega-6 yet. But we tell our patients to eat a healthy omega-6. And then we have our soap bar that has the tea tree oil in it. And then we have a hypochlorous acid spray. And that spray helps keep the bacteria down. So this combination of this therapy helps make your eyelids healthier.

And that’s the first line of treatment that I do with almost all my patients. We need to get your eyelids healthier. And I also do this kind of therapy if somebody is going in for eye surgery as well because they’re less likely to have an infection after surgery if we keep those eyelids really, really clean.

And so what we can do with the oil glands is eat a healthier diet. But we can also do a warm compress. You can buy a warm compress. Or you can make one by simply putting rice in a sock and microwaving it, preferably dry rice, not instant because you don’t want to cook it. You just want to warm it up.

And when you place that over your closed eyelids, what you’re doing there is you’re heating up an oil. And so when you heat up an oil, just like if you put a stick of butter on the stove, it’s going to turn into more of a liquid. And then if you massage the eyelids, that’s going to get the oil glands working a little better, getting them more in sync.

And so those four things sound like a lot. But if you do those four things properly, it will get those oil glands working well. And you’re almost curing dry eye when you do those things.

DrMR: There’s something that I’ve had two times in my life. And I forget the name of the problem. I don’t want to say disorder. It’s just essential when one of those oil glands in the eyelid gets clogged. You can have a little bit of swelling. I think it’s more prone to happen in the lower eyelid. And one of the treatment remedies is a hot compress.

DrTZ: Yeah.

DrMR: What’s the name of that condition? Are you familiar with what I’m referring to?

DrTZ: Yeah, exactly. So the medical term is a hordeolum, an internal or an external hordeolum. And the common term is a sty. And so everybody calls it a sty. And that’s probably what you’re thinking. And that is essentially one of those oil glands getting clogged up. And when it gets clogged up, it backs up because the oil is still being produced. And it creates a lump.

Now, if you get bacteria trapped in there, that’s when it gets infected. And that’s when we usually have to prescribe an antibiotic. But with a typical sty that’s not as infected, we’ll actually do that exact same regimen. And for patients that are prone to that, we’ll talk about diet causing it. And then we’ll talk about how you need to keep your eyelids cleaner and using our spray to keep just the blepharitis away because the more inflamed your eyelids are, the more likely you’re going to have a sty.

DrMR: And blepharitis, that’s inflammation of the eyelid?

DrTZ: You got it. So the blephara is the eyelid, yeah.

DrMR: Yeah, I’ve had that twice in my life. The first time I had it, it freaked me out because it looks weird. And you’re thinking, “What the heck is happening to me?” Thankfully, it was an easy fix. But I might have to get your wash and your spray for something to use as occasional maintenance to prevent that from happening again.

DrTZ: Yeah, if you’ve only had a couple in your life, the spray would be enough for you.

DrMR: Yeah? Okay. Good. That’s good to know.

Okay, it’s actually interesting to hear that in the eye, in the eyelid, we can have these overgrowths. We talk, of course, a lot about overgrowths of bacteria and fungus in the intestines. But this can also, as it appears, happen in the eye. And it sounds like there are some simple remedies from diet through washes and sprays that can help with that. So that’s very good to know.

Vision Problems

What about if we shift gears for a moment? Because there was something else that you mentioned that were vision problems. And one of the things that I’ve heard conflicting things about is glasses. Glasses may detrain some of the muscles that pull on your lens essentially.

And the criticism I’ve heard is using glasses or contacts causes those muscles to weaken and to atrophy. Therefore, they may not be a good solution. Whereas I’ve heard of some home exercises one can do to retrain those muscles. I don’t know if they’re very effective or not. So curious how you come at vision problems. Or maybe you come at it from a completely different angle. But just curious to get your thoughts on all that.

DrTZ: Yeah, so I’m Western-medicine trained, which optometry school does and medical school does. We’re Western-medicine trained doctors. And I’ve actually been studying a lot of Eastern medicine here in the last year because of something that happened in our lives.

And so saying that the eye exercises to decrease your need for glasses is completely bogus and phony? I can’t say that anymore, because I probably would’ve maybe two years ago when I was purely Western medicine thought process. But now that I think a little differently as a doctor, I’m open to explore those. But they’re not studied, and so they’re hard to really prove.

And with all the eye conditions that we have, we don’t know what’s causing them. And so it’s very hard to say that this will work for them if we don’t even know the cause of it. And that’s what most studies are going into—trying to figure out nearsightedness, because we’re becoming more nearsighted as a society.

And there are some studies that show that if you play outside, versus sitting inside on a tablet, a phone, or on TV, if you play outside, you’re less likely to become nearsighted than someone that’s inside.

And [there are] a lot of studies over in Asia in the Chinese population and Japanese, because they’re the most nearsighted culture in the world. And so a lot of studies are going on over there to figure out what’s going on.

There are also great studies here in the States that study kids, trying to prevent their nearsightedness from getting worse. And they’re promising they’ve reduced nearsightedness by 50% in some children.

But we still don’t know the cause of it. And so it’s hard to really say that any of those natural home remedies or the home exercises work. For me, I wouldn’t say they don’t. But it’s hard to prove them because there are no studies that back them up really.

So I’d recommend that if your kid is nearsighted or if you are nearsighted, get outside and play a little bit more. And stop being on your computer all the time.

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Why Our Eyes Get Tired

DrMR: It certainly makes sense that you need a variety of focus stimuli to keep the muscles in the eye working in a range of motion, just like your hip joints could get very tight and stiff if you’re sitting in a chair all day. So theoretically, that certainly makes sense.

I agree with you. I’d like to see some more definitive science to prove this. But I certainly would suspect that some type of exercise would only help. Would it help significantly or not? I guess that’s another issue.

DrTZ: Yeah, I could go into that a little bit more. We’re bending the lens inside our eye to see up close. When we look at something far away, our eyes are relaxed. And so everything is relaxed. That’s why when you’re on a computer for a long period of time, your eyes get tired. Or when you’re reading for a long period of time, your eyes get tired after a while.

But if you’re doing something like just sitting on your porch looking at something far away, your eyes are never going to get tired because you’re just relaxed at that stage of the game.

Vision Therapy

So what we also do—this is kind of on topic but a little bit separate—is we do something called vision therapy. Vision therapy is actually training the muscles inside your eye to focus better, because we cross our eyes when we read. And it trains them how to cross better and just how to work together better.

That being said, it’s completely independent from conditions like nearsightedness and farsightedness. But this is for a whole new set of disease that we see in children where they have the inability to focus their eyes or the inability to cross their eyes. So we train the muscles to do that. But that doesn’t help out with glasses. But we do train the muscles to teach them how. It’s very similar to physical therapy if you were to tear an ACL or something.

DrMR: Sure. Sure, okay. That makes sense. And is there a name for that focus problem or eye crossing problem in children?

DrTZ: Yeah, there are actually quite a few diseases. But the most common one we see is called convergence insufficiency. Converging is bringing our eyes together. Insufficiency—just inability to. So convergence insufficiency is the most common one we see.

Then there’s convergence excess, which means they cross their eyes too much. And then there’s accommodative insufficiency, accommodating being where you focus your eyes, insufficiency again being where you don’t have that ability to do that.

So those are the three most common ones. But there are about 20 more. But I just don’t see them that often in my clinic.

DrMR: And do you think that people will get a decent therapeutic recommendation if they’re just seeing their local doctor for this? Or do you think some of the standard, conventional options may fall a little short.

DrTZ: Oh, yeah. Great question. So it’s a tough question to answer because I don’t want to bash my own profession.

DrMR: Right. I get it, yeah.

DrTZ: But unfortunately, not a lot of doctors look for—it’s called binocular vision, these conditions that I’m talking about, convergence insufficiency. Binocular vision being using our eyes together. And a lot of doctors just don’t look for it.

And if you’re not looking for it, you’re not going to see it. And a lot of these kids and children are getting diagnosed with, “They need reading glasses,” or something like that. And they’re getting diagnosed with ADD and ADHD and learning disabilities when it’s simply that they’re eyes aren’t working together. So they’re working twice as hard as someone that doesn’t have this problem. And that’s why they won’t focus. That’s why they can’t focus.

So if your child is having problems with focusing and they’re having problems with things like skipping lines while reading or just not remembering what they read, those are the telltale signs. And so you can look for a vision therapist in your area or an eye doctor that specializes in vision therapy. And that’s going to be a doctor that does this full time. And that’s going to be your best bet to see and to rule out any problems.

Myself, I’m a primary care eye doctor. I still do a little bit with this. And I love kids. And so I do it personally. But I know a lot of doctors do not.

DrMR: Gotcha. Gotcha. And are you able to assist with this with some of the online courses that you offer? Or do you need to be seen in an office physically for this?

DrTZ: Yeah, so the vision therapy, there is a computer program that my company physically doesn’t sell. But I do sell another company’s in my office. And you literally just take this course. You download it on your computer. It just goes right through and trains you. I can’t think of the name of it right now. But I know there’s an iPhone app for vision therapy. I’m not sure if it’s been studied and how well it works.

But the best results have always shown that in-office therapy always has the best compliance, number one, and effectiveness, number two. But I think those go hand in hand, because if you’re going into the office for an hour three times a week, you’re doing the therapy; where the computer program, I tell them to do it 20 minutes a night at home. And if they do it every night, that’s debatable. Who has time?

Macular Degeneration

DrMR: Yep, I get it. I get it. And what about macular degeneration? I’ve only seen—gosh!—I think one or two cases of this. And maybe people who come in have it. And they just don’t mention it because they’re coming to me more for IBS or GERD or SIBO or what have you.

But I do remember one case early in my career that responded very well to essentially a paleo-like diet and a fairly aggressive dose of vitamin D, because I had pulled some evidence out of the literature that macular degeneration may be classified in the autoimmune box or is in that gray area where some are suggesting it may be autoimmune, some are suggesting it may not be. But he seemed to respond really quite well.

So yeah, curious your thoughts on macular degeneration, what people can do about it, what you’d recommend.

DrTZ: Yeah, so we’re completely reversing from kids to elderly.

DrMR: Right, yeah.

DrTZ: So the number one cause of macular degeneration is age. And so the older we get, the more we tend to see it. And I usually start to see it maybe some signs in the 60s, not typically. But then 70s and 80s is when I typically see it.

And like you were saying, a diet shift is huge because they’re usually eating—let me go back a little bit. So age is number one risk factor. Genetics is number two. And then smoking. If you’re a smoker, you have a four times greater risk of developing it versus that of a non-smoker. And then I always discuss diet with my patients. And so that’s probably where you hit with your patient.

And usually, they have a vitamin and mineral deficiency. And if you get those vitamins and minerals up, that’s going to help with the macular area just like it does with the rest of your body. And then if you also eat a lot of leafy greens, like spinach and kale, those have phytochemicals like lutein, astaxanthin, and zeaxanthin. And those are found abundantly in your macula. And if those are in there, they’re going to scrape your macula from all those free radicals. And the free radicals are what cause the damage to that macular tissue.

And for your listeners, the macula is your central vision. And so that’s how you see 20/20. When you’re looking at something, you’re using your macula. So macular degeneration is the loss of that 20/20 vision. You never go blind from macular degeneration, you lose that sharp acuity that you would have if you had your macula.

So going back to diet, if you eat the phytochemicals—the lutein, zeaxanthin, and astaxanthin—that’s going to really help clean up the macular area and really get rid of those oxidative species, the free radicals. And it’s just going to really clean up everything in that macular area and keep it healthier.

And so I always recommend a green smoothie for my patients. And then I recommend them taking an ARED-studied macular degeneration formula. And that is something my company does make. It’s called the Eye Love Ocular Health Formula. And I take it myself, just because I like all those phytochemicals. But I mostly give it to my patients that have macular degeneration already, to help prevent the progression of it from getting worse.

DrMR: Gotcha. And do you know of any research with vitamin D being able to help with macular degeneration and/or any thoughts on an autoimmune component to that?

DrTZ: I haven’t actually heard any of that. With vitamin D, I’m sure it does help, just like vitamin D helps with pretty much everything. And the studied vitamins that they hit harder are vitamins A, C, and E. And the study shows that you shouldn’t take vitamin A because it can increase your risk for lung cancer if you’re a smoker. That’s debatable, because they used synthetic vitamin A versus a whole-food-based vitamin A for the study because it was government-sponsored study.

So they just studied vitamins A, C, and E. So the macular degeneration formulas that are out there aren’t going to have D in it. But that would be interesting to look up. I never really looked for it.

DrMR: You also mentioned glaucoma and cataracts. So I’m curious in terms of what you think some of the more important aspects of preventing and/or treating both of those are.

Glaucoma

DrTZ: Yeah, so glaucoma is the big mystery of eye care. Actually, eye care in general is a big mystery because we don’t know much about some of these diseases and especially glaucoma, because with glaucoma, how we treat it is we lower the pressure of their eye. But the weird part about glaucoma is you don’t have to have high pressure in your eye to get glaucoma. And so we treat it by lowering it, but it doesn’t necessarily cause it.

So we don’t really know what’s causing the glaucoma. But what I see typically with my glaucoma patients is they’re very unhealthy individuals. They have diabetes. They have high blood pressure. They have some other autoimmune disease. And they’re just not taking care of themselves. Typically, I don’t see a healthy patient with glaucoma.

And so I always, again, go back to diet and talk to them about a healthy diet and eliminating processed food, sugars, and figure out what they’re allergic to and what they’re not allergic to and push more of a plant-based or diet that’s based around their allergies so they don’t have that inflammation inside their body.

Cataracts

Now, going to cataracts, cataracts are something that occur naturally in everybody. And everybody will get a cataract in their lifetime now that we’re living longer.

And it’s very natural where the lens inside your eye actually starts to change around the age of six years old. You can think of a tree. As it gets older, it gets thicker and thicker at the trunk. Same thing with the lens inside your eye.

So when you hit around the age of 40 to 45, that lens has become so thick that you have trouble focusing it or bending it. That’s when you typically see people start to get reading glasses for the first time. And then as you go into your 50s, it gets so bad that it starts to blur your distance and your reading. And then into your 60s and 70s is when it starts to become cloudy. And that’s what a cataract is.

And again, with a cataract, I will see it in a younger population if they’re exposed to a lot of UV light, such as a welder, or if they’re outside for their job. Wearing sunglasses is great for that. And I’ll see it in a younger population if they’re unhealthy individuals like diabetics and everything as well.

DrMR: And now for them, would the sprays that you mentioned and the wash that you mentioned earlier also help? Or are they two separate tracks?

DrTZ: The sprays and the soap to clean up the eyelids is separate from the diseases that are inside the eye. Now, the supplements, like the macular degeneration supplement, do have a lot of antioxidants in it. So antioxidants can prevent any disease really from getting worse. So it could help prevent cataracts, prevent glaucoma, prevent macular degeneration.

Are there firm studies on that? No, because I don’t think there’s a lot of money in that study. So you’re not going to see a company backing it or anything.

But antioxidants in general are good. So that’s why I take our macular degeneration supplement. It’s not because I have it. It’s because of the antioxidants that are in it. And then our omega-3 that we promote for dry eye, that one can be taken for overall health as well.

Dr. Ruscio’s Resources

Hey, everyone, in case you’re someone who is in need of help or would like to learn more, I just wanted to take a moment to let you know what resources are available. For those who would like to become a patient, you can find all that information at drruscio.com/gethelp.

For those who are looking for more of a self-help approach and/or to learn more about the gut and the microbiota, you can request to be notified when my print book becomes available at drruscio.com/gutbook. You can also get a copy of my free 25-page gut health eBook there.

And finally, if you’re a healthcare practitioner looking to learn more about my functional medicine approach, you can visit drruscio.com/review. All of these pages are at the drruscio.com URL, which is D-R-R-U-S-C-I-O dot com, then slash either ‘gethelp,’ ‘gutbook,’ or ‘review.’ Okay, back to the show

Astigmatism

DrMR: And what about stigmatism? For people that aren’t familiar exactly with what stigmatism is, can you define that for them and then tell us what some of your therapies are? I know you said that some people think it’s a non-changeable diagnosis. But it seems like you’ve got other therapies that seem to be helpful. So I’m curious to hear more on that also.

DrTZ: Yeah, so a lot of people think astigmatism is this devastating disease where they’re going to die or something, because it does sound pretty threatening. But it’s actually simply just where the front curvature of your eye isn’t shaped perfectly round. And so you can think of a round basketball. It’s perfectly round.

If the front of your eye is shaped more like an oval or a football, it’s steeper in one way than the other. So let’s say the vertical way, the up and down axis is steeper than the horizontal axis.

And when that happens, when light comes into your eye, it gets focused on two points. But with astigmatism, what you’ll notice is that there’s a little shadow around letters or fine detail.

And so astigmatism is just essentially where your eye is focusing light on two points instead of one. And so glasses, contact lenses, all those therapies just help bring those two points into one.

And so there’s no cure for it or anything. And it’s very normal. Actually, 80% of people have astigmatism of some kind. It just depends on the severity of it. And there are ways that you can prevent all this stuff. There are contact lenses that you can wear at night, and it corrects your vision. And then you wake up in the morning, and you take them out, and you can see the rest of the day. And that corrects both astigmatism and nearsightedness. Those actually work similarly to Lasik.

And so Lasik is permanent. It’s where they actually take a laser to the front of your eye and flatten it to create your prescription correction on the front of your eye. Whereas this contact lens does the same thing that Lasik does at nighttime. But when you take it out, you can see.

New Literature on Eye Care

And it’s not permanent. So after two to three to four to five days of not wearing it, you’ll go back to how you were before. But that’s another good option that a lot of people don’t know about. And that’s actually called orthokeratology. Or you’ll also hear it called CRT. And that’s most commonly what doctors refer to it as. But you can always Google “orthokeratology,” which is O-R-T-H-O-K-E-R-A-T-O-L-O-G-Y. Orthokeratology. That’s hard to spell without it being in front of you.

DrMR: Yeah.

DrTZ: But if you Google that in your area, you should be able to find a doc that does that.

DrMR: That’s actually really great to know, especially if you have astigmatism and you’re freaking out about it. That sounds like a pretty noninvasive therapy, wearing a lens a couple nights a week. And that’s all you really need to balance that out. That’s pretty terrific actually.

DrTZ: Yes, so yeah, you wear it every night. Eventually, once your eye molds to that lens, you can go usually a couple nights without wearing it. And this is actually going back to what we talked about before with children. This has been shown to reduce the progression of nearsightedness by about 50%. And so if you have a 6 year old that’s been diagnosed with nearsightedness, if you started him on this orthokeratology path at 6 years old, their nearsightedness will progress half of what it would if you did not do this.

DrMR: Wow!

DrTZ: And so that’s another option. And a lot of doctors don’t know that because it’s very new literature and it’s new studies. And unfortunately, as you know, in the doctor field, most people don’t keep up with the literature.

DrMR: Yeah, it’s unfortunate. I wish it was easier to make it commonplace for a doctor to take time to stay current with the research. And I know it’s easy sometimes for, at least in my experience, patients to be very critical, especially of their conventional providers.

But I also have a lot of sympathy there, knowing that, especially in the modern day, it’s getting harder and harder to make a living as a doctor. And they, unfortunately, don’t get paid to take the time to get better at their craft and to read and to stay up on things.

And so I have some sympathy there. I wish there was a way that it could be built into their practice so that there would be a way that doctors would essentially be able to at least recuperate some of their time spent staying current, because it does take a fair amount of time.

But you’re right. I guess it’s hard to be good at everything all the time. But yeah, I definitely know where you’re coming from on that.

DrTZ: Actually, that’s the reason we sold one of our clinics and we’re selling our other one. And we’re focusing mostly on online eye care and helping patients and customers from our business online because of the decreasing reimbursements. And I just didn’t have as much fun, because I would have to constantly be seeing more and more patients just to meet payroll and to meet our office expenses.

And online, we have a group on Facebook called the Dry Eye Syndrome Support Community. And we have 3000 members in that. And I can reach 3000 people by just going live on Facebook for 5 minutes and really impact the lives of 3000 people. Whereas in 5 minutes in my office, I could barely impact one person.

DrMR: Yeah.

DrTZ: And so that’s why we’re shifting our focus to more online and teaching people online different therapies that they can do for dry eye specifically.

DrMR: Yep. Yeah, I totally get it. Absolutely. Is there anything else that you think is important for people to know about? Or any other tips or tricks you want to offer people as we move to a close here?

DrTZ: If you’re going to eat well, you’re going to have healthy eyes. And so I always recommend that just treat your body well, and your eyes will return, because they’re pretty much as in sync with your body as anything else.

Importance of Annual Eye Exam

And I always recommend people get their yearly eye exams, because we dilate your pupils to see in the back of your eye. And the back of the eye is the only place that we can see live blood vessels, an optic nerve that connects to your brain. It is literally part of your brain. And we can see that when we look into the back of your eye.

So the importance of that yearly eye exam is we can detect something before you can notice problems or before maybe even a primary care physician can with blood work, because we are seeing live blood vessels and live optic nerve.

So getting that yearly eye exam, and the reason we torture you with dilation drops is because we can detect things. I’ve diagnosed four brain tumors in the last year. I’ve sent patients out for diabetic screenings, and they’ve had diabetes. Because of just simply something I found in the back of the eye.

DrMR: Yeah, I know. I think it’s a great point. And I think this is really salient to my audience, because we learn so much about functional medicine, complementary and alternative medicine, healthy diet, healthy lifestyle. And we really put people in a position where they need doctors less.

So that could erroneously make one think that they don’t need to have their checkups. And I’m very emphatic with my patients about, “No, have your checkups. I’m hoping nothing will ever be found. But you’re in a way better position if you have something found early and knowing about it than you are having it found late stage in the game.”

So as a precaution, it just makes a whole lot of sense. So I completely agree with you.

DrTZ: Yeah, is the WebMD syndrome.

Episode Wrap Up

DrMR: Yeah! Yeah. So if people wanted to connect with you, Travis, follow your work, or try to plug in for your drops or your sprays, where can they connect with you or track you down?

DrTZ: Yeah, thanks for allowing me to do this. So the easiest way to contact me is through Facebook. If you go to Facebook and search “dry eye,” you’ll find the Dry Eye Syndrome Support Community. We’re actually usually the first one that pops up. And that’s a group of about 3000 of us. We’re growing by about 20 per day. But you can tag me in there.

We do a Facebook Live every Sunday at 5 pm where we answer any questions you have about dry eye or about the eye in general. We’ll pretty much answer anything. And that’s always a fun time. We do that Sundays at 5 pm, Facebook Live on the Dry Eye Syndrome Support Community.

Our website is EyeLoveTheSun.com. That’s E-Y-E Love the Sun.com. And our company is called Eye Love. The sprays and our omega-3 and macular degeneration supplements are all there. The spray is actually one of our favorite products we’ve come out with pretty much ever. It’s a prescription spray that was costing about $300 a month to our patients. And we found a way to make it over the counter.

And the reason we love this spray—there are other things out there to clean your eyelids and help with your dry eye, but they’re filled with chemicals. And I counted the ingredients in some of them. There are 13 to 26 chemicals on average for these blepharitis treatments. And the spray is three. We have hypochlorous acid, which your immune system naturally makes to battle bacteria. And we just give your immune system a boost. It’s water. And it’s salt. And that’s it.

And so it’s a very soothing spray. And you spray it right on your eyelids if you have problems with sties or just dry eye in general. If your contact lenses get uncomfortable, the spray is great. And I recommend if you wear makeup, everybody should use this spray.

So we’re pretty excited about the spray. We just launched it in June. So it’s pretty new. But we’ve got close to 4000 patients on it already. So we’re pretty excited about it. So that’s at EyeLoveTheSun.com.

If you want to get on our email list and get a free dry eye book from my wife and a free video series about dry eye, you can go to DryEyeCommunity.com. Just put your email address in there, and we’ll send you all those goodies right there that I just discussed and some other bonuses there. And yeah, we’d love to connect with anybody in your audience that’s suffering from dry eye.

DrMR: Awesome! Awesome. And then one quick question just came up when you said the word sun. I’ve heard some people recommend or state that it’s good to look at the sun early in the morning, late at night. I think it’s called sun gazing. Do you have any thoughts on that?

DrTZ: I knew what you were getting at right when you said that. Please don’t look at the sun. Yeah, there are interesting studies with that. And when the sun is setting and the sun is rising, it’s not as powerful. But you’re still looking straight at a very powerful structure that pretty much emits UV light straight at you.

And you can think of a magnifying glass when you used to burn things with it. You may have never done this. But you’ve seen it in movies where people take a magnifying glass, harness the power of the sun, and they burn something with it.

Well, that can happen in your eye because your eye is a focusing mechanism. So if you were to happen to focus that sunlight just right, you can burn a hole in your macula. And then therefore, you have a hole in your vision for the rest of your life. That’s why I hated the eclipse event that came out. Are you in Oregon? Is that correct?

DrMR: I could say that. I’m in northern California. So we got a glimpse, yeah.

DrTZ: Yeah, so you got to see a little bit. But we’re in South Carolina. We got the total solar eclipse. And I just remember. I was at a park, and there are 500 people staring at the sun. Some had their eclipse glasses on. It just made me really nervous as a healthcare practitioner. But it was a pretty neat event.

But yeah, sun gazing. Again, no studies support that. It can be dangerous because if it focuses inside your eye wrong, you’re blind. And that’s permanent. You can’t get rid of that.

DrMR: Gotcha. Well, good point. I think we’ve given people plenty of other constructive things to do where maybe they don’t have to worry about the purported benefits of the sun gazing. So thank you for weighing in on that.

And thank you for taking the time. This was a great episode. And I’m glad we got to get some information out there to our audience about eye health. Obviously, an important topic. So thank you again for you time and for all the good work you’re doing.

DrTZ: Yeah, thanks for having me on.

DrMR: My pleasure.

What do you think? I would like to hear your thoughts or experience with this.

Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.

Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!

28 thoughts on “How Dysbiosis and Nutrient Deficiencies Impair Eye Health and Cause Everything from Dry Eye to Vision Problems with Dr. Travis Zigler

  1. I’m surprised that one of the points that wasn’t pursued in this interview is that blepharitis is also known as ocular rosacea and its inherent connection to SIBO.

    At age 55 I developed blepharitis out of the blue, and it happened 3 months following my having developed acute rosacea of the face (which is now chronic). My ophthalmologist confirmed what I believed: that they are related and are due at least in part to gut dysbiosis. But it wasn’t until I stumbled across articles that linked SIBO with rosacea that I realized that I might have SIBO. After going through 2 functional medicine doctors who wouldn’t even have me tested, I finally got in to see Chris Kresser (author of some of those articles which were cutting edge back then) and he agreed that I should be tested. And that testing determined that I have methane type SIBO. I’ve tried many treatments (but not antibiotics) and I still have both SIBO and rosacea (both symptomatic and confirmed thru re-breath testing).

    This causes me to believe that dysbiosis of the gut impacts the dysbiosis of the skin and eyelids and eyes, and is the reason why I developed blepharitis (and have also been prone to sties since then). On my first visit with my ophthalmologist for blepharitis, I told him that I had SIBO and he was stunned because that same week that he’d had another new patient with the exact same combination of conditions and diseases. At the time, this gut to eye connection was a relatively new idea for him, and one that he has pursued since then in his ongoing studies and treatments with dry eye.

    At his recommendation, I have used all of the therapies mentioned in this interview. I would have loved to have seen more in-depth discussion in this interview about specific dietary and environmental influences on dry eye. Omega 3 yes, but how much, how often, what form and what types of foods are most effective? Also, I began cycling in 2017 and developed a sty during a bike ride which remained persistent for about a month and then re-flared again later during a bike ride in Europe (fortunately there where 2 MD’s on our cycling tour who also have blepharitis and who were able to get prescription drops for me same day at a French pharmacy!). Those 2 docs commiserated with me about therapies, and we all seemed to have the same daily eye routines and all found that the best prevention was daily heat compresses (which is what my own doctor told me too!). IMO the tea tree soaps etc, are a band aid, so to speak, and can also cause my eyes to feel too dry. If we don’t address the internal dysbiosis, it will be an ongoing problem. I just haven’t yet figured out how to do that.

    Three other prevention/control steps:
    I stopped wearing eye makeup because my doctor confirmed that that would be ideal if I was willing, in order to keep external substances from causing any clogged glands along the eye margin and lash follicles.

    I’m convinced that the wind blowing on my eyes (even with good wrap style sunglasses) causes my eyes to tear and cause sties, perhaps as a reaction to dry air. Both of my sties (the second being a recurrence of the first) occurred while riding at speed. Obviously, I need to find better eye protection. On windy days if I’m outside, I wear sunglasses whether or not they’re needed, for that reason.

    Changing pillow cases very often! I try to do this twice per week.

    I’d love to see a follow up interview pursuing some of these issues, especially the underlying gut dysbiosis/SIBO connection and dietary, etc recommendations.

    1. Thank you, Susan, for making the connection between SIBO and ocular rosacea. and also for the great advice on prevention/control steps, including your endorsement of the daily heat compresses. You sound as cautious in your handling of SIBO as I am. I read and study everything, but haven’t made any huge decisions yet.

      1. My doc introduced me to the EyeEco brand (goggles and green bead pillows) for moist heat compressing (not the instant blue ones that are for dry heat — they can help too, but my doc says that moist heat is best).
        At first I resisted using them regularly, but now I love them and they saved my eyes in France. A side benefit is that they are extremely calming to the mind and put one into a meditative, and often sleep state, so I find them incredibly useful to use at bedtime. They also block out artificial and ambient light, so excellent for sleep time prep. Also great (with or without the moist heat inserts) for airplane travel to protect from all of the dry air and lights.

    2. Hi Susan,
      Very interesting and thank you for pointing out this connection. I will make a mental note for the next time we discuss eye health. I’m curious to see if your eyes will improve after treating SIBO. My book will have a self-treatment plan for SIBO that should allow you to clear it. If you do this please let me know what happens with your eye health.

      1. From Dr. Axe’s website:
        Although rosacea is considered a skin condition, it affects the eyes in 58 to 72 percent of cases.

        Although you can have blepharitis without rosacea, it is very common in those with rosacea.

        Since there is a causal relationship (88% or something like that) of rosacea to SIBO, then it follows that blepharitis is another symptom of SIBO, am I right?

      2. I look forward to seeing your book. I’m willing to try anything (except the antibiotics because I’m not convinced that they are effective in irradiation and cause cause more problems than help).

      3. Also, an excerpt from a Chris Kresser article and broadcast:

        “Chris Kresser: Yeah. It’s really fascinating. I don’t know if you saw this, a recent follow-up from an original study that was done showing 100 percent correlation between acne rosacea and SIBO patients, and then they follow them for several years and found that 100 percent of people who successfully eliminated SIBO had a significant improvement in their rosacea. So, it wasn’t just an association, they actually were able to prove causality there, which is pretty amazing.”

        He also told me the same thing directly in an office visit with him.

        So if it’s 100% causal b/w SIBO and rosacea and 60-70%+ people with rosacea go on to develop ocular rosacea, then doesn’t that demonstrate a very high correlation (if not causation) b/w SIBO and blepharitis?

  2. I’m surprised that one of the points that wasn’t pursued in this interview is that blepharitis is also known as ocular rosacea and its inherent connection to SIBO.

    At age 55 I developed blepharitis out of the blue, and it happened 3 months following my having developed acute rosacea of the face (which is now chronic). My ophthalmologist confirmed what I believed: that they are related and are due at least in part to gut dysbiosis. But it wasn’t until I stumbled across articles that linked SIBO with rosacea that I realized that I might have SIBO. After going through 2 functional medicine doctors who wouldn’t even have me tested, I finally got in to see Chris Kresser (author of some of those articles which were cutting edge back then) and he agreed that I should be tested. And that testing determined that I have methane type SIBO. I’ve tried many treatments (but not antibiotics) and I still have both SIBO and rosacea (both symptomatic and confirmed thru re-breath testing).

    This causes me to believe that dysbiosis of the gut impacts the dysbiosis of the skin and eyelids and eyes, and is the reason why I developed blepharitis (and have also been prone to sties since then). On my first visit with my ophthalmologist for blepharitis, I told him that I had SIBO and he was stunned because that same week that he’d had another new patient with the exact same combination of conditions and diseases. At the time, this gut to eye connection was a relatively new idea for him, and one that he has pursued since then in his ongoing studies and treatments with dry eye.

    At his recommendation, I have used all of the therapies mentioned in this interview. I would have loved to have seen more in-depth discussion in this interview about specific dietary and environmental influences on dry eye. Omega 3 yes, but how much, how often, what form and what types of foods are most effective? Also, I began cycling in 2017 and developed a sty during a bike ride which remained persistent for about a month and then re-flared again later during a bike ride in Europe (fortunately there where 2 MD’s on our cycling tour who also have blepharitis and who were able to get prescription drops for me same day at a French pharmacy!). Those 2 docs commiserated with me about therapies, and we all seemed to have the same daily eye routines and all found that the best prevention was daily heat compresses (which is what my own doctor told me too!). IMO the tea tree soaps etc, are a band aid, so to speak, and can also cause my eyes to feel too dry. If we don’t address the internal dysbiosis, it will be an ongoing problem. I just haven’t yet figured out how to do that.

    Three other prevention/control steps:
    I stopped wearing eye makeup because my doctor confirmed that that would be ideal if I was willing, in order to keep external substances from causing any clogged glands along the eye margin and lash follicles.

    I’m convinced that the wind blowing on my eyes (even with good wrap style sunglasses) causes my eyes to tear and cause sties, perhaps as a reaction to dry air. Both of my sties (the second being a recurrence of the first) occurred while riding at speed. Obviously, I need to find better eye protection. On windy days if I’m outside, I wear sunglasses whether or not they’re needed, for that reason.

    Changing pillow cases very often! I try to do this twice per week.

    I’d love to see a follow up interview pursuing some of these issues, especially the underlying gut dysbiosis/SIBO connection and dietary, etc recommendations.

    1. Thank you, Susan, for making the connection between SIBO and ocular rosacea. and also for the great advice on prevention/control steps, including your endorsement of the daily heat compresses. You sound as cautious in your handling of SIBO as I am. I read and study everything, but haven’t made any huge decisions yet.

      1. My doc introduced me to the EyeEco brand (goggles and green bead pillows) for moist heat compressing (not the instant blue ones that are for dry heat — they can help too, but my doc says that moist heat is best).
        At first I resisted using them regularly, but now I love them and they saved my eyes in France. A side benefit is that they are extremely calming to the mind and put one into a meditative, and often sleep state, so I find them incredibly useful to use at bedtime. They also block out artificial and ambient light, so excellent for sleep time prep. Also great (with or without the moist heat inserts) for airplane travel to protect from all of the dry air and lights.

    2. Hi Susan,
      Very interesting and thank you for pointing out this connection. I will make a mental note for the next time we discuss eye health. I’m curious to see if your eyes will improve after treating SIBO. My book will have a self-treatment plan for SIBO that should allow you to clear it. If you do this please let me know what happens with your eye health.

      1. From Dr. Axe’s website:
        Although rosacea is considered a skin condition, it affects the eyes in 58 to 72 percent of cases.

        Although you can have blepharitis without rosacea, it is very common in those with rosacea.

        Since there is a causal relationship (88% or something like that) of rosacea to SIBO, then it follows that blepharitis is another symptom of SIBO, am I right?

      2. I look forward to seeing your book. I’m willing to try anything (except the antibiotics because I’m not convinced that they are effective in irradiation and cause cause more problems than help).

      3. Also, an excerpt from a Chris Kresser article and broadcast:

        “Chris Kresser: Yeah. It’s really fascinating. I don’t know if you saw this, a recent follow-up from an original study that was done showing 100 percent correlation between acne rosacea and SIBO patients, and then they follow them for several years and found that 100 percent of people who successfully eliminated SIBO had a significant improvement in their rosacea. So, it wasn’t just an association, they actually were able to prove causality there, which is pretty amazing.”

        He also told me the same thing directly in an office visit with him.

        So if it’s 100% causal b/w SIBO and rosacea and 60-70%+ people with rosacea go on to develop ocular rosacea, then doesn’t that demonstrate a very high correlation (if not causation) b/w SIBO and blepharitis?

  3. Hi, what about if your eyes are healthy and they are functioning very well but you have blurred vision? There is no mention of blurred vision caused by biotoxins, brain inflammation or traumatic brain injury. There are 12 cranial nerves and 4 are dedicated to the eyes. Why isn’t there any mention of the role the nerves to the eyes play, and the tool to measure the effects of biotoxins on the brain which causes blurred vision, this is a Visual Screen Contrast test.

    1. There are also some amazing diagnostic tools that ophthalmologists have now to look inside of the eye in a way that is like a microscope into the overall heath of the body. I’ve heard some amazing stories about how warning signs seen this way have diagnosed catastrophic health conditions before they were otherwise known to exist.

  4. Hi, what about if your eyes are healthy and they are functioning very well but you have blurred vision? There is no mention of blurred vision caused by biotoxins, brain inflammation or traumatic brain injury. There are 12 cranial nerves and 4 are dedicated to the eyes. Why isn’t there any mention of the role the nerves to the eyes play, and the tool to measure the effects of biotoxins on the brain which causes blurred vision, this is a Visual Screen Contrast test.

    1. There are also some amazing diagnostic tools that ophthalmologists have now to look inside of the eye in a way that is like a microscope into the overall heath of the body. I’ve heard some amazing stories about how warning signs seen this way have diagnosed catastrophic health conditions before they were otherwise known to exist.

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