Eyes & Neurodegenerative Diseases: An Integrative View

Rudrani Banik, MD

Well, thank you so much, Dr. Sharlin, for having me. It is a pleasure to be here.

Kenneth Sharlin, MD

Dr. Banik, tell the audience a little bit about yourself and about your passion for helping people with ideas, diseases, and particularly neuro-ophthalmology. What has your journey been like? How did you get to do what you do?

Rudrani Banik, MD

Sure. It all goes back to even before medical school. I was, and I knew I would be going to medical school. I was investigating some different fields. I would shadow different doctors. I shadowed a pediatrician, I shadowed a primary care doctor in psychiatry, and then one of our family friends was doing his ophthalmology residency. He said, Why do you not come and shadow me for a day? I was not sure about the eye. I was a little bit crazy about that. But I said, Okay, fine, I will come and spend a day with you. That one day changed my life. 

I followed him into the operating room. I saw how he had done cataract surgery. I saw him do surgeries on children who had crossed-eye strabismus. Then I saw him in the clinic. He was taking care of older people and younger people, a mix of different ethnicities. I said I love this field. The eye is fascinating. I think what I also realized was that, hearing him talk to his patients, he could restore people’s function by giving them back their eyesight. I thought that was so amazing—such a gift to be able to restore someone’s vision. I wanted to do that. That is how I got into Ophthalmology. But even in medical school, I kept an open mind. I delved into other fields, and I also loved Neurology. It was fascinating to me—the pathways, how the brain works, and how you can make a diagnosis based on the part of the exam and then see the anatomical basis of that, maybe on an MRI or CAT scan. 

I fell in love with neurology. Then it was at a crossroads. What do I do? Do I do ophthalmology or neurology? I decided to do ophthalmology because of the technical aspect of things. I loved working with my hands and being able to do surgeries, but neurology was always in the back of my mind in terms of my interest. When it came time to decide on further training or doing a fellowship, I said, I am just going to do neuro-ophthalmology because it blends both of these fields so well. Now, I am just so fortunate to be able to do what I do, practicing as a neuro-ophthalmologist because it is the best of both worlds.

Kenneth Sharlin, MD

Wow. As I understand it, your journey has gone beyond the traditions of neurology and ophthalmology to explore the impact of food as medicine. You have written a book about, Beyond Carrots.

Rudrani Banik, MD

Yes, absolutely. When I began my career in Ophthalmology, I was an Academic Medicine student, and I did that for about 15 years. I thought that was what I would be doing. I would be doing only neuro-ophthalmology. However, I encountered a health issue of my own, which was chronic migraine. I began to have daily headaches—horrible, debilitating headaches. I tried all the medications out there on the market, and nothing was helping me. After about three or four years of having a daily migraine headache, I said, I had to find a different solution. That is when I stumbled across integrative and functional medicine. 

Before I had my health issues, I had never even heard of these fields of medicine. Was never taught in medical school the importance of nutrition and the importance of lifestyle. But I was intrigued and said, I have to do something for my health. I started to take some training in functional medicine. I started to do certification in it, and I started to implement what I learned from my own life and my own dietary choices. what I was eating, what I was choosing to do, and my habits. I implemented those. Finally, I started to feel better, and I said, Wow, this is so incredible that it made such an impact on my health journey.

Instead of having headaches 30 days a month, I went down to having headaches maybe for five days a month, which is a huge improvement in my quality of life. Then, once I started studying the benefits for myself, I started to implement some of these changes for my patients. That is, when I saw the magic starting to happen, when I would recommend to my patients each dietary change and their health would start to turn around. I saw patients who came to me with double vision, for example, from diabetes or high blood pressure-related issues, and I told them about these changes, once they implemented them, some of them were even able to get off of their blood pressure medications and off of their diabetic medications. I said, This is what I want to do. I want to integrate all of these things I have learned from functional and integrative medicine into my routine care of patients. That is what I do now. I do bring together the best of these two different worlds, which should be taught earlier in training. We should all be taught about these approaches to health because they are the foundation for achieving optimal health.

Kenneth Sharlin, MD

That is wonderful. Now there is an old expression: The eye is the window to the soul. From my learning, the eye is not just the window to the soul, but it is also a window to understanding its many diseases. Many chronic diseases are a microcosm, is it not? Why is it? What can we learn from the eye?

Rudrani Banik, MD

The eye is intimately connected to all of our organ systems. You may think it is a small organ; it works in isolation, but it does not. First and foremost, it is a direct extension of the brain. so it is part of our central nervous system. There are so many neurologic conditions that we can diagnose through an eye exam. Beyond that, there are many other conditions we can diagnose through an eye exam. I mentioned earlier diabetes and high blood pressure. There are countless patients I have diagnosed with both of those conditions simply through an eye exam. 

Some of those findings on the eye exam are asymptomatic. You may not even know that you have early diabetic retinopathy unless you go to the doctor—the eye doctor—and get a dilated exam. It can be important in the diagnosis of conditions. Then there are other conditions. There are autoimmune conditions that can be diagnosed based on an eye exam. You mentioned earlier that the eye is a window trial. It is a window to our general health. I think I counted once there are over 200 systemic conditions that can be diagnosed based on an eye exam. It is fascinating. It is truly a window into how all of our organ systems are doing.

Kenneth Sharlin, MD

Now. I am wondering, what are some of the eye conditions that can affect people with Parkinson’s disease?

Rudrani Banik, MD

There are many, and I will group them into five categories, we can go through each of them and talk a little bit about what are the symptoms, what are the findings, and maybe some of the treatments that can be used. The first thing I would start with is Dry Eye and Black Friday’s. We combine them. Many people with Parkinson’s and Parkinsonian-type conditions have dry eyes, and there are various reasons why one may have dry eyes. I have Parkinson’s. The most common reason is because there is a decreased blink rate. We know that people with Parkinson’s have slow movements and bradycardia, and in terms of their eyes, they blink less. Normally, an individual would blink about 15 to 20 times a minute. People with Parkinson’s probably blink about five times a minute. When they do not blink as much, they are not lubricating their eyes. When the blanket spreads, the tears over our cornea help to lubricate. We are just not lubricating enough. When we blink less, and also when the tears start to evaporate when we are not blinking enough. There, that all goes together. 

Those are two reasons for having dry eyes. Then there are so. Many. Patients that are used for Parkinson’s can also cause dryness of the eyes. medication-induced dry eye, and then blood ferritin causes inflammation of the eyelids, where there are almost dandruff deposits that develop on the margins of the eyelids where the lashes come from. That can also lead to dryness. There are, again, many reasons why people with Parkinson’s may have dry eyes. Common symptoms include blurry vision, burning of the eyes, a gritty sensation, or a sandy sensation in the eyes. what she for these two, a few, or a loved one. That is one of the first things to come about. I think I would say that in my practice, which is again biased towards neurology and neurological issues, about 90% of my patients have some form of dry eye. It is very, very common.

Kenneth Sharlin, MD

I am going to say with the caveat of talking to your doctor first, but I am curious: what are some of the more common medications that can cause dry eyes that a Parkinson’s patient might be taking?

Rudrani Banik, MD

Absolutely. Discuss it with your doctor, and also coordinate your care with your optometrist or ophthalmologist. If there is a potential cause-and-effect issue, then maybe consider switching medications if it is feasible. I think overall, though, if you need a medication to manage your Parkinson’s, you need that medication. But maybe the dose could be adjusted, or the timing could be adjusted, etc. There are things that you can do. Then separately, there are many things you can do for dry eye, starting from the basics, which is just use lubricating drops and over-the-counter lubricating drops. 

But in my practice, I also incorporate a lot of nutritional guidance for people who have dry eyes. What are some foods that they could eat or include in their diet to help support their dry eye? Also, what are some supplements people can take to help them with their dry eye? Then, of course, lifestyle factors, which are vital in managing dry eyes. Many things are within people’s control that they can address and incorporate into their lives to help them with their dry eye symptoms.

Kenneth Sharlin, MD

Yes, just specifically if folks are wondering that, to my knowledge, the most common medications that can contribute to dry eyes that are used in Parkinson’s to some extent, although I must say less and less, are the anticholinergic drugs. But trihexyphenidyl, Artane, and Cogentin; that thing could be gentle. They are also used in psychiatric disorders to some extent, although I would say in general. With the growth of the available pharmacological interventions for Parkinson’s and the realization that this particular class of drugs has some unwanted side effects for sure, I would say the trend is moving away from using these drugs in general, although would you agree they would find their way in other ways? 

That is very concerning to me as a more holistic neurologist. For example, sleep, of course, is a huge problem in general for our society, and the availability of over-the-counter sleep aids is ubiquitous. Too often, these sleep aids utilize antihistamine drugs. But these antihistamine drugs—by the way, histamine is the neurotransmitter of wakefulness. When we use an antihistamine, we are blocking the neurotransmitter of wakefulness. However, drugs have more than one pharmacological target. 

Often, these antihistamine drugs are also anticholinergic. We are talking about things like diphenhydramine or Benadryl. If used over and over and over again, there can be some potentially very serious consequences. Even if you have seen it over many years of training and practice, occasionally someone can take just a single dose of an anticholinergic drug and end up in the hospital in a delirium state. While we are certainly, again, not saying, Hey, look at your drug labels and your bottles, and we do not want anyone stopping their medication, that is a talk with your doctor. It is just an awareness that that class in particular can have a pretty profound effect on the eyes and the brain.

Rudrani Banik, MD

I am so glad you brought that up, Dr. Sharlin because many people take over-the-counter drugs. The antihistamines you mentioned for allergies also, and may not realize that what they are taking for their allergies is contributing to their visual issues, their dry eyes. It is important every time you go to see an eye doctor, take your list of medications with you. If there is a finding on your eye exam, share that list, and ask, could any of my medications be contributing to some of the visual issues that I am having? Some of the anticholinergics can also lead to blurry vision. It can affect our powers of accommodation. It may make it more difficult to read. Again, all of these symptoms may be a result of thinking about what the root cause of something is. You may have an underlying medical condition that is the root cause of something, but you may also have a medication that is the root cause of some of your symptoms. Think about this for some time. You have to be your detective and bring up these issues with your provider and have a discussion about them.

Kenneth Sharlin, MD

Wonderful. Now, when I think of Parkinson’s in the eyes as a neurologist, I also think about eye movement abnormalities. Can you talk a little bit about that?

Rudrani Banik, MD

Sure. Parkinson’s can certainly affect our eye movements in several different ways. The most common symptom that many people with Parkinson’s have is that they have trouble reading. The reason why movements are involved here with trouble reading is that when we look at distance or eyes in parallel, they are straight. But when we read our eyes slightly, turn in a little bit. This sense of Convergence. Do this. It is part of our normal physiology, our training a little bit so we can read and have depth of field when we are reading now. People with Parkinson’s begin to lose that ability to converge their eyes. That is the medical term, which is convergence. They lose that ability. Instead of our eyes turning in when we are reading people with Parkinson’s, their eyes may start to drift out. This is a condition called convergence insufficiency, which is highly common in people with reading issues like Parkinson’s. It may make it very difficult to focus when reading, but sometimes it can lead to double vision when reading. Instead of seeing a single word or single letter, you see overlapping letters and overlapping words. Typically, the duplication is horizontal. The words are shifting in and out, horizontally as opposed to vertically. That tends not to happen so much with Parkinson’s. It is more of the horizontal shifting that people say they notice or may report. Now, what can you do about that?

Well, what I typically recommend for patients, if they have mild convergence insufficiency, is that they do some exercises, and they are very simple exercises one can do. They are called pencil push-ups. I do not know if you have heard about this before, Dr. Sharlin. It is very simple, but you take a pen or pencil, so I will just mimic it with my finger. You look at the tip of that pen or pencil, and you hold it at arm’s length, and then slowly you bring that tip back. Closer to yours. Nose.  At some point, that tip will start to get blurry. then, at some point, that tip will split into two. It will start to look double to you. That is where you want to stop. When it starts to split into two images, you hold it and try to focus it back to single. When it starts to become double, that means your eyes are starting to diverge. They are moving outward. You want to try to strengthen those muscles to keep them single and hold them for about 10 seconds. Anything can. You bring it slowly closer to your nose as possible.

Now, when we are young, children, for example, can get almost to the tip of their noses and keep single. But most adults will probably get about three or four inches away from their nose. That is the goal. Now, some people with convergence insufficiency are only able to hold it up to here, and then the image starts to split. Again, practice this exercise every day and try to get as close to your nose as possible, with the goal being about three or four inches from your nose. That will help a lot when you are reading. If that is not sufficient, Let us see if you have been trying these convergence pencil push-up exercises. It is still not working. You are still seeing double. Then go visit your eye doctor. Sometimes what we can do is put a prism inside your glasses, and the prism will help you keep the images single. Instead of seeing double, That is a great alternative for convergence insufficiency. If that does not work, then sometimes, and this is in the most extreme of cases, surgery may be required to help the eyes converge a little bit, but it is again very rare that we have to include that type of intervention in our treatment.

Kenneth Sharlin, MD

Now, when we think about neurodegenerative Parkinsonism as a whole, there are some distinguishing eye movement features that may swing the pendulum more toward a condition that is not Parkinson’s disease but related to Parkinson’s. I am thinking of the multiple systems. atrophy, of course. Can you help folks understand why we, as neurologists and neuro-ophthalmologists, just look at eye movement when we are evaluating our patients with Parkinsonism and what we will see?

Rudrani Banik, MD

Yes, absolutely. Sometimes the eye movement exam can help guide us in one direction or another, or perhaps something else. You mentioned multi-system atrophy, but there is another condition that is Parkinsonian, which is progressive supranuclear palsy, or PSP. Sometimes the eye exam can help us distinguish between these various kinds of sound waves. The other things,  in addition to divergence, we look at are: how do the eyes track? We do a test called pursuit, and we see how the patient tracks that target, moving very, very slowly across their vision. Normally, when one is tracking, it is a smooth movement, but oftentimes in Parkinson’s, it is almost a jerky type of movement, what we call a cog wheel pursuit or psychotic pursuit. We may think more if we notice that it is not moving smoothly. This could be Parkinson’s disease or multi-system atrophy, which can also cause a jerky type of pursuit movement. 

The other thing we check is saccades. Saccades are fast eye movements. In contrast to pursuits, which are slow movements, saccades are fast movements. We have the patient look to the target in their periphery to see another target. We see how accurately they can move their eyes to that target. Again, that is called a saccades. Sometimes, in multi-system atrophy, saccades may be insufficient instead of getting to the target. It may look slightly off-target. Then after we fixate on that target, an undershooting saccades is what we call it. We look for that on the eye exam, and it can be very strong. Sometimes patients have trouble if they are following a moving object, or maybe they are in a car, and they are having a lot of disorientation when they are in a car because they are having trouble with their moving vehicles or other targets that they are trying to look at. This may explain a lot of their symptoms. 

In progressive supranuclear palsy, or PSP, the condition I mentioned earlier. Usually, vertical movements are affected first, in contrast to Parkinson’s and MSA, where horizontal movements tend to be affected first. In PSP, vertical movements are slowed, so patients may have a lot of trouble looking down. For example, they have trouble breathing, or if they are trying to eat a meal, they have trouble looking down to see their food. Oftentimes, they may miss something if they try to work on something; they may miss the food on their plate, or they may end up on the floor because they are not able to look down very well. This is very special. Things we look for on an eye-decrement PSP, and some of them are slightly subtle, so you may have to see a neuro-ophthalmologist; perhaps a general ophthalmologist may not be so tuned in with some of these subtle changes.

If you have some of these issues or some of these symptoms, try to get in touch with another ophthalmologist. Another symptom that can happen about eye movements is what we call square wave jerks, where the eyes, instead of looking at something and being focused on it, tend to veer off a little bit and then veer back. What we may see on an eye exam are these very, very fine movements. It is different from something else called nystagmus. These are very fine horizontal movements that go off target and then back to target, off target, and then back to target. Again, square wave tricks can be seen in mainly MS, but they can also sometimes be seen in Parkinson’s disease as well.

Kenneth Sharlin, MD

That is fascinating. I want to ask you: you have trained through the Institute for Functional Medicine, I believe, and so did I, and there is a series of lectures that are given routinely about the nutritional physical examination. A big part of that is the eyes. I am just curious if you use some of that in your practice and if you notice changes in the eyes that you attribute to nutrient-specific imbalances.

Rudrani Banik, MD

I have attended those lectures. I have not found them to correlate as much with the specific neurologic basis of disorders. I have not found that there are specific nutritional deficiencies, for example, that may be associated with abnormalities in pursuit or abnormalities in seconds or square wave jerks. It is more so the underlying neurologic condition that tends to cause some of these issues.  The reason I say that is because I always include nutrition in my treatment protocols for my patients. I do treat them; if they have certain B-to-B vitamin deficiencies, then I do recommend certain supplementation or including foods with B vitamins; or if they have a magnesium deficiency, 

I do recommend magnesium foods, rich foods, or supplementation. I have heard from my patients that some of their other symptoms to improve, for example, spasticity neuropathic pain, or cramping fatigue. But I have not seen changes in their eye exam when we replenish those nutrients. I guess my point is that, after nutritional treatment or supplementation, I have not seen those eye exams. The motor exam changes in reverse. That is why I am saying I have not seen a benefit when using those types of nutritional treatment interventions for my patients with some of these issues. It is unfortunate. You would hope that people would with these. improvement issues, but I have not experienced that.

Kenneth Sharlin, MD

I do not use that nutritional eye exam much in my practice, but I know that certain nutrient imbalances can present with specific findings in and around the eye, with the little lids, the eye itself, and so forth. Sometimes it can be a clue that you might want to get this checked because, very often, when I see this, it can suggest that you have a specific nutrient imbalance. But I agree.

Rudrani Banik, MD

We know that there is one when there is one nutrient that is in doubt, so I would change this item. We can certainly diagnose vitamin A deficiency by looking at the ocular surface. Many people with vitamin H have a deficiency and also have dry eyes. That is one vitamin that I tested for and supplemented with for Bennett, with benefits that I have seen. It is important to think about the nutritional status of the eye. The other thing that I always ask my patients about in terms of their diet, and sometimes I do terms for them as well, are the omegas. the ratio between omega 3 to 6, and I have found that when patients have an improved rate and improved ratio, normally the ratio we would say is anywhere from four, omega 6 to 3 ratios, 4 to 1. Sometimes they have a much higher ratio. For example, to normalize the omega-3 ratio, I have seen benefits in dry eye and some issues with contrast sensitivity because we do need omega-3 for our retinal health. I have had patients there make a ratio and notice that the quality of their vision is better or that their night vision is better. It is something to consider in that respect as well.

Kenneth Sharlin, MD

Yes. Now, as a neurologist, sometimes I see patients who’ve maybe started with the ophthalmologist and they say, Go see the neurologist first, or maybe I might say, As a neurologist, I can see the ophthalmologists might say that what I am getting to is that the eyes essentially are the receivers of light and the translators of that light information into electrical and chemical information that then the brain can understand. But all of that is ultimately interpreted in the visual cortex of the brain. Then signals are, of course, sent out to other association areas. We can maybe associate what we see with our knowledge of what that is, how it smells, how it tastes, and so on. But I am just wondering: can you offer the folks watching this any clues that if they are experiencing a visual symptom, it may not always be the eyes themselves? What should we be thinking about? Maybe that is not your eyes, but your brain.

Rudrani Banik, MD

Yes. The connection between the eye and the brain is intricate and complex, but there are certain things that one should watch out for, and I would say the main thing is loss of peripheral vision. if you are in the back maybe you are sighted or on one side; that could be a brain issue. Some people notice that they come in. We do a test called a visual field test. It is when we formally evaluate their peripheral vision and their peripheral visual field that we find a deficit. that can be caused by something, for example, a stroke in the brain, in the visual cortex of the brain, or some of the associated visual association pathways of the brain, the temporal lobe or the parietal lobe, or there could be something more serious, for example. An aneurysm or a tumor,  there are many patients that I have been diagnosed with. For example, the pituitary tumor Can cause loss. Of peripheral vision. That is something, Doctor; they can do the visual field test. It is a very straightforward test to do. A lot of patients do not do the test, but it is very important. It gives us a lot of clinical information and helps us to localize where the brain’s problem may be.

Other things that can be a brain issue are, for example, loss of color, vision, or contrast. Sometimes it is not the eye that is the problem. It is the brain that is the problem because the brain is not able to process the information supplied by the eyes. There could be cerebral causes for these issues. Again, the same types of conditions may cause some of these changes in color perception or contrast. Again, the top things would be strokes, tumors, and aneurysms. It is important to, if you are having any of these symptoms, share them with your doctor, or your eye doctor. 

If necessary, they may refer you to a neurologist or two in her ophthalmologist to further investigate. Sometimes people have trouble reading. For example, it is not that they cannot see the words; it is not that they cannot process the words or that they are missing part of their vision. They can only see the left half, and they are missing the write-off. All of these types of symptoms do need to be investigated further with either a neuropathic exam or a neurologic exam, and possibly even some imaging with an MRI, to find out what the cause of this is and make sure nothing more serious is going on. 

Kenneth Sharlin, MD

Yes, I am a big fan of Dr. Oliver Sax’s writing, and so it was the book The Man Who Mistook His Wife for a Hat that inspired me to become a neurologist that he has, and that is not related at all, of course. But he has written a little bit more specifically about the visual cortex and some of his insights into human existence. Ultimately,  that is what he was writing about the human journey. I am just curious. We’ve talked about nutrition, and this is critical to eHealth. What are some of the other integrative approaches to managing these issues that we see in conjunction with neurological disease?

Rudrani Banik, MD

In my practice, I use nutrition as the foundation, but lifestyle is also very important. I asked the patient, How much sleep are they getting? How much movement do they have in their day? I try to stay away from the word exercise because I know some patients are intimidated by the word. movement; are they walking? Are they stretching, or are they sitting all day? These are important. Then what are their stressors? I think that perhaps one of the elephants in the room when it comes to a lot of neurologic disorders is when people are stressed out. For the cause, it may be their neurologic symptoms. I talked to them about mindfulness. I know you recently had an interview about mindfulness as well. 

These are all topics. I think that most providers may not broach with the patients or may not ask about them. I think it is important to put it all together. Your nutrition, your sleep habits, healthy sleep habits, blue light exposure—that is another, especially when it comes to issues. How often are they on screens later in the day? Yes, we are all on screens for the majority of the day, but particularly towards the evening after the sun has set. Could that excess screen time in the evening be linked to their sleep issues? Is it keeping them up? Is it causing their brains to race? Is it causing more stress in their lives? I talked to them about that. then, of course, I also use botanicals and sometimes even supplements, depending on what the issues are, to try to optimize one’s vision as well as their brain health. I think it all comes together. It is not just a single magic bullet, or there is no magic cure. It addresses all of these foundational aspects of health that will improve your risk, support, eye health, and neurologic health. It is important to think of it as a whole, integrated system, not just as individual organs.

Kenneth Sharlin, MD

Yes. Some people say, Dr. Sharlin, should I take this supplement? Should I take that supplement? I say that most of the time we measure, we determine what your imbalances are. If they are significant, let us use a supplement to raise those levels more aggressively. But we are always thinking about food as well, yet we cannot measure botanical levels. I am just curious: one or two botanicals that you find are frequent go-to’s in your toolbox.

Rudrani Banik, MD

I love Rosemary. Rosemary has a lot of data behind it in terms of its benefits for cognitive health. There is also some emerging science using rosemary for retinal health as well. That is one of my go-to’s. People can use it for cooking. They can use it as part of their natural food intake. But they could also use it as an oil with rosemary, or they could take a supplement with rosemary in it. Rosemary extract, among the other phytonutrients, is oftentimes neglected when it comes to eye and brain health. The macular carotenoids We can measure these. We typically do not, unless it is a clinical study. However, the macular carotenoids are pigmented nutrients. They are part of the carotenoid family. relatives of vitamin A and beta-carotene, but they are critical for eye health as well as brain health. The specific macular carotenoids that I always use in my patients are lutein and zeaxanthin. Now, they are a mouthful. They’re hard to remember and hard to pronounce, but these are yellow-pigmented molecules that our bodies cannot make. We need to get them from the diet. They get absorbed by the body. They get preferentially deposited in the macula in the back of the eye. The macula is the part of their retina that gives us our 2020 vision.

To have a 2020 vision, you need to have sufficient levels of lutein and zeaxanthin. What pigmented compounds do is phenomenal. They act as our natural blue-light filters and UV filters. When you are out in the sun, these pigments help absorb those harmful rays and neutralize them. They do the same for blue light. If you have a lot of UV exposure or a lot of blue light exposure, consider eating lots of foods rich in lutein and zeaxanthin, such as leafy greens, spinach, and kale, which are excellent sources, but also egg yolk, which is a wonderful source of lutein and zeaxanthin. There are even some herbs and spices that are rich sources of lutein and zeaxanthin. For example, cilantro, parsley, and paprika All of these have high levels of lutein and zeaxanthin. Colorful foods, including yellow and orange bell peppers, will not only benefit your eye health, but they will also benefit your cognitive health. 

There are many published side studies looking at these two carotenoids and their benefits for memory, cognition, and sleep. There are a lot of benefits that I think are overlooked. certainly consider including them in your diet and maybe supplementing if you think that you are not getting enough. I will just share with you some data in terms of how much we need. We need about 6.5 milligrams of lutein in our diet for our health. We probably need more for our overall health. Overall health, maybe ten milligrams a day. Most people on a Western diet probably only get 1 to 2 milligrams of lutein. Most of us are probably deficient in it. Again, try to boost your intake, but also take a supplement. If you think that your intake is not sufficient,

Kenneth Sharlin, MD

Now you are seeing patients. Dr. Banik, if someone wanted to come and see you at your clinic, could they do that? Can they make an appointment?

Rudrani Banik, MD

Yes, I do see patients. My practice is based in New York City, and I also offer telemedicine visits. However, based on state laws, I am only licensed in New York State, so I can see you through telemedicine. If you are in New York State at the time of the visit, That is an option as well.

Kenneth Sharlin, MD

You have a website, rudranibanikmd.com. Tell me what I’d find on that website, and what are some of your recommendations there?

Rudrani Banik, MD

On my general website, which is my full name, rudranibanikmd.com, shares a lot of great information. There are blogs on there about vision health, brain health, and migraine as well. Because I have a particular interest in migraine, the shop page on my website is for my supplement. If anyone is interested in some of the supplements I have curated for my health and brain health, they can take a look at them. I currently have five different products. One is multi-specifically curated for vision health. 

One is a specific supplement that I hope has lutein and a couple of other carotenoids that are important for vision health. It also has rosemary in it, which we were talking about earlier. Then I have an omega-3, I have a probiotic, and I have a separate supplement for migraine as well. Please take a look at that. If you are interested in anything, then my books are on the website as well. I have my book and nutrition copy on carrots, and I have a Beyond Carrots cookbook. That is a companion to the main book.

Kenneth Sharlin, MD

Excellent. Well, Dr. Rudani Banik, thank you so much for participating today in the Parkinson’s Solutions Summit. I am going to encourage the folks watching this to check out your website and your Shopify store for your excellent supplements and take care of your eyes because when you are taking care of your eyes, you are taking care of your brain, your heart, your whole body, and your well-being. It has been a pleasure to visit with you today.

Rudrani Banik, MD

Thank you so much. Dr. Sharlin. It has been my pleasure.

Kenneth Sharlin, MD

Thank you. Again.