Dry Eye: An Interview With Corneal Specialist Dr. Peter Polack

Found on: https://www.wheatbellyblog.com/2018/07/dry-eye-an-interview-with-corneal-specialist-dr-peter-polak/

I met ophthalmologist and corneal specialist Dr. Peter Polack while speaking in Ocala, Florida. He told me that, by having his patients with dry eye—which has increased dramatically over the last 20 years—remove all wheat and grains, he is seeing this condition reverse within weeks, along with all the other health benefits.

Unlike other ophthalmologists, who virtually have nothing to do with diet and therefore prescribe the costly drugs Restasis and Xiidra (each cost $500-$550 per month), Dr. Polack rarely has to resort to use of these awful agents.

Here Dr. Polack speaks about his phenomenal experience.

More about Dr. Polack and Ocala Eye can be found here. Dr. Polack also invites questions about dry eye: http://bit.ly/dryeyequiz. (The personal info is not required to post questions.)


Dr. Davis: Thank you Doctor Polack, for agreeing to tell us about your experience. Now, I met you in Ocala., when I was there to speak, and you shared with me some of your stories about eye health. Our listeners should know that you are a practicing ophthalmologist, a very busy guy, and you told me about all the incredible experiences you are having with the kind of lifestyle that I’m advocating, that now you are advocating. Could you tell us what you told me when we first talked?

Dr. Polack: Thanks for having me on. I’m a cornea specialist and what falls under my purview are such things as cataract surgery, corneal transplants and refractive surgery like LASIK and PRK, and also what are called external diseases. So that’s anything that affects the surface or the front part of the eye. And that can be anything from allergies to severe ulcerations and perforations and pretty nasty stuff.

But the other thing that falls in that category is dry eye. Now my father was a cornea specialist. He actually was a professor of ophthalmology, and he would deal with severe dry eye cases — people who had reactions to transplants, graft-versus-host disease, things like that. But those are extremely rare.

As far as the garden-variety dry eye that I’m seeing, he didn’t see nearly the amount of dry eye that I’m seeing today. That kind of got me to wondering; what’s different? What’s different now than back then? I’m not the one who discovered this, but I started doing a lot of reading, and I found that, well, it’s the nutritional aspect of it. What’s happened in the last 20 years is this emphasis on low-fat diets.

It’s almost become a joke in my clinic now with the techs, when patients come in complaining of dry eye, one of the first things I asked them is well, tell me what you eat. You’ll hear a kind of snickering because they know what the patient’s gonna say: Well I’ll have cereal for breakfast. Then I have some toast, and then I have a sandwich — bread of course, whole wheat, you know, because my doctor said whole wheat’s good for me. And then I have, you know, another sandwich, and some cookies, and then I’ll have pasta. And I’ll explain: you’ve got to completely eliminate that. And they have this shocked look on their face like; What? That’s all I eat. What am I supposed to eat? And I say well you’re supposed to eat what humans were designed to eat.

I have this lengthy checklist of things to do. It covers a lot of things. It’s based on what we find on an exam and also in testing: lifestyle changes, turning your ceiling fan off at night, things like that; medications — over the counter. I try to stay away from prescription things as much as possible, much to the chagrin of the drug reps that come by and ask: You’re a dry eye specialist. How come you’re not pushing our drugs anymore?

Then at the bottom of the list, I’ve got all these books. I’ve got Wheat Belly on there, and we’re adding Undoctored now, and of course Paleo diet, and things like that. We emphasize cutting out the wheat, getting more healthy fats in the diet: grass-fed beef, grass-fed butter. Some of the most recalcitrant cases are people who are vegan and vegetarian. They just kind of give me a sneer when I tell them they got to get more fat in the diet.

I would say that, at least over the last 10-12 years, that I’ve been promoting that with patients, they’ll come back (the ones that stick with it), they’ll come back three months later and say: My eyes feel better, and also my joints don’t ache. My back is not stiff. I’ve lost 30 pounds, and what’s weird is like my blood sugar’s down and my blood pressure’s down. I say: Well, what did your primary care doctor say? They say: Well, they don’t know what it is. But I told them what I’m doing, and they say, well it can’t be that.

I think I joked to you when I when I saw you that have actually, this is true, I’ve gotten calls from primary care doctors, very upset with me, asking What the hell is the ophthalmologist telling my patients what to eat?, and I think, visually, I say okay, I know who that doctor is. That’s the guy who’s overweight. He’s on statins. He’s probably on Viagra. He’s you know getting on to me. These patients come back, and you know I haven’t done a formal study obviously, this is all anecdotal, it is a busy clinic, but I’ve been starting to collect stories and things. We may put together like a little dry guide or something and put some resources such as your books and things, but it’s just been way way too many patients.

I’m not trying to be immodest or anything, but our eye clinic — we’ve probably helped more people reduce their metabolic syndrome than a lot of primary care doctors have.

Dr. Davis: That’s absolutely spectacular. Despite the misgivings and push back you get from some of the primary care. Now of course this is not what most other ophthalmologists are doing, right?

Dr. Polack: No, it’s interesting. Dry eye treatment has become a big industry. It’s probably three billion dollars, and that’s not even looking at the lost productivity. There are these things popping up now called dry eye universities. Well, of course they’re sponsored by drug companies. There are a couple of prescriptions. You’ve probably seen them on TV — prescription drugs for dry eye. There is a place for those, if you’ve exhausted everything else. People have pretty well socked-in autoimmune disease; they’re following all the nutritional advice, and they still have this problem. So, we may get to the point that we do that.

But when you look at these [drugs], their symposia and things like that, where doctors go, to it’s basically how to put a dry eye clinic in your practice (which we do have, an accredited dry eye center). There’s not a problem with that. The problem is that it is sort of structured around these prescription medications.

Dr. Davis: These drugs for dry eye are pretty expensive too, aren’t they?

Dr. Polack: They’re very expensive, and they don’t really have to be. One of them, Restasis®, which has been around for a long time. It’s cyclosporine. Cyclosporine has been around for a long time. When my father had patients that had corneal transplants, that kept rejecting their grafts, they would actually mix up cyclosporine and things like peanut oil — because it has to be mixed in an oil. The patients would put that in their eye. This company found a way to emulsify the oil and put the drug in there. It’s a good drug. There’s a newer one called Xiidra®, and these work on sort of the inflammatory pathways in the eyes.

But of course, these people come in with all these autoimmune problems, and their whole body is just lit up with autoimmune and inflammatory things. You start talking to them about their diet, and it’s wheat, and pasta, and cereal, and bread and whole wheat, because “whole wheat’s good for you”. They’ll say “whole wheat’s good for you” We’ll always ask who they are when we hear “they say”. They is the commercials: the American Heart Association, I guess too, and the American Diabetic Association. We’ve talked about that before.

When we start asking them questions about what else is going on (review of systems, as we say in medicine), well My back hurts. Look at my joints; they hurt. A lot of these are young people, so they really don’t have a reason to be having these problems. They have gut problems; gut dysbiosis. They’ve got inflammatory bowel. We could probably come up with a syndrome to call this. They have dry eye and dry mouth. That’s called the Sjögren’s syndrome. But they have invariably have thyroid problems; invariably they have some type of joint issues, and invariably they have some type of GI issues.

It’s just this big ball of wax, and all this stuff stuck together. Almost without question, they’re eating wheat at every meal, or vegetarian or vegan, and no fat in the diet. It’s amazing. It’s really amazing to see also the turnaround of some of these patients just after 8-12 weeks of doing this, if they can stick with it.

Dr. Davis: Doctor Polack, thank you very much for sharing your very impressive experience

The post Dry Eye: An Interview With Corneal Specialist Dr. Peter Polack appeared first on Dr. William Davis.

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