RHR: The Ocular Microbiome, with Dr. Harvey Fishman

In this episode we discuss:
What is the ocular microbiome?
How the microbiome affects eye diseases
T cell activation in the eye
HLA-B27 and genes that play an important role in immune function
A nutrient-dense and anti-inflammatory diet for eye health
Antibiotics prior to surgery
Show notes:
Dr. Harvey Fishman's website: fishmanvision.com

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Chris Kresser: Dr. Fishman, welcome to Revolution Health Radio. I'm so happy you could join us. I've really been looking forward to this.
Dr Harvey Fishman: Thank you so much for having me, Chris. This is wonderful.
What is the ocular microbiome? Chris Kresser: So, my audience has been well aware of the gut microbiome for many years. We've also talked about the skin microbiome. We talked about the vaginal microbiome, the lung microbiome, more recently the nasal microbiology, and so it's not surprising to learn that there is also an ocular microbiome. I'm really looking forward to talking to you more about this and how it contributes to eye disease. Because in the conventional world, the options for preventing eye disease in the first place and then addressing them, I think, have come a long way but maybe still leaves something to be desired. I'd first love to start out with just hearing a little bit more about your background, how you became interested in the ocular microbiome in your work as an ophthalmologist, and what led you down this path.
Dr. Fishman: That's great. So, I have a pretty interesting background, where I started off in the world as a physical chemist, studied neuroscience. I was in an analytical chemistry microfluidic laser lab at Stanford and really got interested in how to measure molecules almost at the single molecule level. We were looking at vesicular and synaptic release, neurotransmitters, and what the chemical basis of learning and memory was.
 You’ve heard of the gut microbiome—and maybe even the skin, nasal, and vaginal microbiome. But did you know that the eyes also have a microbiome and that it plays a key role in ocular health? 
That was sort of my background, and then I sort of did some interesting work in neurobiology, looking at retinal cells and how they grow and their regeneration, so I've had a lot of sort of technical background and analytical chemistry background. And then the last couple of years,