Vision/Glaucoma/Nystagmus
Vision/Glaucoma/Nystagmus
Treatment of severe glaucomatous visual field deficit by
chiropractic spinal manipulative therapy: A prospective case
study and discussion. Gorman RF., Wingfield BR J Manipulative
Physiol Ther 2000;23:428–34)
This is the case of a 25 year old female patient with severely
reduced visual fields arising from terminal glaucomatous
retinal damage.
The woman suffered from congenital glaucoma and sought chiropractic
care for spinal pain, headache, and classic migraine. Advanced
optic disk cupping was present, and loss of vision was near
complete. A 3-degree island of central vision and a small
area of peripheral light sensitivity had remained relatively
stable for 3 years after a trabeculectomy procedure that
had resulted in intraocular hypotony.
Immediately after the first chiropractic adjustment significant
visual field improvement was recorded in the remaining eye.
Maximal improvement of vision was achieved after 1 week (4
adjustments). Total monocular visual field had increased
from approximately 2% to approximately 20% of normal. Corrected
central acuity had improved from 6/12 to 6/9. Independent
reexamination by the patient's regular ophthalmic surgeon
confirmed the results.
From the abstract:
“Recovery of vision in this patient
was an unexpected and remarkable outcome, raising the question
of whether chiropractic spinal manipulative therapy may be
of value in the management of glaucomatous visual field loss.”
The types and frequencies of nonmusculoskeletal symptoms
reported after chiropractic spinal manipulative therapy.
Leboeuf-Yde C, Axen I, Ahlefeldt G, et al. J Manipulative
Physiol Ther Nov/Dec 1999:22(9) 559-64.
“How frequently [do] patients report nonmusculoskeletal
symptomatic improvements and [what are] the types of such
reactions that patients believe to be associated with chiropractic…”
Twenty
consecutive patients from 87 Swedish chiropractors answered
questionnaires on return visits. A total of 1,504 questionnaires
were completed and returned. Twenty-three per cent of patients
reported improvement in nonmusculoskeletal symptoms, including:
- Easier to breathe (98 patients)
- Improved digestive function (92)
- Clearer/better/sharper vision (49)
- Improved circulation (34)
- Less ringing in the ears (10)
- Acne/eczema better (8)
- Dysmenorrhoea better (7)
- Asthma/allergies better (6)
- Sense of smell heightened (3)
- Reduced blood pressure (2)
- Numbness in tongue gone (1)
- Hiccups gone (1)
- Menses function returned (1)
- Cough disappeared (1)
- Double vision disappeared (1)
- Tunnel vision disappeared (1)
- Less nausea (1)
Changes in eyesight associated with upper cervical specific
chiropractic. Kessinger, Robert. Abstracts from the 14th
annual upper cervical spine conference Nov 22-23, 1997 Life
University, Marietta, Ga. Pub. In Chiropractic Research Journal,
Vol. 5, No.1, spring 1998.
This a study conducted on 65 patients
in a private office to assess the influence of upper cervical
specific chiropractic care on eyesight. Subjects’ eyesight
was examined via Snellen Eye Chart with standard testing
procedures. A before and after study was performed with
a six-week program of upper cervical specific chiropractic
care.
The study included patients who had no previous history
of specific chiropractic care and were eight years old and
older. This study indicates significant objective changes
in eyesight.
Changes in visual acuity in patients receiving
upper cervical specific chiropractic care. Kessinger R, Boneva
D. J Vertebral Subluxation Research 1998 Vol. 2 No. 1 pp. 1-7.
This
is the study of sixty-seven subjects who had not experienced
chiropractic care, ranging in ages from 9 to 79. They were
evaluated in each eye before and six weeks after receiving
chiropractic care.
Evaluation showed improvements in percent
change in distance visual acuity (% DVA) following upper cervical
specific chiropractic care at distances “typically” associated
with less than normal, normal and better than normal vision,
with no correlation between upper cervical vertebral “listing."
Chiropractic
care of a pediatric glaucoma patient: a case study. Conway,
CM, Journal of Clinical Chiropractic Pediatrics 1997 (2)2 p.
155-156.
The article describes the reduction of infections as
well as the restoration of normal intraocular pressure in a
17-month-old Caucasian female with glaucoma and chronic sinus
infections.
The parent stated that the child had been born with
glaucoma and had 13 eye surgeries before she was 15 months
old. The girl also has recurrent sinus infections which led
to eye infections so severe that she had been hospitalized
twice. The girl was also scheduled for adenoid surgery in less
than one month of presentation to the chiropractor. Mother
was told the surgery had a 70% change of helping the sinus
infections.
Child had a long history of antibiotic use along
with other medications. Mother stated the birth was a “fast birth”,
from onset of labor to delivery was about 7 hours.
Child was
adjusted using a hand held adjusting instrument and craniosacral
technique was also performed.
Results: Two months prior to seeking
chiropractic care she was placed under general anesthesia to
get intraocular pressure readings of 21 in the right eye and
28 in the left eye. After one month of chiropractic care her
intraocular pressure was measured as 17 R and 15 L. Adenoid
surgery was cancelled. After 4 months of care, the intraocular
pressure was 14 R and 11 L. As of the writing of this paper
the subject is 3 years old, is seen every two to four months
and rarely has a cold or flu symptoms. Her intraocular pressure
is normal and she is off all medications.
Subluxation location
and correction by Stephen R. Goldman, D.C. Today’s Chiropractic
July/August 1995 p.70-74.
Case Study No. 1
A 2-year old child had a medical diagnosis of ‘developmental
communication disorder.’ He was non-responsive to any
external stimuli, even to receiving an injection…did
not respond to sound or touch…Chiropractic analysis
revealed an axis subluxation.
“On the third visit, when
I walked into the room, he began to cry. That was the first
time that he responded to anything happening around him. By
the sixth adjustment, he started to follow certain commands
and stopped making repeated hand motions. He started to talk
after the 12th office visit. At present, he has an extensive
vocabulary and is slightly hyperactive; he is probably making
up for lost time.
Case Study No. 3
A 77-year-old woman, diagnosis by a neuro-ophthalmic specialist
was ocular myothenia (symptom of blurred vision and double
vision on and off during day)
Chiropractic analysis: Axis subluxation.
By the ninth visit, all symptoms had disappeared. Presently
under maintenance care with no recurrence of problem.
The eye,
the cervical spine, and spinal manipulative therapy: a review
of the literature. Terrett, A.G. and Gorman, R. Frank. Chiropractic
Technique Vol. 7, No. 2, May 1995.
From the abstract:
Practitioners of spinal manipulative therapy
(SMT) note that after SMT, patients occasionally state that
their vision has improved. Visual improvement is mentioned
by patients more commonly than the appearance of reports in
the literature would suggest.
Various ocular effects of SMT
have appeared in the literature. These have included changes
in visual acuity, oculomotor function, intraocular pressure,
and pupillary size.
This paper reviews the literature regarding
connections between the eye, the cervical spine and SMT with
a view to future research in this area.
Various theories that
have been proposed are briefly discussed.
Gorman, an ophthalmologist
and Terrett a chiropractor have collaborated to produce an
excellent article on the subject of vision and chiropractic
(or, as they insist on calling it, SMT).
They searched the literature
and found 12 journal articles from 1964 to 1992 describing
the experiences of 187 patients with visual changes after cervical
spinal care. They have rated these articles, they discuss them
and they discuss a dozen dramatic case histories from the literature.
Conditions included in this study are blurred, decreased vision,
contraction of visual fields, spots before eyes, oculomotor
(eye muscle) dysfunctions (diplopia, nystagmus, visual fatigue
etc.), pupillary changes, ptosis, eye pains, dry eye, tearing
eye, distention of eye and others.
Interestingly, Gorman believes
that chiropractic adjustments rejuvenate the brain and that
the improvements in vision and eye conditions are merely a
side effect of overall improved brain function. (See mental
health and chiropractic earlier in this book.)
The prospective
treatment of visual perception deficit by chiropractic spinal
manipulation: a report on two juvenile patients. Stephens D.,
Gorman RF., Chiropractic Journal of Australia. 1996; 26:82-86.
A
14-year old girl and an 8-year old girl suffered from tunnel
vision (constricted visual fields). After seven visits (once
a week) the 14 year old’s visual acuity went
from 20/50 in both eyes to 20/25 in both eyes. The 8-year
old was 20/25 in both eyes before care and 20/25 right eye
and 20/30 left eye after care.
Does “normal” vision
improve with spinal manipulation? Stephens, D. and Gorman F.
Journal of Manipulative and Physiological Therapeutics 1996;
19:415-8.
From the abstract:
A 22-year-old man suffered from a painful
neck. His vision was in the normal range as measured by computerized
static perimetry. His visual fields were tested before and
after a normal office spinal manipulation. After this procedure,
there was a measurable rise in the visual sensitivity of
both eyes.
The association between visual incompetence and spinal
derangement: an instructive case history. Stephens D, Gorman
F. Journal of Manipulative and Physiological Therapeutics;
1997; 20:343-350.
This paper discusses the case of a 13 year
old child who was referred to a chiropractic clinic after an
ocular examination which he had as a result of getting gradually
increasingly severe headaches over a 6 month period.
Ocular
exam showed constricted visual fields when measured to a small
stimulus. After spinal adjustments the visual fields returned
to normal.
The step phenomenon in the recovery of vision with
spinal manipulation: a report on two 13-year-olds treated together.
Stephens D, Gorman F, Bilton D. Journal of Manipulative and
Physiological Therapeutics Nov. 1997; 20(9), pp628-33.
Two 13-year-old
female cousins with constricted visual fields and diminished
visual acuities were given spinal adjustments. After seven
spinal adjustments, the girls had recovery of normal vision.
The change in visual function after spinal adjustments has
been called the “step phenomenon.” There
is an indication that spinal adjustments may have an effect
on brain function.
Treatment of visual field loss by spinal
manipulation: a report on 17 patients. Stephens D, Mealing
D, Pollard H, et al. Journal of the Neuromusculoskeletal System,
summer 1998; 6(2), pp. 53-66.
This paper describes 17 consecutive
patients from 9-52 years of age who had concentric narrowing
of the visual fields. Some of their symptoms included headaches,
dizziness, blurred vision, photophobia and fatigue.
Complete
recovery of the visual fields and many accompanying symptoms
occurred in 11 patients who completed the course of chiropractic
treatments.
For example, one 21 year-old male had been suffering
from severe headaches, blurred vision, memory disturbance and
postural hypotension for seven months shortly after being
knocked unconscious by a blow to the head. A narrowing of
the visual fields was found and the patient received spinal
care. After the first visit the headaches stopped, memory
improved and dizziness decreased. Visual fields returned
to normal by the second visit.
Monocular scotoma and spinal
manipulation: the step phenomenon. Gorman, RF Journal of Manipulative
and Physiological Therapeutics 1996; 19:344-9.
From the abstract:
Objective: To discuss a case history wherein
microvascular spasm of the optic nerve was treated by spinal
manipulation.
Clinical Features: A 62-year-old man who developed
a scotoma in the vision of the right eye during chiropractic
treatment.
Intervention and Outcome: Spinal manipulation treatment
was continued with total resolution of the scotoma. The rate
of recovery of the scotoma was mapped using computerized
static perimetry. These measurements showed that significant
recovery occurred at each spinal manipulation treatment,
producing a stepped graph.
From the conclusion: This case history
suggests that spinal manipulation can affect the blood supply
of localized areas of brain tissue. More important is the converse
implication that microvascular abnormality of the brain is
caused by spinal derangement.
The author added: "Spinal
manipulation can affect the function of the optic nerve in
some patients presumably by increasing vascular perfusion."
Effects
of a chiropractic adjustment on changes in pupillary diameter:
a model for evaluating somatovisceral response. Biggs L, Boone
WR. Journal of Manipulative and Physiological Therapeutics,
1988; 11: 181-189.
The relationship between a cervical chiropractic
adjustment in subluxated vs. unsubluxated subjects, and autonomic
response monitored as change in pupillary diameter was evaluated
in 15 subjects.
Pupillary diameter was shown to change significantly
following manipulation in those shown to have a subluxation
complex by a battery of chiropractic tests. Controls without
subluxation were given a sham treatment (massage) to differentiate
a placebo or nonspecific effect. They exhibited no pupillary
change on follow-up.
Ocular dysfunction associated with whiplash
injury. Brown S, Aust. J Physiother 1995;41:55-6
From the abstract:
Ocular and visual signs and symptoms have
been reported to have been associated with whiplash, but there
was no scientific study which had investigated these anecdotal
reports. This study investigated several aspects of the ocular
function of whiplash subjects, non-specific injured neck injury
subjects and a control group. Results indicated that visual
accommodation (focusing), visual convergence and aspects of
pupil function were significantly affected in the whiplash
subjects only.
Study on cervical visual disturbance and its
manipulative treatment. Zhang C, Wang Y, Lu W, et al. J Trad
Chinese Medicine, 1984; 4:205-210.
From the paper:
Determination of blood flow by x-ray in 18 of
our cases shows that blood flow of the cerebral hemispheres
greatly improves after manipulative treatment. The same is
true in similar animal tests.
Study on cervical visual disturbance
and its manipulative treatment. Changjiand I, Yici W, Wenquin
L et al. Journal of Traditional Chinese Medicine 1984 4:205.
This
is a report on 114 cases of patients with cervical spondylosis
who had associated visual disorders. Visual improvement was
noted following “manipulative treatment” in
83% of these cases. Furthermore, of the 54 cases followed
up for a minimum of six months, 91% showed a stable therapeutic
effect. Cases of blind eyes regaining vision were included
in the report.
The treatment of presumptive optic nerve ischemia
by spinal manipulation. Gorman RF. Journal of Manipulative
and Physiological Therapeutics, 1995 18 (3): 172.
This is a
case report of a 62 year-old male with a one week history of
monocular visual defect that experienced dramatic visual improvement
after a week of “spinal manipulation.” “Spinal
manipulation can affect the function of the optic nerve in
some patients presumably by increasing vascular perfusion."
The
common cold, pattern sensitivity and contrast sensitivity.
Smith AP, et al. Psychological Medicine, 1992; 22:487-494.
This
evidence indicates a possible link between vertebral subluxation
complex, susceptibility to the common cold and vision sensitivity.
Monocular
visual loss after closed head trauma: immediate resolution
associated with spinal manipulation. R. Frank Gorman. Journal
of Manipulative and Physiological Therapeutics. Vol. 18, No.3,
June 1995.
This article discusses the case history of a 9-year
old child complaining of headaches and blurred vision. Her
visual fields were constricted and she had a history of recurrent
abdominal pain, headaches and “red eyes.” The
author practices manipulation under anesthesia and the patient
had two sessions"
“For a year after the spinal treatment,
the patient had a much better demeanor and was generally
free of troublesome headaches and ocular symptoms.”
Hypotheses
regarding the pathogenesis of this condition (visual problems
and recovery after manipulation) are discussed.
Neuro-opthalmological
findings in closed head injuries. J Clinic Neuroopathalmol
1991; 11:272-7.
Among the findings is the fascinating revelation
regarding vision and trauma: “Visual loss after closed
head trauma has been reported to occur in 35% of such injuries.”
“A Dangerous Twist” (a video recording) “60
minutes” TCN Channel 9, 1986. An Australian TV show
discussing the effects of spinal manipulation on vision.
Visual
recovery following chiropractic intervention. Gilman G, Bergstrand
J. Journal of Behavioral Optometry 1990; 1:73-74.
A 75-year-old
man experienced a blow to the head resulting from a fall. He
felt headaches and dizziness but the next morning woke up completely
blind. Three months later the patient was referred to a chiropractor
who found C1-C2 subluxation. It was hypothesized that this
subluxation could explain the blindness as causing sufficient
irritation to the superior cervical ganglion which gives rise
to the postganglionic sympathetic innervation to the blood
vessels of the optic nerve, including the retina itself. The
cervical adjustment would relieve irritation to the ganglion
and restore normal circulation to the optic nerve.
After 11
chiropractic adjustments over a 3-month period, the patient’s vision returned. The author notes: "Behavioral
optometrists have often been interested in the work of chiropractors
and the resulting vision changes."
Chiropractic adjustments
and esophoria: a retrospective study and theoretical discussion.
Schutte B, Teese H, Jamison J: J Aust Chiro Assoc Dec 1989
19(4): 126.
This is a retrospective review of 12 children with
esophoria (deviation of a visual axis towards that of the other
eye when fusion is prevented - Dorland’s Medical Dictionary,
24th edition), concluding that such patients may respond
to cervical spine adjustments.
Early pathogenesis following
vertebral strain. Burns L. Journal Of The American Osteopathic
Association, Oct. 1946 P.103.
Spinal strains are produced in
experimental animals. Histologic changes occur in the spinal
tissues, heart, kidneys, stomach and the eye.
A pilot study
of applied kinesiology in helping children with learning disabilities.
Mathews MO, Thomas E, British Osteopathic Journal Vol. X11
1993, Ferreri CA (1986)
From the paper:
Most children showed significant gains in visual
perceptual organization. Some made significant gains in other
important skills such as short-term auditory memory. Significant
improvements were observed both at home and at school with
regard to motivation, attitude and performance.” Reports from treatment included: “Dyslexia
teacher says he no longer needs help.” “No more
thumb sucking.” “Asthma much better on the whole.”
An observer’s
view of the treatment of visual perception by spinal manipulation.
A survey of 16 patients. Gorman RF. Sydney, Australia, 1991
(published privately).
Four ophthalmologists examined 12 patients
before and after spinal manipulation. In all cases the vision
improved (either the visual field and/or visual acuity). Non-visual
difficulties also improved: “spine hump straightening out, arm movement
improved,” “feels more positive and a lot happier.
Does not wake up in the morning tired. More outgoing and
talkative.”
The side effects of the chiropractic adjustment.
Arno Burnier, D.C. Chiropractic Pediatrics Vol. 1 No. 4 May
1995.
Case history:
S. S. Female. Age 17.
Physical problem: Headaches, acne and “coca cola” eye
glasses for nearsightedness.
Chiropractic results: Within three
months of care she was symptom free, no longer needing glasses.
Results remained consistent for two years (lost touch after
moving away).
Presenting Vertebral Subluxation: Axis posterior,
D1/D2 PIR, D12/L1 Pl.
Original Adjustment: Meningeal contact
on sacrum double notch, structural manual adjustment of D1/D2
in lateral flexion and extension, D12/L1 in extension and axis
in extension supine with a spinous contact.
The influence of
atlas therapy on tinnitus. Kaute B.B., International Tinnitus
Journal Vol, 4, No. 2, 165-167 (1998).
From the abstract:
We present questions and thoughts of an outsider
on the proprioceptive input of the posterior small cervical
muscles to the brainstem as a source of tinnitus. After treatment
of whiplash injuries and other muscular conditions with Arlen’s
atlas therapy, some patients reported that their tinnitus
had abated with the muscular tensions. Atlas therapy has
been proven to slacken the muscles and seems to quiet to
normal levels afferent impulses to the brainstem. This has
been proven to apply to nystagmus.
Upper cervical management
of a patient with neuromusculoskeletal and visceral complaints.
McCoy M. Today’s Chiropractic
May/June 2001. P. 46-47.
This is the case of a 65-year-old man
who began to have symptoms of lower extremity pain and
parasthesias, ambulatory problems, urinary difficulties (having
to urinate every half hour) and visual problems after back
surgery which fused his thoracolumbar segments. Patient also
had gout which affected his right big toe, ankles, elbows
and fingers. He was on Indocin for the gout. He was also
on medication for high blood pressure and wore glasses for
reading.
In the case history it was revealed that he had a head
injury as a child on two occasions.
First adjustment: during
the evening of his first adjustment he experienced shock-like
sensations bilaterally into his arms and legs. He also reported
chills, a fever, and coldness in his hands, sweats, an increase
in frequency of urination, gluteal muscle soreness and loss
of appetite. By the next morning the symptoms resolved.
Patient
had twenty chiropractic visits over a 5 month period. On 7
visits he did not need an adjustment. The numbness and tingling
along the right side of his body are gone. He is walking better.
His legs feel stronger and he is not using his cane much. Sitting
and standing are less troublesome.
He reports a decrease in
frequency of urination to only a few times a day. Patient reports
he doesn’t need
his glasses for reading anymore.
Mobilization of the Spine.
Grieve GP Churchill Livingston, London/New York, 4th edition,
22-23. (1984)
All those experienced in manipulation can report
numerous examples of migrainous headaches, disequilibrium (vertigo),
subjective visual disturbances, feelings of retro-orbital
pressure, dysphagia, dysphonia, heaviness of a limb, extra
segmental paraesthesia, restriction of respiratory excursion,
abdominal nausea and the cold sciatic leg being relieved
by manual or mechanical treatment of the vertebral column.
Totally
blind, now sees. Millard, FP, Toronto, Ont. Canada. Journal
of the American Osteopathic Association September, 1921 p.
47
This is a case report of a 4 year old that “fell on
the ice while playing hockey. A few months later his sight
failed and he became totally blind…his parents took
him to a hospital …he was finally pronounced ‘hopelessly
blind.’ “From the paper:
Would the correction of
the atlas and axis cure his blindness?...I reduced the subluxations
with one movement and told him to sit up. ‘ I told him, “That is all today, report
at this hour tomorrow,’ and I walked out.”
The morrow came and the appointed hour. There was a smile
on the boy’s face as well as the mother’s. He
could discern objects…he could see as well as he could
before being stricken blind.
Copyright 2004 Koren Publications,
Inc. & Tedd Koren,
D.C.