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.

Top of Page