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, patient 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, oculomator 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 have 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 and discuss them and discuss a dozen
dramatic case histories from the literature. Conditions included
in this study are blurred, decreased vision, contraction of visual
fields, sports before yes, 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 the vision and
eye conditions are merely a side effect of overall improved brain
function.
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.
One 14-year old girl and one 8-year old girl suffered from
tunnel vision (constricted visual fields). After seven visits
(one 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, 20/30 left eye after
care.
Does "normal" vision improve with spinal manipulation? Stephens,
D. and Gorman M. JMPT 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.
Monocular scotoma and spinal manipulation: the step phenomenon. R.
Frank Gorman, 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 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 treatment of visual perception defect by spinal manipulation. A
prospective study of twelve consecutive patients. 24th Annual
Scientific Congress of the Royal Australian College of
Ophthalmologists 1992 Nov 1-6.
Ocular dysfunction associated with whiplash injury. Brown S, Aust.
J Physiother 1995; 41:55-56
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 distubance and its manipulative treatment.
Zhang C, Wang Y, Lu W, et al. J Trad Chinese Medicine, 1984 4:205-210.
"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 animals tests."
Study on cervical visual disturbance and its manipulative treatment.
Zhang C, Wang Y, Lu W, et a. J Trad Chinese Medicine, 1984; 4:205-210.
Report on 114 cases of patients with cervical spondylosis who had
associated visual disorders. Visual improvements was noted following
"manipulative treatment" in 83% of these cases. Furthermore, of the
54 cases of blind eyes regaining vision were included in the report.
The treatment of presumptive optic nerve ischemia by spinal
manipulation. Gorman RF. JMPT 1995 18 (3):172.
A case report where a 62-year old male with a 1 week history of monocular
visual defect 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."
Changjiang I, Yiei W, Wenquin L. Et al Study of Cervical Visual
Disturbance and its manipulative treatment. Journal of Traditional
Chinese Medicine 1984 4:205. This is a report on 114 cases of
cervical spondylosis with visual disorders. Improvement in
vision was found after "manipulative treatment" in 83% of cases.
54 were followed for up to six months and all had a stable
therapeutic affect. Blind eyes regaining sight are among some
of the benefits discovered.
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 closed head trauma: immediate resolution
associated with spinal manipulation. R. Frank Gorman. Journal of
Manipulative and Physiological Therapeutics. Vol. 18, No.3, June 1995.
The author, a medical doctor has been investigating spinal care and
it's relationship to vision, mental health, emotional wellness and
overall health. This article discusses the case history of a 9-year
old child complaining of headaches and "red eyes". The author
practices manipulation under anesthesia. After two manipulations
"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) is discussed.
Neuro-ophthalmological findings in closed head injuries. J Clinic
Neuroopathalmol 1991; 11:272-7.
Among it's findings is the fascination 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 of vision.
Visual recover following chiropractic intervention. Gilman G,
Bergstrand J. Journal of Behavioral Optometry 1990; 1:73-74.
An 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, if it caused 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.
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.
A retrospective review of 12 children with esophoria (deviation of a
visual axis towards that of concluding that such patients may respond
to cervical spine adjustments.
Early pathogenesis following vertebral strain.
Burns L. JAOA, 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)
"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 our, 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.
This is a case history of J.C. male, 1 year old taken from the records
of Dr. Arno Burnier of Yardley, PA. 81. South Main Street Yardley,
PA 19067, 215-4936589. Nearly all D.C.s have miracle cases, but Dr.
Burnier has written his up. This is again an appeal for all D.C.s to
write up their interesting cases.
S.S. Female age 17.
Physical problem: Headaches, acne and "coca cola" eye glasses for
near-sightedness.
Chiropractic results: Within three months of care was symptom free
and no longer needed glasses. Resulting remained consistent for two
years (lost tough after moving away).
Presenting Vertebral Subluxation: Axis posterior, Di/D2 PIR, D12/L1 P1.
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.
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