Subluxations Decrease Vision

OBJECTIVE: To discuss a patient whose spinal abnormalities may have caused subliminal visual field loss.

CLINICAL FEATURES: A 22-yr-old man suffered from a painful neck. His vision was in the normal range, as measured by computerized static perimetry.

INTERVENTION AND OUTCOME: To define a guideline for a proposed investigation into visual field changes with spinal adjustment, 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.

CONCLUSION: The use of computerized static perimetry changes to measure the cerebral effects of spinal manipulation is recommended for future chiropractic research.

Stephens D, Gorman RF. Does 'normal' vision improve with spinal manipulation? J Manipulative Physiol Ther 19 (6): 415-418 (Jul 1996)

Cerebral Effects of Manipulation

OBJECTIVE: To discuss a case history wherein microvascular spasm of the optic nerve was treated by spinal manipulation.

CLINICAL FEATURES: A 62-yr-old man 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.

CONCLUSION: The use of computerized static perimetry to measure the cerebral effects of spinal manipulation has increased knowledge of how chiropractic works. The further recovery of vision with each spinal adjustment suggests that more treatment may be better than less treatment in the chiropractic management of such cases.

Gorman RF. Monocular scotomata and spinal manipulation: the step phenomenon. J Manipulative Physiol Ther 19 (5): 344-349 (Jun 1996)

Manipulation Restores Vision

OBJECTIVE: To discuss the case of a patient who demonstrated that spinal injuries may cause both cortical and ocular visual loss that was ameliorated by manipulative care.

CLINICAL FEATURES: The patient suffered separate incidents of binocular and monocular loss of vision. A female child, aged 9 yr, presented with bilateral concentric narrowing of the visual fields that returned to normal immediately after spinal treatment. Approximately 1 yr later, she returned with monocular loss of vision after she was struck on the head by a ball.

INTERVENTION AND OUTCOME: The child was treated by spinal manipulation under anesthesia; the vision was found to be normal on awakening from the anesthesia. Both visual recoveries were authenticated by an independent ophthalmic specialist.

CONCLUSIONS: This case history adds to the other recorded occasions in which vision is noted to improve when the spine is manipulated. Discussion is directed to the basic pathogenesis: is her condition a form of psychoneurosis, is it a variant of migraine, or could it be a combination of both conditions?

Gorman RF. Monocular visual loss after closed head trauma: immediate resolution associated with spinal manipulation. J Manipulative Physiol Ther 18 (5): 308-314 (Jun 1995)

Manipulation Increases Cerebral Blood Flow

OBJECTIVE: To discuss a case of presumptive optic nerve ischemia successfully treated by spinal manipulative therapy.

CLINICAL FEATURES: A 62-yr-old male patient suffered from a 1-wk history of monocular visual defect in association with headaches and neck strain. Ocular examination revealed no pathology in the optic nerve head or retina that could explain the abnormality of vision. Based on physical signs, a presumptive diagnosis of optic nerve ischemia was made.

INTERVENTION AND OUTCOME: Vision improved dramatically in the week of spinal manipulation therapy, as measured by serial computerized static perimetry.

CONCLUSION: This case study records improvement in optic nerve function when measured before and after spinal manipulation using computerized static perimetry. It contends that spinal manipulation can affect the function of the optic nerve in some patients, presumably by increasing vascular perfusion. I hypothesize that derangement of the cervical spine produces microvascular spasm in the cerebral vasculature, including that of the eye.

Gorman RF. The treatment of presumptive optic nerve ischemia by spinal manipulation. J Manipulative Physiol Ther 18 (3): 172-177 (Mar 1995)