I was looking through the holiday mail and ran across an engaging letter from a chiropractor practicing in Iran. Dr. Mohsen Radpassand writes: "As a chiropractor in Iran, I became familiar with you through Dynamic Chiropractic, and recently you mentioned your new book, The Chiropractic Approach to TM Disorders.
"In Iran I am practicing part-time three days a week, and I am also studying medicine at the Teheran Medical Sciences University. As a student I am allowed to subscribe to journals (up to $200 a year) and I have managed to subscribe to JMPT, Chiro Sports Med, and Chiro Technique only. I have since run out of money. Therefore, as a chiropractor, a student of medicine, and as a World Federation of Chiropractic delegate in Iran, I request that you donate your book to me."
Signed: Mohsen Radpassand, D.C.
Dr. Radpassand, thank you for your letter. Your book is on its way. I hope this helps you in representing chiropractic in your country.
Can Chiropractic Procedures Affect Vision?
This is an interesting question, especially from my perspective as the professor for the course, "Eyes, Ears, Nose, and Throat." I believe that there are many clinicians who can state from experience that chiropractic care has improved at least one aspect of their patient's vision. I too have seen reports of visual changes in my patients. Are these changes coincidental or do they occur as a result of chiropractic care? We can answer this question by looking at the experiences of other chiropractors.
How do we do this? First, we take on two premises: Visual changes can occur as a result of chiropractic care; and these changes occur repeatedly within chiropractic. If these premises are valid it stands to reason that there should be some reports of this experience in the chiropractic literature. Our next step is to peer into the wealth of chiropractic information.
In order to expedite the search of chiropractic literature, I tapped into the services of Chirolars. Chirolars is the only fully operational chiropractic computerized database. I use it because of its speed and searching power. Sure enough, Chirolars found what we needed: articles discussing improved vision following manipulation.
Examples of Visual Improvement
Drs. G. Gilman and J. Bergstrand reported chiropractic treatment provided a return of vision in an elderly male who initially presented with traumatic vision loss.1 Bryant et al., reported on the use of cervical manipulation in the treatment of oculomotor palsy.2 Chang-Jiang et al., published a very interesting paper: They found that when treating the common disease, cervical spondylosis, the associated blindness or blurred vision was alleviated. They reported the effective rate of improved vision in 114 cases treated in the past seven years to be 83 percent. Within this figure, cases with visual improvement of more than six rows on the test chart comprised 34.4 percent; 45.6 percent improved 2-5 rows; 9 of 12 blind eyes regained vision, seven of which restored to more than 1.0. Of the 54 cases followed for a minimum of half a year, 91.1 percent showed stable therapeutic effect.
Are visual disorders related to cervical disorders?
The answer appears to be "yes" and two lines of evidence may be used to support this. First, Wolf3 and many others have reported on the use of cervical manipulation to affect disorders of the eye. Judging from the amount of literature on this subject, one can reasonably conclude that certain visual disorders are related to the cervical spine. Second, you may find it valuable to note that visual disorders have been reported in conjunction with degenerative changes of the cervical spine. Chang-Jiang et al., (the authors previously mentioned) found that impaired vision caused by cervical spondylosis comprised 2.1 percent of the cervical syndrome.
How is this relationship between manipulation and impaired vision explained?
This is a most interesting question. Fortunately, we as clinicians can speak to well-founded explanations discussing this relationship. Next month we will take a detailed look at these explanations.
References
- Gilman G, Bergstrand J: Visual recovery following chiropractic intervention. J California Chiropractic Association, p 22, 26, 28, June 1990.
- Bryant T, Stauffer W, Simon G: Cervical spine treatment of oculomotor palsy: a case report. American Chiropractor, p 38-39, 1988.
- Wolf A: Osteopathic manipulative procedure in disorders of the eye. Year Book, Academy of Applied Osteopathy, p 71-75, 1970.
With each article I encourage you to write the questions you may have, commentaries on patient care since attending the TM seminars, or thoughts to share with your colleagues, to me:
Darryl Curl, D.D.S., D.C.
2330 Golden West Lane
Norco, California 91760
Please enclose your return addressed, stamped envelope.
Editor's Note:
Dr. Curl will be teaching MPI's Temporomandibular (TM) seminar on February 22-23, 1992, in Tampa, Florida. You may register for the seminar by dialing 1-800-327-2289.