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Category: Case Studies
Date 9-aug-1996
Case Title The Association between Visual Incompetence and Spinal derangement: An Instructive Case Study
Author Danny Stephens, D.C., R. Frank Gorman, M.B.B.S., D.O
Main Condition/ Disease  Visual Disturbance
Source Journal of Manipulative and Physiological Therapeutics (JMPT); Volume 20, No5, 343-50; (June 1997)
Abstract The case discusses the case of a 13-year-old child presenting with headaches and migraines who was examined for visual field loss. The authors present four methods to test visual field abilities of patients. These are finger perimetry, wall perimetry, kinetic perimetry and static perimetry. Following spinal manipulative therapy the child’s vision recovered.
Summary Stephens and Gorman in yet another paper focus on visual deficit concerned with the narrowing of visual fields. They cite numerous studies which suggest a link between recovery of vision following spinal manipulation. One of the hypotheses as to the cause of the vision loss they suggest is cerebral hypoperfusion (deficient or reduced blood flow) which “has been confirmed to part of upper spinal derangement”. Patients have even presented with painful necks and this hypoperfusion even without “any noteworthy spinal trauma”. In this case the patient, a 13 year-old girl presented with ongoing minor headaches which resulted in a more severe headache. Her examination was normal except that during the application of the 4 perimetry tests outlined in the abstract the authors found deficits using the wall, kinetic and static perimetry tests. In particular the kinetic test showed the visual fields to be “manifestly abnormal”. Having seen this type of visual loss prior the authors sought permission to carry out spinal manipulation. This manipulation consisted of rotary and lateral flexion thrusts to the c-spine, thoracic and lumbar spine manipulation. Specific upper cervical analysis and adjustment as described on my site was not used. The visual field results following the spinal manipulative therapy (SMT) revealed immediate full visual fields. In other words, the patient’s vision improved significantly. According to the authors “the patient was able to read the last line of the visual acuity chart.” A telephone follow up with the patient some 3 months later showed she no longer had headaches and her mother remarked on improvements in learning, sport and attitude. The authors conclude that SMT should be considered in the treatment of symptoms as a result of head trauma and whiplash and suggest that chiropractors utilize the various ophthalmic tests and equipment available to check for visual field loss before and after the application of SMT.
Keywords chiropractic manipulation, visual loss, vision, cervical

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