The Return of Color Vision Secondary to Macular Degeneration After Chiropractic Care
SOURCE: Chiropractic J Australia 2017; 45 (1): 38–43
Thomas A. Brozovich D.C
Palmer College of Chiropractic,
1000 Brady St,
Davenport, IA 52803, USA
Objective: To discuss the chiropractic management of a patient whose unilateral color vision loss associated with macular degeneration resolved after treatment.
Clinical Features: A 66-year-old female with a history of cervical, thoracic and lumbar pain and a four-year history of macular degeneration of the left eye resulting in a loss of color vision sought chiropractic care for primarily her spinal pain. Initially she was not requesting care for her loss of color vision. She reported having multiple recent traumas (falls) injuring her cervical, thoracic and lumbar region.
Intervention and Outcome: The patient was adjusted based on location of her subluxations (intersegmental joint dysfunction). She had 17 treatments over 8 month. A thermography study was performed of the face before and after treatment and a more symmetrical thermal pattern was obtained. Her spinal pain reduced. She also unexpectedly had a return of color vision in her left eye.
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Conclusion: The patient responded favorably to chiropractic care, which resulted in a decrease in spinal pain and improvement in left eye color vision.
Keywords Macular Degeneration; Color Blindness
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INTRODUCTION
A patient seeking care for musculoskeletal symptoms following trauma is common in chiropractic practice. Patients may concomitantly have other health problems identified during the history and physical examination. The chiropractor’s treatment is typically intended to reestablish joint function and reduce inflammation. On occasion, symptoms and conditions other than musculoskeletal may respond to chiropractic care.
Macular degeneration has a number of causes: age, genetics, mutation, Drusen bodies, hypertension, cholesterol, oxidative stress, race, and exposure to sunlight, vitamin D deficiency, and smoking. Symptoms include visual distortion, blind spots, photostress, photophobia, better night vision, peripheral vision sensitivity, and color vision loss. [1] Macular degeneration also causes color vision loss and is not directly associated with age and is not well understood. [2] It rarely causes total blindness. [3] The macula covers about 2% of the retina, and the receptors most concentrated in the macula are the cones, which are color receptors. The visual loss seen with macular degeneration is better described as a loss of contrast sensitivity, with the contour of objects, shadows and color vision being diminished. [4] Drusen bodies are similar to laques and can deprive the photoreceptors of the retina of blood and oxygen. This can explain the progressive loss of vision; however; clinically it’s common to see Drusen bodies in patients with normal visual acuity. Therefore, there must be another factor that accounts for loss of vision with macular degeneration.
Thermography is a method for recording the temperature of the skin. This can be visualized using non-contact high resolution infrared thermography. Interpretation of a thermogram, according to the American Chiropractic College of Thermology, is based on relative symmetry between like points on the body and based on the research by Uematsu. [5, 6] There is normally less than .4°C difference between sides in a normal individual. The forehead has less than 0.2°C difference between right and left side. [6] The skin area is for heat transfer. The loss of heat through the skin is in the form of infrared radiation and can be documented with thermography. The vascularity of the skin is controlled by the autonomic nervous system. When there is a sympathetic nerve fiber injury which is part of the autonomic nervous system due to compression as in tumors or disc herniation, or in irritation as in local autoimmune response from trauma, there will be asymmetry of skin temperature noted on the thermogram. [6]
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