Integrative Medicine and Vision Dr. Marc Grossman, O.D. L.Ac. Conflict of Interest Statement:
I have no conflict of interest. " The question is not what you look at, but what you see."
- Henry David Thoreau
“The eyes are the windows to your soul”
- William Shakespeare
“An ounce of prevention is worth a pound of cure.”
- Benjamin Franklin Allied Complementary Practitioners Holistic physicians Chiropractors Herbalists Osteopaths Nutritionists Cranial sacral therapists Functional medicine practitioners Alexander teachers Ayurvedic Feldenkrais practitioners Meditation teachers Reiki masters Homeopaths Tai chi Naturopathic Doctors Qi Gong Acupuncturists Bach Flower Yoga Teachers Essential oils Somatic based psycho therapists Massage therapist Flower essence Holistic dentists Hypnotherapy Rolfing Integrative Vision Care in the Optometric Office
● Refraction
● Eye exercises and visual hygiene ● Psycho behavioral insights exophoria, esophoria ● Stress and rx - story about veterinarian ● Different types of ● Pathology - Holley - cataract Nora - macula myopia,astigmatism etc degeneration connie, Marc azoff - glaucoma ● Mother eye father eye ● Applied kinesiology - for rx ● EMDR ● Yoga postures
● O ring test
● Janet Travell M.D. Trigger points Integrative Medicine Philosophy
• Integrative Medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle.
• It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative. www.integrativemedicine.arizona.edu
PIM – U of Arizona
Optical differences in cases of multiple personality disorder
Optical differences in cases of multiple personality disorder - NCBI - by SD Miller · 1989
MPD subjects had significantly more variability in visual functioning across alter personalities than did control subjects.
“The blind woman who switched personalities and could suddenly see” - The Washington Post - 2015/11/24
“...B.T. referred to him 13 years later for treatment for dissociative identity disorder, once called multiple personality disorder. B.T. exhibited more than 10 personalities, each of them varying in age, gender, habits and temperament. ... alternated between sighted and sightless personalities, her vision switched as well.” Exercises to Keep the Eyes Healthy
Exercise # 1: BREATHING Exercise # 2: VISION STATEMENTS Exercise # 3: PALMING Exercise # 4: FIGURE EIGHTS Exercise # 5: THE HOT DOG Exercise # 6: SCANNING Exercise # 7: EFFORTLESS FOCUS Exercise # 8: NEAR AND FAR FOCUS Exercise # 9: EYE MASSAGE Exercise # 10: ZOOMING Exercise # 11: SUNNING
See your handout for more details! ACUPRESSURE MASSAGE FOR THE EYES EXERCISES FOR BETTER EYE HEALTH
ACUPRESSURE Acupuncture/acupressure is an ancient system of healing developed over thousands of years as part of the traditional medicine of China, Japan, and other countries in East Asia.
The practice is rooted in the discovery of the meridian system, the channels of energy that run throughout the body. Stimulation of specific areas on the skin affects the functioning of certain organs of the body.
Centuries of practical experience show that when energy is flowing smoothly throughout the body one enjoys health, while blockages in any of these energy currents results in pain and disease. Trigger Points and Vision
The two neck muscles whose referred pain patterns reach the lens of the eye:
Splenius Cervicis & Sternocleidomastoid (SCM) Splenius Cervicis
The referred pain chart here shows that while the Splenius Cervicis muscle may be located in the neck, its referred pain concentrates sharply right at the back of the eyeball, often affecting muscles of the eye, including the muscle that adjusts the shape of the lens for focus. As a result, a trigger point in the Splenius Cervicis can cause problems focusing the eye on that side resulting in aggravating blurred vision. Sternocleidomastoid (SCM)
And the same is true for the SCM:
There are two divisions of the SCM. The top layer runs from the bony prominence behind the ear (mastoid) to the sternum. This is the division whose trigger points (white X's) refers pain to and around the eye in a sideways question mark pattern (as well as the back of the head, top of the head, cheek and jaw, and sternum). Blurred vision is a common symptom as a result. Syntonics
Syntonics is a color light therapy that utilizes standard color filters with an incandescent light source (similar in the visible spectrum to natural sunlight). Syntonics is used to treat specific functional vision conditions. The object of the color of light is to bring the visual system into balance by activating aspects of the central nervous system. Myopia (Nearsightedness) Statistics ➡ 2% vs 32% ➡ computers have made the problem worse ➡ percentage is nearing 90% in some areas ➡A third of the world's population is myopic ➡ half of the world’s population will be myopic by 2050 ➡ one-fifth of them at a significantly heightened risk of blindness ➡ more than 80 million people in the U.S. ➡ a function of how we overuse our eyes ● Glasses or contacts ● LASIK surgery ● Low-dose atropine ● eye exercises ● Astaxanthin ● Nutrition ● Diet ○ Lutein ● Juicing ○ Zeaxanthin ● Natural daylight. ○ Bilberry ● Exercise ○ Omega-3 fatty acids ● Breast-feeding ○ Vitamin D3 ● Vision therapy ○ Multivitamin, ● good visual hygiene Cataracts
Glutathione
Comprised of three amino acids: glutamine, glycine, and cysteine.
Glutathione levels in the body may be reduced by a number of factors, including poor nutrition, environmental toxins, and stress. Its levels also decline with age. EYE DROPS Can -C n-acetyl carnosine
Cineraria homeopathic
Oclumed
Lanomax Nutrients for Cataracts
Vitamin C -2000 mg buffered extend absorption time
20-30 times higher in lens then blood plasma
Glutathione - Comprised of three amino acids: glutamine, glycine, and cysteine.
Lutein
Alpha lipoic acid
Carnosine Lanomax Glaucoma Beta-Blockers
● Contained in many drugs ● Inhibit aqueous humor formation ● Timoptic, Timoptic XE, Betimol ● Cause about a 25% drop in IOP ● 10% to 20% of patients do not respond ● Can have side effects on nervous system Beta-Blockers
● Can lower blood pressure, and cause heart problems for vulnerable elderly patients ● Betimol is less likely to negatively affect heart rhythm, Timolol can upset the cholesterol ratio ● Beta-blockers also can lead to emotional depression ● Side effects disappear when the beta-blocker is discontinued Prostaglandin Analogs
● Two weeks to achieve maximum effect ● IOP generally is reduced during sleep a. First dose after waking up b. Second dose in afternoon Nutrients
● Oxidative stress and free radicals ● Optic nerve requires healthy circulation to the eyes ● Circulation to the optic nerve is poorer for those with glaucoma ● Glaucoma is not just a matter of normal IOP ● Keep the optic nerve properly nourished ● Different nutrients depending on type of glaucoma Nutrients for Open Angle Glaucoma
● For circulation: Ginkgo biloba and/or vinpocetine, Revision liver tonic ● For optic nerve health: Coleus forskohlii, taurine, bilberry, grapeseed extract, magnesium, folate, vitamin B6, vitamin B12, N-acetyl-cysteine, alpha-lipoic acid, CoQ10, omega-3 fatty acids, and vitamin C. ● For helping reduce eye pressure: Coleus forskohlli, vitamin C, and alpha-lipoic acid. Essential Nutrients
● Essential Antioxidants ● Alpha-lipoic acid (150mg–300mg per day) ● Aminoguanidine (75mg, 3 times per day) ● Bilberry (vaccinium myrtillus). 180mg–240mg per day ● Ginkgo biloba. 120 mg per day ● Taurine. 500mg–1,000mg per day ● Curcumin. 500mg per day ● Vitamin B1 (thiamine). 50mg–100mg per day ● Vitamin B6 100mg per day ● Vitamin B9 (folate form). 800mcg or more per day ● Vitamin B12 (methylcobalamin): 1,000mcg per day ● Vitamin C (buffered and ascorbated). 2,000mg per day Essential Nutrients (continued)
● Vitamin E. (200 IU three times per day) ● Vitamin E combined with CoQ10 ● Very Important a. DHA, B complex, and vitamin E (DHA 200mg– 400mg per day b. B complex and vitamin E 400 IU) c. Essential fatty acids. 3,000 IU per day d. Magnesium. 500mg per day ● Helpful a. Coleus forskohlii. 350mg–500mg per day; b. Green-leafy vegetables, carrots, and beets; c. Green tea extract. 725mg per day; d. Resveratrol. 125mg-175mg daily e. Quercetin. 250mg–500mg per day f. Turmeric (curcumin). 500mg per day g. Melatonin Diet: Foods Known to Increase IOP
● Coffee ● Glutamate (MSG) ● Artificial sweeteners Diet: Foods Known to Decrease IOP
● Eat a healthy diet high in fruits and vegetables ● Beta- carotene, vitamin C, vitamin E, and selenium ● Drink lots of water! a. 16 four-ounce glasses of water per day, every half-hour ● Avoid carbonated, caffeinated, and alcoholic beverages ● Green tea is very beneficial Lifestyle: Activities Known to Increase IOP
● Excessive exercise ● Breath control ● Inverted yoga postures ● Computer use Lifestyle: Activities Known to Decrease IOP
● Regular exercise ● Hormone supplementation ● Breathing ● Sleep position ● Manage stress ● Recommended eye exercises ● Marijuana Essential Oils
● Laurel leaf ● Saffron ● Frankincense ● Spike lavender ● Keep essences away from the mouth, eyes, and mucous membranes ● Add a pure oil like olive or coconut oil ● Do not put the neutralizing oil in the eye Macular Degeneration DRY MACULAR DEGENERATION
1. Accounts for about 90% of all cases
1. Also called atrophic, non exudative or drusenoid macular degeneration DRY MACULAR DEGENERATION
Drusen
⦿ Drusen is an aggregation of hyaline material located between Bruch’s membrane and RPE.
⦿ Drusen are composed of waste products from photoreceptors.
⦿ Drusen > 63 microns in diameter are statistically associated with visual pathology and are termed early ARMD.
⦿ Hypo/hyper pigmentation of RPE may be present
NEJM, Vol 342 (7): 483-492 DRY MACULAR DEGENERATION: VISUAL WET MACULAR DEGENERATION
⦿ Accounts for about 10% ⦿ Also called choroidal neovascularization, subretinal neovascularization or disciform degeneration ⦿ Abnormal blood vessels grow beneath the macula ⦿ These vessels leak blood and fluid into the macula damaging photo receptors ⦿ Progresses rapidly and can cause severe damage to central vision http://www.blindness.org Nutrients
Lutein
Zeaxanthin
Meso zeaxanthin
Omega 3 fatty acids
Astaxanthin
Blberry Lutein Content of Foods Food Mg / serving Kale (raw) 26.5 / 1 cup Kale (cooked) 23.7 / 1 cup Spinach (cooked) 20.4 / 1 cup Collards (cooked) 14.6 / 1 cup Turnip greens (cooked) 12.2 / 1 cup Green peas (cooked) 4.1 / 1 cup Spinach (raw) 3.7 / 1 cup U.S Department of Agriculture, Corn (cooked) 1.5 / 1 cup Agricultural Research Service, Broccoli (raw) 1.3 / 1 cup USDA Nutrient Data Laboratory. Romaine lettuce (raw) 1.1 / 1 cup 2005. USDA National Nutrient Green beans (cooked) 0.9 / 1 cup Database for Standard Reference, Broccoli (cooked) 0.8 / 1/2 cup Release 20 (2007), Nutrient Data Papaya (raw) 0.3 / 1 large Laboratory Home Page Egg 0.2 / 1 large Orange (raw) 0.2 / 1 large How Much Lutein and Zeaxanthin?
American adults get, on average, only 1 to 2 mg of lutein from their diet each day.
10 mg of lutein, 10 mg of meso-zeaxanthin and 2 mg of zeaxanthin per day is recommended
Orange pepper had the highest amount of zeaxanthin of the 33 fruits and vegetables tested.
Eggs from free-range, pastured hens have bright orange yolks, which is an indication of their elevated lutein and zeaxanthin content. Berries and Eyes
Dark blue or purplish, almost black-colored berries like black currants and bilberries contain high amounts of the antioxidant anthocyanins.
Bilberry and Grape Seed Extract
Useful for inhibiting or reversing macular degeneration.
Long-term supplementation with bilberry extract is effective in prevention of macular degeneration and cataract.
Dosage 120-150 mg per day ( 1 mg per pound of body weight ) Astaxanthin
Produced by the microalgae Haematococcus pluvialis. Other sources are salmon, shellfish and krill.
Helps protect for ARMD, Cataracts, Cystoid macular edema, Diabetic retinopathy, Computer eye strain
Helps prevent light-induced damage, photoreceptor cell damage,and damage to the neurons of the inner retinal layers.
Recommended dosage is 6 mg per day.
Chinese Medicine and the Eye How We See 15 - 53 Common Eye Conditions Treated
⦿ Macular Degeneration (wet & dry)
⦿ Glaucoma ❖ Dry Eyes ⦿ Retinitis Pigmentosa
⦿ Usher’s Syndrome ❖ Blurry Vision ⦿ Optic Neuritis (MS)
⦿ Optic Nerve Atrophy ❖ Nearsighted & Farsighted ⦿ Diabetic Retinopathy
❖ Computer Eye Syndrome
❖ Floaters
❖ Uveitis What Causes of Failing Vision? ⦿ Genetic Predisposition ⦿ Trauma/ Injury/ Illness ⦿ Drugs/Medications ⦿ Metabolic Imbalances ⦿ Poor Nutrition ⦿ Eye Strain ⦿ Epigenetic Stress Factors ⦿ Poor Circulation ⦿ Systemic Disease Conventional Medicine
⦿ The eye is diagnosed and treated as an isolated organ pathology.
⦿ Decline of vision is said to be a “natural process,” that can either stabilize or get worse. Conventional Approaches for Eye Disease
⦿ “Corrective” Glasses & Contacts Lenses
⦿ Medications
⦿ Surgical Procedures
⦿ “Wait and See What Happens…” Chinese Medicine Approach
⦿ Deals with the body as a whole, rather than in individual “parts.”
⦿ Everything is “connected,” and vision can be influenced by all organs in the body.
⦿ According to Chinese Medicine, most eye disease is related to Liver (functional) and/or Kidney (structural) dysfunction.
⦿ Holistic-Integrative approach produces the best outcomes for our patients. How Acupuncture Helps Vision
⦿ Increases Blood Flow the eye (O2 + food) ⦿ Stimulates Nerve Cells ⦿ Charges Dormant Retinal Cells ⦿ Regulates the Autonomic Nervous System ⦿ Promotes a Parasympathetic Response ⦿ Treats BOTH eye condition & underlying cause Computer Eye Strain: A Holistic Solution Conventional Treatment ● Ergonomics ● Software ● Vision Therapy ● Eyeglass Lenses Complementary Approach ● Ergonomics ● Environmental light ● Nutrients & Diet ● 20/20/20 rule ● Lifestyle ● Software ● Yoga & Stretching ● Breathing ● Rest & Eye Exercise ● Water ● Amber-colored lenses ● Remember to blink Statistics
● Computer Eye Strain is the #1 vision complaint in the USA ● Consists of a combination of vision problems, typically noticed during and after long hours on the computer. 70% of American adults are now using a smartphone on a daily basis.3 250+ million
Smartphone users in the United States, 2018
www.statista.com On average, americans aged 18 and older spend more than 11 hours per day
using a computer, watching TV or videos, or using smartphones and other electronic devices.4 Computer Ergonomics
Your eyes should be approximately at the level of the top of the screen.
Your elbows should be at 90 degrees, and your wrists should be straight. Avoid Eye Strain with your Laptop Laptops allow you to work anywhere, but their design does require attention to ergonomics!
The risk of strain to the eyes, neck, shoulders and arms is actually higher with laptops than with desktop computers because you cannot locate the keyboard and the screen at appropriate levels.
Consider using an external monitor or getting a laptop stand with a mouse and keyboard. Complementary Approach
Along with the ergonomic recommendations previously shown, there are excellent supplements one can take to help protect the retina and lens from blue light, sun damage, and overall, help protect vision. Lutein
Zeaxanthin
Nutrients and Black currant seed oil. Supplements Astaxanthin
Omega-3 fatty acids
Eye fatigue homeopathic pellets
Dry-eye eye drops (no preservatives) Yoga Poses Rest & Eye Exercise Like other muscles in the body, our eye muscles need frequent rest in order to perform at their highest levels. One of the key aspects for preventing eye strain is effective rest.
Take breaks from the computer and perform eye exercises to alleviate eye stress! Amber-colored lenses
These are the best color lenses for computer eyewear and sunglasses, because this particular color neutralizes blue light. Over time, UVA light affects the macula and contributes to the onset of macular degeneration and cataracts. The cornea and the lens absorb most UVB rays, so these rays may cause even more damage to your eyes than UVA rays. Environmental light. Don't use computers, smartphones, and other handheld devices as well as televisions, without other sources of light in the room.
Dilated pupils allow more blue light from electronic devices to reach the retina. Use the 20/20/20 Rule
Look away from your computer at least every 20 minutes,
...gaze at a distant object at least 20 feet away
...for at least 20 seconds.
Also, take a short 2-minute break every 30 minutes to stretch and do eye exercises. Breathing
Poor posture and breathing habits reduce available oxygen that in turn adds stress to the physiology.
Nose breathing allows for 20% more oxygenation than mouth breathing as breathing through the nose accesses the lower lobes of the lungs as well as releases nitric oxide.
A humidifier in the winter helps keep your eyes more comfortable. Thank you! Contact Information
845.475.4158