The treatment of presumptive optic nerve ischemia by spinal manipulation.

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.