Treatment of visual field loss by spinal manipulation: A report on 17 patients

THE PURPOSE OF THIS ARTICLE is to report on the recovery of visual field loss that is associated with spinal manipulation therapy. Seventeen consecutive patients with concentric narrowing of the visual fields, as measured by kinetic and static perimetry, were treated by outpatient spinal manipulation. Outpatient spinal adjustments were the sole method of treatment in all cases, unassisted by any other modalities of physical medicine. Complete recovery of the visual fields occurred in 10 patients; three were lost to follow-up after having made significant improvement, and two did not regain full visual fields despite a number of sessions of treatment, although they were significantly improved. In one patient, the visual field loss was noted to have recurred on review some months later. Another patient discontinued treatment for an overseas trip, during which time he was well. On his return to Australia, he developed constitutional symptoms again and presented for more spinal manipulation treatment, at which time his visual fields were again noted to be constricted. The recovery of constricted fields of vision with spinal manipulation has been recorded. These recoveries question the understanding of this condition, which interprets the visual disability as a form of hysteria. The query is raised whether this form of visual loss may be a manifestation of cerebral vascular hypoperfusion. More research is required to elucidate the nature and extent of the effect of spinal manipulation on vision.