Integrative Medicine

and VisionDr. 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

Chiropractors

Osteopaths

Cranial sacral therapists

Alexander teachers

Feldenkrais practitioners

Reiki masters

Homeopaths

Naturopathic Doctors

Acupuncturists

Yoga Teachers

Somatic based psycho therapists

Massage therapist

Holistic dentists

Holistic physicians

Herbalists

Nutritionists

Functional medicine practitioners

Ayurvedic

Meditation teachers

Tai chi

Qi Gong

Bach Flower

Essential oils

Flower essence

Hypnotherapy

Rolfing

Integrative Vision Care in the Optometric Office

● Refraction

● Eye exercises and visual hygiene

● Stress and rx - story about veterinarian

● Pathology - Holley - cataract Nora - macula

degeneration connie, Marc azoff - glaucoma

● Applied kinesiology - for rx

● Yoga postures

● O ring test

● Janet Travell M.D. Trigger points

● Psycho behavioral insights

exophoria, esophoria

● Different types of

myopia,astigmatism etc

● Mother eye father eye

● EMDR

• 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

Integrative Medicine Philosophy

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.”

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!

Exercises to Keep the Eyes Healthy

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

● Nutrition

○ Lutein

○ Zeaxanthin

○ Bilberry

○ Omega-3 fatty acids

○ Vitamin D3

○ Multivitamin,

● good visual hygiene

● Astaxanthin

● Diet

● Juicing

● Natural daylight.

● Exercise

● Breast-feeding

● Vision therapy

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

Corn (cooked) 1.5 / 1 cup

Broccoli (raw) 1.3 / 1 cup

Romaine lettuce (raw) 1.1 / 1 cup

Green beans (cooked) 0.9 / 1 cup

Broccoli (cooked) 0.8 / 1/2 cup

Papaya (raw) 0.3 / 1 large

Egg 0.2 / 1 large

Orange (raw) 0.2 / 1 large

U.S Department of Agriculture,

Agricultural Research Service,

USDA Nutrient Data Laboratory.

2005. USDA National Nutrient

Database for Standard Reference,

Release 20 (2007), Nutrient Data

Laboratory Home Page

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

⦿ Retinitis Pigmentosa

⦿ Usher’s Syndrome

⦿ Optic Neuritis (MS)

⦿ Optic Nerve Atrophy

⦿ Diabetic Retinopathy

❖ Dry Eyes

❖ Blurry Vision

❖ Nearsighted & Farsighted

❖ Migraine Headaches

❖ 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

● Ergonomics

● Nutrients & Diet

● Lifestyle

● Yoga & Stretching

● Rest & Eye Exercise

● Amber-colored lenses

● Environmental light

● 20/20/20 rule

● Software

● Breathing

● Water

● Remember to blink

Complementary Approach

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+ millionSmartphone users in the United States, 2018

www.statista.com

On average, americans aged 18 and older spend more than

11 hours per dayusing 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.

Nutrients and

Supplements

Lutein

Zeaxanthin

Black currant seed oil.

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

michael@naturaleyecare.com

845.475.4158