Can chiropractic care disrupt vision?

For people who usually have their necks adjusted by a chiropractor, the Kellogg Eye Center of the University of Michigan has an interesting case to know: it has been shown that high-speed neck manipulation has been shown caused eye strain and uneven vision.

The risk is rare, but the one that Yannis Paulus, M.D., retina specialist at Kellogg, reports in the American Journal of Ophthalmology Case Reports.

Flares and energy rotations sometimes performed during high-speed neck manipulations have been associated with lesions of the retinal blood vessels. The resulting abnormal bleeding in the eye can also lead to vision loss.

This was the case for a 59-year-old woman who had a "tadpole-like" vision as she was returning home from a visit to a chiropractor. She had just received manipulation of the cervical spine using the high-speed technique to relieve her headaches.

The woman's vision has returned to normal in about two weeks without treatment.

Her optometrist, co-author of the case report, referred her to the Kellogg Eye Center.

Since the cells of the retina are so sensitive, even the smallest lesions in the blood vessels can cause vision problems.

That's why Paulus encourages patients to report their activities in alternative medicine – and doctors listen to them carefully and inform them of possible side effects.

Risks of chiropractic treatment

The experts in cardiology have talked about the health risks of chiropractic treatment.

High velocity neck manipulation has been associated with some type of stroke, or dissection of the vertebral artery, which has led the American Heart Association to issue a warning in 2014.

Short and fast movements of the neck can cause a small tear in the walls of the arteries of the neck. Damage to the artery wall can lead to a stroke if a clot forms on the site and breaks down later to block a blood vessel in the brain.

Eye problems can follow, including double vision or occlusion of the central retinal artery, a blockage of the artery carrying oxygen to the nerve cells of the retina at the back of the eye.

But the case of Kellogg suggests a new complication: direct damage to the structures of the eye due to the force of neck adjustments.

According to the authors, this is the first time that chiropractic care leads to multiple preretinal hemorrhages. Other possible complications disrupt the vitreous humor – the limpid, gel-like substance that fills the eye between the lens and the retina.

The high-speed technique may have induced posterior vitreous detachment or PVD, which occurs when the vitreous humor moves away from the retina.

No specific treatment is needed for PVD. According to the American Society of Retina Specialists, most patients no longer notice flashes of vision after three months and "floating patients" tend to improve.

Complications due to MPV are rare but can be serious and in some cases require urgent treatment, such as a laser treatment to seal the retinal tear or surgery in case of retinal detachment.

Although the connection to chiropractic care is considered a temporal association, it is difficult to ignore the timing of the patient's ocular symptoms following the chiropractic visit.

Paulus does not exclude other chiropractic visits for the patient but notes that "her chiropractor may have to change the techniques used during her visits".

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