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Ask an expert - body - head - eyes

16 questions

A:  We are always cautious about answering questions about conditions for which there has been little research evidence. The one summary of trials on the use of acupuncture for glaucoma really does not say very much

http://www.ncbi.nlm.nih.gov/pubmed/23728656

A part of the problem here, as the author of the review says, is that the standard method of testing procedures in the West, the randomised double blind control trial, involves one group getting a real treatment and the other group getting a sham treatment, to test the difference in outcome. No physician, however, would leave a condition like glaucoma untreated because of the potential for serious sight loss, so until someone tests the effects of standard treatment against standard treatment plus acupuncture there will be nothing definitive to point to.

All of us have treated people with glaucoma, either as a primary condition or as a secondary condition after a patient has presented with another problem, and I'm sure all of us can report some success. As the author of the review says, blockages in the flow of energy which prevent the free flow of fluids sums up what glaucoma is, and it would seem intuitively possible that acupuncture would have an effect. This expert's experience, though, has been that it takes a long time to achieve sustained and sustainable results, and the medications remain a part of the picture throughout. What acupuncture seems to do well is to prevent uncontrollable variations in pressure, but there is no statistical evidence to which we can point.

We have searched the internet and found surprisingly little patient feedback about the treatment of glaucoma with acupuncture. Most of the official charities and organisations do not have a great deal of feedback from patients on their websites, and we have not been able to trace many forums of sufferers. That these exist is not in doubt; the internet has created thousands of forums across the globe. The best that we can say is that if you search, you will find quite a few, and our experience is that they tend to be  a great deal more measured than used to be the case. Where it used to be 'it works, oh no it doesn't' the entries now tend to reflect the wider range of outcomes and views.

We do not ourselves 'bank' feedback on specific conditions, primarily because we take the generalist view that we treat the person as much as or more than we treat the condition. However, our best advice as always is to go to see a BAcC member local to you for a brief face to face assessment. This will enable someone to see your problem not simply as it is but against the backdrop of your overall health. This will enable them to offer a much better view of what might be possible and also enrich any basic understanding of how your problem may have arisen from a Chinese medicine perspective.  

On this basis we would always recommend that someone should visit a local BAcC member to seek a face to face assessment and also to try to understand the problem in its overall context in the body, not just as a specific manifestation. This is how Chinese medicine works, treating people not conditions.

What we would say, however, is that occasionally you come across websites for people treating eye conditions, especially two clinics in the USA and one clinic in India, which claim amazing success rates for these kinds of conditions. Our view is that if something was that effective we would all be doing it, so there may be something unique to the character of these set-ups which is driving such spectacular improvements. We tend to agree with the last answer; success can take a while, is always relative, and often reduces the impact of the condition more than totally removing it.

However, acupuncture will certainly not do any harm, and may well do some good.

Q:  Over the past 18months I have experienced difficulty looking into the distance, watching TV and latterly even walking around outside. My left eye closes regularly. My sight is OK.  Recently I have also noticed my lefthand side of my face is slightly distorted. I have had several eye tests all confirming that. I have received Botox for bletherspasm which has helped with the left eye closing but nothing else. I have had an MRI scan which all came back normal. I wondered if acupuncture could be something that could help?

A:  We are very sorry to hear of your experience. It must be rather unnerving to have had all the relevant tests and still have neither a formal diagnosis nor an effective treatment for your problem.

On the assumption that the MRI and other tests rules out any neurological problems, we do have to say that what is happening to you is suggestive of some form of energetic blockage on one side of your face not dissimilar to Bell's Palsy, which as our fact sheet shows we do treat with some cautious claims for success

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/bellas-palsy.html

The reason for mentioning this is not because it is Bell's Palsy, but because in Chinese medicine the understanding and treatment of the problem readily lends itself to other problems which manifest as one-sided disturbances. As you have probably read on our website, traditional acupuncture is based on theories of a flow of energy called 'qi' and its rhythms, flow and balance. When this is disrupted in any way it can give rise to symptoms. Sometimes this disruption can be very superficial, where a problem is generated, as for example in the Chinese understanding of Bell's Palsy, by exposure to a climate condition. BP is much more common in China where people work outdoors, and a strong wind blowing on one side of the face is sometimes seen as the cause. 'Wind' is seen to disrupt and block the flow. We see occasional cases, less so now that aircon is so common, where people have driven for long distances with a car window open to their right side.Of course, the superficial flow of energy also connects to deeper flows which connect in turn to Organs, functional units which are similar to their western counterparts but have wider meaning. Some of the functions governed by the Organs can have effects on areas of the body, especially one-sided effects. The skill and art of the practitioner lies in gathering all of the information and making sense of what is stopping the flow and how it can be corrected as economically and elegantly as possible.

Clearly not all problems of this type are going to be treatable, but for those cases where there is some reasonable chance of change and improvement, there will often be clear diagnostic information which will guide a practitioner. There is no substitute for popping along to visit a BAcC member local to you who can give you a brief and informal assessment, hopefully without charge, of what he or she believes may be possible with acupuncture treatment.

 

A: We are always cautious about answering questions about conditions for which there has been little research evidence. The one summary of trials on the use of acupuncture for glaucoma really does not say very much

http://www.ncbi.nlm.nih.gov/pubmed/23728656

A part of the problem here, as the author of the review says, is that the standard method of testing procedures in the West, the randomised double blind control trial, involves one group getting a real treatment and the other group getting a sham treatment, to test the difference in outcome. No physician, however, would leave a condition like glaucoma untreated because of the potential for serious sight loss, so until someone tests the effects of standard treatment against standard treatment plus acupuncture there will be nothing definitive to point to.

All of us have treated people with glaucoma, either as a primary condition or as a secondary condition after a patient has presented with another problem, and I'm sure all of us can report some success. As the author of the review says, blockages in the flow of energy which prevent the free flow of fluids sums up what glaucoma is, and it would seem intuitively possible that acupuncture would have an effect. This expert's experience, though, has been that it takes a long time to achieve sustained and sustainable results, and the medications remain a part of the picture throughout. What acupuncture seems to do well is to prevent uncontrollable variations in pressure, but there is no statistical evidence to which we can point.

We have searched the internet and found surprisingly little patient feedback about the treatment of glaucoma with acupuncture. Most of the official charities and organisations do not have a great deal of feedback from patients on their websites, and we have not been able to trace many forums of sufferers. That these exist is not in doubt; the internet has created thousands of forums across the globe. The best that we can say is that if you search, you will find quite a few, and our experience is that they tend to be  a great deal more measured than used to be the case. Where it used to be 'it works, oh no it doesn't' the entries now tend to reflect the wider range of outcomes and views.

We do not ourselves 'bank' feedback on specific conditions, primarily because we take the generalist view that we treat the person as much as or more than we treat the condition. However, our best advice as always is to go to see a BAcC member local to you for a brief face to face assessment. This will enable someone to see your problem not simply as it is but against the backdrop of your overall health. This will enable them to offer a much better view of what might be possible and also enrich any basic understanding of how your problem may have arisen from a Chinese medicine perspective.  

A:We were asked this question a little while ago, and our answer was:

A great deal depends on what is causing the dark circles to appear. Normally we all associate dark circles under the eyes with tiredness, but assuming that this is not the case with your question, there are a number of diagnostic patterns within Chinese medicine for which dark circles might indicate an underlying weakness of energy, or 'qi' as the Chinese call it. Some people's inherited energy, for example, can have been compromised by the health of either parent at conception or by a difficult pregnancy. In these sorts of cases, their management of their life has to be a little more careful, i.e. they may not be able to manage 60 hour working weeks and party all weekend. In some cases the dark circles are a permanent feature.

The key thing to bear in mind is that this will be one symptom or sign amongst a number of others, and treatment would generally be focused on the underlying imbalance. You will see, however, a growing number of websites which promise to do away with dark circles and other signs with facial or cosmetic acupuncture. The BAcC's view is that these procedures are useful when used in the context of a traditional diagnosis and treatment of the whole system. If they are simply applied as one-off symptomatic treatments in many cases whatever gains are made will be lost very rapidly. That is not to say that there may not be cases where this is a sign of local stagnation which acupuncture might help to clear, but in the majority of cases treating the whole system would probably be necessary as well.

We cannot give out referrals to specific members who focus on this kind of work, but it is a relatively straightforward search using google to find a BAcC member in your area who also does facial or cosmetic acupuncture. There are indeed a number of organisations set up by BAcC members as support networks for people doing this kind of work, and they have searchable databases of members who have taken postgraduate training in this area. We recommend that you find someone who is both a BAcC member and trained in cosmetic acupuncture to assess whether treatment may be of benefit to your specific needs.

We think that with the benefit of hindsight we placed too much emphasis on the use of 'facial' or 'cosmetic' acupuncture.' That is not to say that this is not an interesting case of an ancient technique being used to meet modern needs, but there are more cases of darkness under the eye which are the result of a long-standing systemic weakness or simple genetic inheritance than there are case which are going to be fixed by a couple of good nights sleep and a few needles.

We would advise you to visit a BAcC member local to you, not necessarily one who uses cosmetic acupuncture, and see what they can tell you based on a brief face to face assessment.

Q: I have macular degeneration and I would like your opinion on the work of Dr. Lundgren and his Santa Fe protocol. Has no one followed this up in the U.K.? If I can obtain any reassurance I would certainly go to the States for treatment.

A: We have been asked about the treatment of macular degeneration before, and our most recent answer was:

We conducted a search and the best we could come up with

http://www.ncbi.nlm.nih.gov/pubmed/21355157

a study in Chinese which appears to demonstrate that acupuncture out-performs conventional medical treatment. Otherwise the only direct reference is a Cochrane Review summary which identifies the fact that there is a systematic review or similar on their files as pending

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1705651/

With conditions like this there are a number of difficulties involved in answering the 'does acupuncture work?' question. From a Chinese medicine perspective, although twenty patients may have the same named western condition there could be twenty different treatments. The symptom from this perspective is merely the weak link where an overall imbalance tips something into poor or degenerating function, and although local treatment could achieve some useful short term gains, helping to improve the underlying balance is the key to getting well and staying well. This involves treating the person as much as treating the disease.

Conditions like this can often become unintentional money pits, and it is easy to build up a treatment habit based more on hope than experience. Practitioners are often inclined to fall into the same trap in pursuit of better health for their patients. The best positive result one might achieve could be a decrease in the extent of deterioration, or as one patient put it once, 'do you know, I think I'm getting worse slower'. Of course, this is unverifiable and largely unmeasurable, but there is no doubt that many patients have reported anecdotally that they have exceeded the expectations of their clinicians in maintaining reasonable function longer than anticipated. Naturally there are a great many other factors which make this possible, not least of which is that seeking complementary treatment is itself evidence of a determination to do something which is probably reflected in someone's overall health.

From a Chinese medicine perspective the eyes as a functional unit have close relationships with two or three major Organs (capitalised to differentiate them from the western concept of an organ) and if there is evidence of a generalised weakness in relevant related Organic functions, a practitioner might think that there is some hope that treatment may be of value. There is also plenty of discussion in Chinese texts about local needling and its potential to halt or even slightly reverse decline.

We have to be realistic, though. The kind of deterioration which this condition causes is well-documented as likely to continue, and it would be a foolish practitioner who tried to instil too much optimism in a prospective patient about the chances of major improvement. However, it is always worth while talking to a BAcC member local to you, and we are sure that our members will be only to happy to give you advice on the basis of a brief face to face assessment.

We are aware of the work of the clinic you mention, as well as two or three similar clinics in India. However, we do not have enough independent corroboration of the results claimed to offer a view, although we have to say that the techniques in the Santa Fe Protocol are not traditional acupuncture. The use of ear acupuncture, electroacupuncture and scalp acupuncture are used by an increasing number of BAcC members, but are not within the mainstream traditional acupuncture training.

We are sorry not to be able to give you more positive advice, but it would be remiss of us to support something whose provenance we cannot check. The best we can offer by way of advice is that you try to find someone who has undergone the treatment with whom you can discuss their experience. In our experience American blog sites abound, and if someone has had a very good, or indeed very bad, experience, you are certain to be able to read about it and make contact.

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