A New Holistic Perspective on Glaucoma

A New Holistic Perspective on Glaucoma

By Andy Rosenfarb, ND, LAc.
Glaucoma is not just an eye disease; it’s an effect of a larger systemic disease pattern. In the field of holistic eye care, we realize that symptoms like peripheral vision loss (tunnel vision) and increased eye pressure are always effects of underlying health conditions. We need to understand and correct the underlying causes – treating symptoms has proven to be insufficient. Unlike conventional medicine, we do not try to control symptoms, we seek the root cause.

Primary GoalsThe primary goals are clinical objectives involved in addressing glaucoma include:

  • Regulate Autonomic Nervous System & Control the Global Stress Response
  • Regulate Oxygen Supply to the Eyes
  • Regulate Blood Sugar (Glucose) Supply to the Eyes
  • Regulate & Control Inflammatory Response
  • Promote Neuro-Protection by Activating Antioxidant Production
  • Essential Fatty Acid (EFA) Support

Reporting the Research

Specific herbs, vitamins and minerals and alternative therapies support and regulate each of the above stated objectives. I am working on putting together a research report demonstrating clear evidence-based research supporting this information. My goal is to have it available within the next year. Some of the supplements are already well known like Ginko, Turmeric, dang gui, bilberry, ginseng salvia, fish oil and more recently resveratrol. These among others are widely known nutrients and botanicals and have been used for thousands of years. It is just now that they are being researched and increasing evidence is supporting their efficacy. It is not enough to just say that “X” herb is helpful for glaucoma, we must understand why, when and how to use them. For example:

ANS Support – Ginseng
Oxygenation – Dang Gui, Salvia, Ginko
Blood Sugar Stabilization – (proper diet and nutrition)
Neuro Inflammation – Tumeric, Resveratrol
Neuro Protection – Alpha Lipoic Acid, N-Acetyl Cysteine (NAC)
Fatty Acid Support – DHA, Omega 3, 6, 9

When we collectively consider and regulate all of potential trouble spots that may result in conditions like Glaucoma, we often see improvement in the overall health, and the condition of glaucoma may begin to improve. In many cases there is even some restoration of lost vision. When the above physiological processes are regulated we revitalize the dormant cells in the eyes. Dormant cells may be inactive, but are not dead or totally dysfunctional. It has been suggested by many experts in the field of neuro science that as long as the nucleolus of the cell is still alive and functioning, a cell may be restored to its normal, healthy state.

Dysfunctional Automonic Nervous System
In the field of holistic eye care, we never treat specific eye diseases, in this case Glaucoma. We treat the patient based on comprehensive clinical findings that paint a picture of a patient’s entire state of health. We make global observations about peoples’ overall health as they relate to certain health conditions – like Glaucoma. In this case we can say based on the holistic model that Glaucoma is an effect of an underlying dysfunction of the body’s Autonomic Nervous System (ANS). There is an overwhelming base of evidence in the field of neuro-science that supports this theory and it seems to be extremely accurate.

Co-Existing Conditions
In my years of clinical experience I observed that most of my patients with glaucoma had one or more of the following co-existing conditions: hypertension, elevated cholesterol, poor peripheral circulation, poor kidney function (based on blood test analysis), elevated homocystene & C-reactive protein (cardio inflammatory-stress markers), urination problems, poor digestion, poor hearing, poor memory, etc. Conventional medicine has recently been looking at each one of these as a causative factor for glaucoma including cardiovascular disease and H-pylori as possible causes for glaucoma. After spending much time researching brain and neuro science, it become obvious to me that the common thread in this clinical picture was improper functioning of the ANS. Although conventional medicine and the pharmaceutical companies have attempted to put out countless drugs in an attempt to regulate the ANS, none seem to be as effective as alternative therapies.

Regulating ANS with Acupuncture
In my experience there is nothing that regulates the ANS more effectively and more rapidly than acupuncture performed by a well trained professional. Acupuncture falls under the category of Sensory-Based Therapies (SBT). Drugs work fast but there are always side effects, acupuncture and most SBT’s have little or no known negative side effects. Risks only occur when acupuncture is performed by someone who is poorly trained. This includes physicians, or “Medical Acupuncturists” who have taken weekend courses or a 300 hour course (mostly on video). Be sure to ask about both training and experience if you wish to seek out acupuncture. There are few well trained acupuncturists who specialize in the treatment of eye disease and I train quite a few each year. You will find practitioners all over the country and our clinic is happy to help you find someone in your area that may be able to help you, a friend or family member.

The goal is to use safe and natural methods that will help improve and support the healthy regulation of the entire ANS, circulation, inflammation, glucose, and neuro-protective mechanism. Supporting these processes may dramatically slow the rate of or arrest the progression of degenerative vision loss. Other effective holistic therapies include supplementation (herbs, vitamins minerals), exercise, relaxation techniques, massage, diet, stress management, meditation, and lifestyle modifications.

I often get asked by my patients, “Why doesn’t my doctor know about or recommend alternative therapies?” There may be a host of reasons but the most common response I hear is that there is a lack of peer reviewed double-blind scientific research supporting it’s efficacy. That position is simply untrue.

Research
It is a fact that there is little research performed in the US on the efficacy of alternative modalities that have positive effects on patients diagnosed with glaucoma. This is mainly because drugs are more profitable than herbs, and therapies l ike acupuncture are much more cost effective and hold significantly lower risk than eye surgery or medication. Here are some research studies on glaucoma and acupuncture that show a positive outcome. We can expect that there will always be someone who will criticize and the research methodology:

Acupuncture For Patients With Glaucoma
EXPLORE: The Journal of Science and Healing, Volume 1, Issue 5, Pages 372-376
M.Kurusu, K.Watanabe, T.Nakazawa, T.Seki, H.Arai, H.Sasaki, N.Fuse, M.Tamai

Henry H.L. Chan, Mason C.P. Leung, Kwok-Fai So. The Journal of Alternative and Complementary Medicine. April 2005, 11(2): 315-322. doi:10.1089/acm.2005.11.315.

Teh-Ching Chu, David E. Potter. Journal of Ocular Pharmacology and Therapeutics. August 2002, 18(4): 293-305. doi:10.1089/10807680260218461.

It is not possible to patent herbs, vitamins, or minerals and therefore little money can be made – pharmaceutical companies are in the business of mass producing highly profitable drugs, and making sure that we stay on those drugs. It is in the company’s best interest to keep any new research on any non-medical beneficial information for glaucoma (and other health conditions), that is non-drug related from the general public. Why? Because it takes away from their profits. It is a sad truth that our country is “Pharmaceutically Biased” rather than “Scientifically Based.”

Virtually No Side Effects
The greatest advantage in using nutritional supplementation and sensory based therapies like acupuncture is that there are virtually no side effects. Cautions should be used when recommending supplements so as to avoid any negative herb-drug interactions. A well trained practitioner will be aware of these contra-indications. In general, holistic therapies are safe and pose little risk. Of course glaucoma meds have a lot of side effects including eye irritation, blood pressure irregularities, fatigue, frequent urination, headaches, etc. The risk of eye surgery and invasive procedures are present and there are increased risks for causing further damage to the eyes. Holistic therapies will not make vision worse, unless used by someone who is inadequately trained. The worst case scenario with holistic eye therapies is that they won’t work. The risks are small and the potential upside is great.

With the growing amount of information available on the internet, the public is rapidly becoming more aware of this state of affairs. New research on alternative treatments is showing up on sites like Google Scholar and other research-based web sites. Here are a few research abstracts that investigate the link between glaucoma and cardiovascular disease. They are on the right track but seem to be missing the ANS component:

The Role of Age and Cardiovascular Disease in Glaucomatous Optic Neuropathy1
Survey of Ophthalmology, Volume 43, Issue null, Pages S27-S42, S.Hayreh.

Retinal Microvascular Abnormalities and their Relationship with Hypertension, Cardiovascular Disease, and Mortality
Survey of Ophthalmology, Volume 46, Issue 1, Pages 59-80
T.Wong, R.Klein, B.Klein, J.Tielsch, L.Hubbard, F.Nieto

Relationship between Helicobacter pylori infection and glaucoma
Ophthalmology, Volume 108, Issue 3, Pages 599-604, J.Kountouras

The first two studies suggest the cardiovascular link to glaucoma, which we now know is rooted in ANS dysfunction. The third study suggests the link between glaucoma and H-pylori. The ANS also regulates digestion; impaired ANS regulation will have a degenerative effect on the Gastro-intestinal function rendering it more susceptible to infections like H-pylori. Do your own research and find out what is available to you!

About Dr. Rosenfarb
Dr. Andy Rosenfarb, ND, L.Ac. is an international leading authority on holistic eye health. He is a doctor of Naturopathy and a Licensed Acupuncturist. Dr. Rosenfarb has dedicated his life’s work to uncovering the underlying causes of degenerative vision loss. He has also created Acu-Gen, a holistic system that supports eye health. Acu-Gen has shown to be extremely helpful for most degenerative vision loss cases. Dr. Rosenfarb is the author of “Healing Your Eyes with Chinese Medicine.”

Treating Chronic Open-Angle Glaucoma with Acupuncture & Chinese Medicine

Treating Chronic Open-Angle Glaucoma with Acupuncture & Chinese Medicine
By Andy Rosenfarb, MTOM, Dipl. Ac., Dipl. C.H.
January, 2007
This article has been published in Acupuncture.com, April 2007
Over the last 10 years, in my practice I have specialized in TCM Ophthalmology. I have made quite a few significant clinical observations through diagnostic testing, treatment and direct feedback from my patients. In my clinical practice, I incorporate TCM with nutrition and “functional medicine.” Functional medicine uses methods to measure how weak (yin) or stressed (yang) the body’s organs, glands, and systems may be. Among these include blood sugar, adrenals, thyroid, pituitary, oxidation, hydration, ATP-energy production, etc. Both TCM and functional medicine look to uncover patterns of disharmony. The idea is to relate the patient’s symptoms (glaucoma in this case), to the underlying disease pattern.

Chronic open-angle glaucoma is a very common condition affecting about 3 million Americans¹. In my experience, it can be successfully treated with nutrition, acupuncture and Chinese medicine. In chronic open-angle glaucoma, the intraocular pressure (IOP) gradually increases because the eye’s drainage canals have gradually become congested. This build-up of fluid in the eyes can eventually damage the retina and optic nerve. Early glaucoma can be easily detected with regular eye exams. A “tonometer” will measure IOP and a vision field test will detect any peripheral vision loss.

In the early stages, the person will usually be unaware of increasing IOP. Often, by the time open-angle glaucoma progresses, some vision loss may be present whereas conventional medicine will usually recommend eye drops. The drops are used to lower the IOP in an attempt to keep the eye pressure down. The objective of the medication is to lower the IOP as to not cause damage to the optic nerve or retina and, thus, preserve vision. Many patients using these eye drops report that the drops burn and irritate their eyes and causing blurry vision. So conventional medicine offers a solution to lower the IOP, where the side-effects of the medication may be decreased vision… go figure?

The TCM classics say that in most cases chronic open angle glaucoma falls under liver-kidney yin deficiency with liver yang rising. Acupuncture points are suggested to sedate the liver and stomach channels. In my experience, this is most often the correct treatment for acute closed-angle glaucoma, NOT chronic open-angle glaucoma. Of course, you will always want to do your TCM evaluation (tongue, pulse, four-pillar, etc.) to be certain of the dominant pattern. I have personally found that most cases of open-angle glaucoma are due to a weak/deficient Gall Bladder and Kidney. This pattern is often coupled with an underlying Yang weakness.

Through using the principles of Chinese medicine, we can determine the origins of most diseases. In many cases, we can help the patient recover from many forms of illness. The TCM condition(s) of vision loss should first be distinguished with Yin-Yang theory. Looking at the Taiji Yin-Yang symbol, we can learn a lot about the nature of vision loss and how to treat it. Conditions like glaucoma and diabetic retinopathy will usually manifest with peripheral vision loss. The Yin aspect of the Taiji symbol mimics a loss of peripheral vision (dark outer and bright inner); therefore, the condition must be yin dominant and yang deficient. In cases like macular degeneration where the central vision is lost, the opposite condition is present. There is brightness on the periphery and darkness in the center. This means that the condition must be of a yang nature with yin deficiency. Please take a minute to observe this as it is a very simple yet important consideration into understanding the TCM pathogenesis of central and peripheral vision loss. Once this has been determined, you can do your other TCM exams to determine the channels and organs are being most affected.

In terms of treatment, I tend to treat the UB, ST and GB channels. GB being a yang channel delivers the Yang-Qi from the liver to the upper body and eyes. The UB is the yang channel of the water element that delivers the Yang-Qi of the kidney to the upper body and eyes. Stomach channel points are also important to deliver the spleen nutritive Yang-Qi to the eyes. A basic point prescription for Gall Bladder & Kidney weakness is:

Treatment:

GB-1 (local), GB- 20 (move Qi to the eyes), GB-21 (move Qi in GB), GB-30 (move Qi in GB), GB-37 (special eye point), GB-40 (source), GB-43 (tonification), UB-2 (local), UB-64 (source), UB-67 (tonification) St-2 (local), St-36 (horray), St-41 (tonification)

Extra Glaucoma points:

Extra Glaucoma #1 – I cun superior to SJ-23; and one finger-width lateral. In the tender spot, needle posterior until a strong “de-Qi” sensation is obtained.

Extra Glaucoma #2 – ½ cun anterior to St-5; needle superior in tender area as to obtain a strong “de-Qi” sensation.

Eye Exercises to Reduce IOP – Using the middle finger apply pressure below the eyeball, pressing in and up for 10 second, then rest for 10 seconds. Do this 3 times in a row 3 times each day.

As far as Chinese herb formulas go, for this pattern I usually combine and slightly modify two traditional formulas: Wen Dan Tang and You Gui Wan. The therapeutic goal is to mobilize the Qi and Yang of the Kidney, Stomach, and Gall Bladder. Sometimes I will add Er Chen Tang to help clear a path for the clear-yang to ascend to the eyes.

Moxa is also a great adjunctive therapy for glaucoma patients presenting with this kind of deficiency pattern. Use moxa on St-36, CV-12, UB-20, UB- 19, UB-22, and UB-23. Massaging clove oil or cinnamon oil into the GB and UB meridians can also be another effective way of activating the Yang-Qi in the channels.

Very briefly, in terms of functional medicine, I have found that chronic open-angle glaucoma is due to too low oxidation (Qi and yang deficiency) and diminished ATP cellular output (also Qi and yang deficiency). Using oxidants (not anti-oxidants) will help stimulate the metabolism and move the fluids in the eye, which may lower the IOP. Anti-oxidants slow down the fast -catabolic metabolism which we do not want to do. This may contradict most naturopathic and nutritional “antioxidant eye protocols.” A high dose of cod-liver oil (6000-9000 iu/day) is a great oxidant to help patients with open-angle glaucoma. Sterol fats like milk, cream, butter, cheese, etc. can potentially make this condition much worse.

Some herbs that can help boost ATP (Qi) production for open-angle glaucoma are Siberian Ginseng root, Astragalus, Ginkgo Biloba, Cat’s Claw, Capsicum, Colus Forscholi and Clove. These boost the Qi to increase circulation of the stagnant fluid in the eye. Once catabolic activity (Yang-Qi) is activated, the fluid may begin to drain through the eye, lowering the IOP and potentially lowering the risk of optic nerve and retinal degeneration.

NOTES:
1- Glaucoma Research Foundation, October 2006.