Bilateral simultaneous optic nerve dysfunction after pariorbital trauma: Recovery of vision in association with chiropractic spinal manipulation therapy

Objective: To discuss the recovery of optic nerve function after chiropract ic spinal manipulation in a patient with loss of vision as a result of faci al fracture from a fall. Clinical Features: In a fall down a stairwell, a 53-year-old woman with mig raines fractured her right zygomatic arch, which was later treated surgical ly. Approximately 3 weeks after the accident, vision in her contralateral e ye became reduced to light perception. Electrophysiologic studies revealed that the function of both optic nerves was diminished, the right significan tly more than the left. Single photon emission tomography showed pancerebra l ischemic foci. Intervention and Outcome: Chiropractic spinal manipulation was used to aid recovery of vision to normal over a course of 20 treatment sessions. At tim es, significant improvement in vision occurred immediately after spinal man ipulation. Progressive recovery of vision was monitored by serial visual fi eld tests and by electrophysiologic studies. Unfortunately, the patient ref used a further single photon emission tomographic study when visual recover y was complete. Conclusion: This case report adds to previous accounts of progressive and e xpeditious recovery of optic nerve function in association with spinal mani pulation therapy.