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Diplopia case; what to do? Any suggestions


#1

Diplopia case: My husband came back from work (army) this weekend with complaints of diplopia. First he suffered some pain in and aroud his (left) eye, eyebrow and head, then after a few days he started seeing double when using both eyes. Using one eye at the time is fine. (sees things double on top of each other.) He also can see clear in a distance like 20cm from eyes. Docters have no clue. Eyes are perfect, scan perfect, blood more than perfect. The’re still running tests. He is in army, been to all sorts of places and was para-jumping at the time when returning home with this complaint. Lyme tests will come back today. TCM diagnosis so far: spleen def, liver blood xu, loose stools,frequent urination, also at night, spontanious sweating, pale face, very slow/ fine pulse (but sports a lot), large/pale tongue/teethmarks, some white coating. History with lot of sinusitis problems. so, very on the xu side… Could it be some sort of Bell’s Palsy but on his Eye Nerve (that’s a gut feeling) ?? Ofcourse I’ll start treatment today, so any more suggestions? TIA! kind regards, Eline


#2

remember in TCM the liver opens to the eyes. Diplopia could occur due to weak liver yin and or blood failing to hold the liver yang; in the case of the eyes the relative excess of the yang there could account for the double vision.

I’d suggest a treatment that focuses on both liver yin and blood. Points I’d recommend; LV 8 (liver yin), LV 6 (liver blood), UB 2 and/or UB 3 (local points), [SP 3, SP 6, ST 36] for spleen def. In our system we use here I’d also use T9 (liver) and C3 (eyes).

My approach would be to try working on the liver yin/blood first, if that doesn’t yield results maybe then focus more on the possibility of it being local/neurological. in that case I’d suggest scalp acupuncture (sensory and vision areas) along with a few local points by the eyes.


#3

Thank you, Stephen. I’m indeed working on the Liver Blood xu, and locally. No result as yet… I am curious about the scalp area’s though?


#4

In addition to what @stephen stated the most important points of our system would be to add GV 17, and UB 9 on both sides (visual cortex of the brain) and then either both GB 15 and GB 16 (areas along the optic tract) or choose an area in that area that is pressure sensitive (i.e. “ashi” point). Strong tuina in the neck generally and along the scm (just slightly behind it) - “window of the sky points” would also be important.

Local points will be mixed results, but the points above on the scalp should work well. I’ve treated cases like this from simple bumps on the occiput that patients didn’t even remember doing initially (so light taps) as well as hard falls in the area which were often accompanied by blood pressure changes along with the visual issues. As for the others, use something that drains some heat from the eyes. Maybe something simple like the Yang Wei Dai Mai EV points (TH 5 and GB 41).

Keep in mind that not everything is tied to an underlying diagnosis, particularly when something comes out of the blue following some sort of activity. Not that you shouldn’t focus on the underlying issues, but they are not always the answer in acute situations. It would be nice if we are all that straightforward :smile:


#5

Thank you Chad! tried the pointes yesterday, during treatment (along with other points). No result as yet. But it may take longer to get some results probably! No Ashi points found by the way, but GB 14/GB1B2 area is vey tender to touch. I also noticed that is eyelid doesn’t work/close accordingly with his eyemovements, as if it is a bit ‘slow’? (been watching him all the time… can’t help it ;-). So for instance he’s looking down and his eyelid stays a bit more open instead of turning downwards. Muscle weakness i guess. Maybe working on Spleen a bit more. Thank you for all your advice so far!


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