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Macular
Degeneration
Scott C. Richards, M.D. WHAT IS MACULAR DEGENERATIONAge-related Macular Degeneration (AMD) affects millions of older Americans, many of whom are legally blind because of the condition. As AMD advances, vision can become so compromised that ordinary everyday activities become difficult. Watching TV, reading, driving, seeing a picture on a wall, or reading a road sign can be extremely frustrating or even impossible. Some of this decreased vision is due to "blind spots" or distortion in the central vision. AMD can also cause difficulty with low-contrast tasks such as reading the newspaper, difficulty distinguishing colors, and generalized blurriness of the vision. Many patients describe a large black or grey spot in their central vision that is present for a few minutes upon awakening in the morning. Others report that words on a page seem to "jump around" or "run together", making reading much more difficult. In most cases, the peripheral vision remains good despite loss of the central vision. Although many medical techniques are available for the prevention and treatment of AMD, most of these techniques are designed to stabilize rather than improve the vision. Once vision has been lost due to macular degeneration, it is usually felt to be a permanent visual loss. However, we are sometimes surprised by a dramatic improvement in a patient's vision months or years after "permanent" damage to the retina. These occasional recoveries of vision are encouraging, and imply that there may be ways to improve macular function or partially heal the retina, even in macular degeneration. Many alternative therapies have been used for this purpose, but the most promising seems to be acupuncture. Acupuncture has been used for more than 3,000 years for treating and preventing illnesses. The World Health Organization has documented the effectiveness of acupuncture for many conditions. Medical schools and research facilities throughout the world are currently teaching and researching the many uses of oriental medical techniques. Acupuncture has become more accepted by the western medical community in recent years, and is a useful complement to traditional medical care. There are several reasons to think that acupuncture might be useful for eye conditions, including AMD. The Chinese have used acupuncture to treat eye problems for centuries, and although their ancient descriptions of medical problems differ greatly from our modern terminology, the basic problems with eyes have not changed all that much. Many of the "meridians" or channels of energy flow in the body as described by the Chinese begin or end at the eyes, and many classical Chinese acupuncture points are known to influence the eyes and clear the vision. Also, acupuncture seems to work best for functional problems rather than structural problems. In other words, acupuncture cannot set a broken bone or remove a tumor or an inflamed appendix or a cataract - Western medicine is far superior for these types of visible problems involving the structure of the body. Where acupuncture is most useful is in improving the function of organs or tissues - reducing inflammation and spasm in muscles, relieving nausea and pain, or treating some of the vague problems that Western medicine has trouble diagnosing and treating. Macular degeneration is partly a problem of the function of the retina, making acupuncture a reasonable approach for improving vision Many different acupuncture approaches have been tried for the treatment of AMD, including traditional Chinese acupuncture and variants of acupuncture developed in Japan, France, Denmark and the United States. After training in medical acupuncture at UCLA, Dr. Richards has traveled extensively to investigate many of these additional techniques. The acupuncture treatment he is presently using is based primarily on the techniques developed by Freddy Dahlgren, D.Ss., D.Ac., M.Ac.F. and John Boel of Denmark where Dr. Richards personally had the opportunity to train. More traditional Chinese acupuncture approaches are also used, depending upon how the patient responds during treatment.
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