14 December 2010

Could acupuncture treat a lazy eye?

Acupuncture could be an alternative to eye patches or drops for older children with amblyopia, new research suggests.


Acupuncture could be an alternative to eye patches or drops for older children with amblyopia, new research suggests.

Children treated by a certified acupuncturist had similar improvement in their affected eyes as those who wore a patch over the strong eye for a couple hours a day: Most participants in both groups advanced two lines or more on an eye chart over the course of the study.

"Acupuncture has been used for a lot of things in Chinese medicine," senior researcher Dr Robert Ritch of the New York Eye and Ear Infirmary, told. "And it's being used more and more in the West. But evidence-based medicine to see what it actually does is relatively lacking."

Up to 5% of people around the world suffer from amblyopia. It is the most common cause of vision problems in children. Between 30% and 50% of cases are anisometropic amblyopia, caused by differences in the degree of nearsightedness or farsightedness between the two eyes.

The solution

The problem can be corrected with glasses or contact lenses if caught at an early age. But both are less effective for children beyond about the age of 7, who have traditionally been treated with patches.

"Patching can be annoying for kids," Dr Matthew Gearinger of the University of Rochester, said. "It may be socially tough to wear a patch at school, and wearing a patch at home can interfere with homework."

Another option, medicated eye drops, blur sight in the good eye and can also make homework difficult, Gearinger said.

In the new study, Ritch looked at 88 children in China between the ages of seven and 12 who suffered from amblyopia and had already been wearing glasses for at least 16 weeks.

They randomly assigned the children to wear a patch over the good eye for two hours every day, or to attend five acupuncture sessions weekly; both groups received their respective treatments for up to 25 weeks. The acupuncture needles were inserted at sites on the body associated with vision in traditional Chinese medicine.

The study

All the children were also given new glasses to wear and asked to perform an hour of daily near-vision activities.

By the end of the 25 weeks, the researchers found that sight in the effected eye had improve by at least two lines on an eye chart in 28 (66.7%) and 31 (75.6%) eyes in the patching and acupuncture groups, respectively.

More than twice as many children, who received acupuncture overcame the condition compared those who wore an eye patch: 42% versus 17%.

While Gearinger suggests that the concept is interesting and the potential for an alternate treatment for lazy eye encouraging, he cautions that the number of children studied was small. He also noted that the treatment option may be impractical in the US, where there are few acupuncturists with experience treating amblyopia.

Even if they were available, "it is a lot to ask parents to drive to a local acupuncturist 5 days a week, rather than just using drops or a patch at home," he said.

The findings

Dr Peter Lipson, of the University of Michigan, also pointed to some limitations of the study, including the fact that "everyone knew who was patched and who got acupuncture," which could have biased the outcomes.

Lipson, who was not involved in the work, further suggested that without an untreated group the study can't rule out the possibility that not doing anything, or simply using corrective glasses and performing daily exercises, would work just as well.

"This is not, in my opinion, evidence toward acupuncture being as good as standard care, only that in this particular study children did about the same if they received standard care or non-standard care," Lipson told. "It says nothing at all about acupuncture."

The researchers speculate in the Archives of Ophthalmology, published online today, that acupuncture needles placed at vision-related points on the body might work by increasing the blood flow to both the eye and brain. But they acknowledge that what lies behind acupuncture's apparent success remains unclear.

Ritch and his team are following up with more studies to improve the understanding of how acupuncture may be helpful in these cases.

"Don't knock Chinese medicine," said Dr Ritch. "It's been around for more than 3,000 years and there's a lot we don't understand yet."(Reuters Health/ December 2010)

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