(Branch Retinal Vein Occlusion)
Candis Cantin Kiriajes
When I was 13 years old I was diagnosed with mild myopia with astigmatism. Since that time I have used glasses for driving or watching movies – my use of glasses has been very limited as I do not like wearing them. One of the benefits of being near sighted however is that you can do close work with no visual problems – and for most myopic people they don’t usually need reading glasses when they enter their 40’s because their nearsightedness allows them to see the tiniest print. But they still need them for viewing
distant things.
Fast forward to my 63rdyear. Last June I was driving home from the Bay area and I noticed that my glasses did not “work” any more. They actually made me see things blurry. So, I took them off and found that I could see better without them! I figured it was time to see the optometrist and get a new prescription. (it had been four years) But I put it off until the next thing happened.
About a month later I noticed that the vision in my right eye was obscured – like I was looking through crumpled cellophane wrap. This continued to get worse and I finally made an appointment with the optometrist. He checked my vision and found that my right eye had spontaneously improved by 65% and my left by 35% - I could read the charts almost perfectly at the 20/20 level – in spite of the “cellophane” effect in the right eye. He then took a picture of my right eye which had the fuzzy vision and found the
cause of the problem – it is called “branch retinal vein occlusion” - a blood clot in a vein in my eye had caused my vein to pop and was leaking blood on to the retina. There is another condition called “Central Vein Retinal Occlusion” which is worse because that vein is in the center of the eye and obscures vision more completely. To say the least, when the doc showed me the photo of my eye and I saw all this blood leaking in it, I was freaked out! But my first thought after the initial freak out was “I have to figure out what
remedies I will use for this.”
The optometrist sent me immediately to an ophthalmologist who reexamined my eyes and told me if it got worse to come in immediately. He recommended aspirin 81mg and vitamin C. There is no other treatment other than laser treatment if “rogue veins” begin for form. This is the eyes way of trying to handle the situation. It sometimes tries to create new blood vessels that are not very strong and the bleeding just continues.
When I returned home that day, I went on line and began to do the research on this condition. Here are some of the things I found out;
A retinal vein occlusion occurs when the circulation of a retinal vein becomes obstructed by an adjacent blood vessel or a blood clot. This results in the stoppage of blood flow, causing hemorrhages in the retina. I’ll explain this in more detail later.
Here are the Symptoms
Sudden onset
Blurred or missing area of vision (if a branch vein is involved)
Severe loss of central vision (if a central vein is involved)
Possible causes or contributing factors include the following:
Aging, highest rate of occurrence in people in their 60s and 70s
High blood pressure, hypertension
High cholesterol
Smoking
Glaucoma, diabetes, and other conditions are risk factors
Cardiovascular disease
Vein occlusion is diagnosed by examining the retina with an ophthalmoscope. Fluorescein angiography may be performed in some cases to study the circulation of the retina and to determine the extent of macular edema or swelling – The doc said I had both macular and retinal swelling.
Following a vein occlusion, the primary concern is to treat the secondary complications. If areas of the etina are oxygen-deprived, LASER may be used to prevent growth of delicate vessels, the ones I mentioned earlier, that could break, bleed or cause glaucoma. The retina has veins that carry blood away from the retina (and ultimately back to the lungs and heart for oxygen replenishment and recirculation). Think of streams and rivers: tiny creeks combine to form streams or small rivers (branch veins) which combine to form one large river (the central vein, the "Mississippi River" of the retina).
For reasons that are not always clear, a blockage can develop in a vein, in either a branch vein or the central vein. Branch vein occlusions tend to happen in people over 45, often with some history of high blood pressure and perhaps diabetes and high cholesterol. Central vein occlusions tend to happen in patients over 60. When vein occlusions happen in patients under 40 we must consider a predisposition to blood clots, and we may send you to a hematologist (blood clotting doctor) for special tests.
These vein occlusions cause blood flow to "back up" into the retina, causing bleeding and swelling within the retina itself. This bleeding and swelling in the retina reduces vision. Per the medical system they say that nothing can be done about the occlusion itself. Some exotic treatments, including injecting TPA ("clot buster" medicine) into the vein, dissecting the vein (sheathotomy), and making an incision in the optic nerve (radial optic neurotomy) have been initially greeted with great fanfare but have not graduated to the level of widely-used, evidence-based interventions.
Based on the Branch Vein Occlusion Study clinical trial, the only intervention (for branch vein occlusions) based on a high level of evidence is grid laser for cases where the retinal swelling does not go away on its own after a few months.
In the past few years, retinal physicians have started to inject steroids into the eye for retinal swelling associated with branch and central retinal vein occlusion. This particular use of steroids is not FDA approved, e.g. is "off-label." Steroid injection carries risks, including cataract, glaucoma, and in-the-eye infection. The steroid injection often needs to be repeated, or the swelling may return after the steroid effect wears off after 3-4 months.
So, basically, what I found out is the doc don’t have any solutions for this condition – aside from trying to handle any underlying cause such as high blood pressure, diabetes etc. so that the retinal condition doesn’t reoccur or just continue to get worse. I don’t suffer from any of the conditions that would predispose me to branch retinal vein occlusion other than my age. So, as I began to reflect on this condition, one of my all
time favorite herbs – tienchi ginseng (Notoginseng) came to my mind. But before I go into a whole write up about the virtues ofthis herb I am going to talk about a category of herbs that Chinese medicine expounds upon. Just as an aside, I feel that the ways in which Chinese Herbology categorizes herbs has can enhance an herbalists of various traditions in their understanding of herbs and can benefit from the study of these categories. These categories give an in-depth look at the herbs, what the energetics are
(hot, cold, wet, dry etc., the patterns it addressing, the organs/meridians that are affected and the formulation that it would work best in.
Herbs that Regulate the Blood –
In Chinese medicine herbs in this category deal with three types of blood pathology:
Bleeding disorders thus herbs that stop bleeding are used
Blood stasis. The herbs that invigorate the blood and help dissolve clots are used.
Blood deficiency. These are herbs that tonify the blood are employed to nourish the person in general.
In category one, bleeding disorders, herbs are used for various types of bleeding, such as uterine bleeding, excess menstruation, nose bleeds, bleeding from trauma or retinal bleeding are examples. The herbs in this category are best blended with herbs that help to rectify the underlying cause of the bleeding. There will be more about the combinations and formulas later in the article.
Category Two, blood stasis, deals primarily with conditions in which the flow of blood is retarded, becomes blocked or is “Static.” The most common symptom of blood stasis is certain types of pain caused by lack of proper flow of blood. The pain from stasis of the blood is rather precisely localized and feels deep or sharp and may be of long duration. Most common types of pain of this nature are lower abdominal pain, chest pain, pain from trauma (bruising internal and external), and internal bleeding (like what I had in my
eye.) This concept can be understood in modern biomedicine as hematological disorders including hemorrhage, congestion, thrombosis (a stationary blood clot along the wall of a blood vessel, frequently causing vascular obstruction. Some authorities differentiate thrombus formation from simple coagulation or clot formation, thickening of the blood), and local ischemia (A decrease in the blood supply to a bodily organ, tissue, or part caused by constriction or obstruction of the blood vessels.)
Category three, blood deficiency, is handled by nourishing the blood. Primary manifestations of this are pale face and lips, diminished vision, dullness of the eyes, palpitations, lethargy, menstruation irregularities, pale tongue and fine pulse. Most of the herbs listed in this category do not directly nourish the blood but instead strengthen the body and improve its nutrition thereby indirectly increasing the number of circulating blood cells. Many times I will use the herbs in these categories with meat soups with the
addition of molasses to help nourish the blood more deeply.
1 Tienchi Ginseng - Superstar of Blood Regulators/ blood adaptogen
“Tienchi is more valuable than gold” words of Li Shih-chen, famous pharmacologist of the Ming Dynasty.
Tienchi is also know as Panax notoginseng, pseudoginseng, and san chi. It is in the araliaceae family
Properties: slightly bitter, slightly sweet, warm
Channels entered: liver, stomach, large intestines
Recently, one of my students asked me if I had to make a choice of one herb what it would be. Tienchi ginseng was my answer. Tienchi is considered a Tonic herb – one that builds, sustains, nourishes and supports our body. It also stops bleeding without causing blood stasis. In fact it resolves blood clots which is a form of blood stasis and keeps the blood moving in the proper way within the vessels. It is used for both internal and external bleeding. Because if this dual action it is used for many varied conditions. For
example, since it moves the blood it helps to alleviate pain; it can be used for traumatic injuries, swelling and pain due to sprains, falls, or accidents where there is bruising internally or externally. I have used it as well in formulas for heart conditions, arthritis, headaches, back pain and stomach pains which show signs of blood stagnation. In its prepared form (cooked) it builds the blood. In “raw” form tienchi appears to provide the raw material for the human synthesis of major adrenal hormones such as cortical and reproductive hormones such as testosterone, estrogen and progesterone. The most significant research however is around its ability to affect positively the heart and its tributaries. Thus, depending if you use it raw or prepared, Tienchi covers all three of the categories listed above!
I feel that tienchi ginseng is a true blood adaptogen and can help to handle not only the acute condition presenting but also help to clear up the underlying pattern that might be the true cause of an illness. For example, with branch retinal vein occlusion, the person might have diabetes, high blood pressure, plaque buildup in the arteries as well as bleeding in the eye. Tienchi can address all of these conditions.
Back to my story. After deciding on Tienchi ginseng as one of the primary herbs for my condition, as a secondary herb I decided on dan shen, (salvia miltiorrhiza root, and red salvia root.)
2. Dan Shen/ Red salvia root/salvia miltiorrhiza root
Properties: bitter slightly cold
Channels entered: heart, pericardium, liver
Dan shen is in the category of “herbs that invigorate the blood” which again are used primarily in treating problems associated with blood stasis and circulation problems, such as stroke, chest pain (angina pectoris), and other diseases of the heart and blood vessels. It is also used for menstrual disorders, chronic liver disease, and trouble sleeping caused by complaints such as rapid heartbeat and tight chest. It is also used to relieve bruising and to aid in wound healing.
Dan shen appears to thin the blood by preventing platelet and blood clotting. It also causes blood vessels to widen, and thus improve circulation. Because of its cooling nature it is effective in clearing heat from the system and easing irritability. So I had two herbs that I felt would be appropriate for this condition. The next herb that I added to the formula was:
3. Chinese hawthorn berries/ crataegus pinnatifida/ rose family/shan zha
Properties: Sour, sweet, slightly warm
Channels: liver, stomach, digestive system
The hawthorn fruit is high in vitamin C and contains the same antioxidants that are found in grapes. Hawthorn is often used in Chinese herbal medicine to aid digestive functions in the human body, especially in helping in the digestion of protein.Hawthorn berries promote the flow of spleenqiand removes stagnation of food in the stomach as well. It lowers the blood pressure, and has shown to be useful in the prevention and treatment of atherosclerosis.
Other herbs that I considered were goji berries, and chrysanthemum flowers, bilberry, and eyebright. As I was contemplating my formula I was still searching the internet for info on my condition when I came across a formula calledCelosia 10 from Seven Forests herb company. It contained some of the herbs that I discussed previously plus had other herbs that I had not considered.
Here is the formula:
Celosia, rehmannia, dan shen (red salvia root), red peony root, eclipta, tienchi ginseng, sophora flower, chrysanthemum, goji fruit, and tang kuei.
4. Celosia Seed (qing xiang zi), feather cockscomb/Celosia argentea L
Properties: Sweet/ cool
Channel entered: liver
According to the principles of traditional Chinese medicine, celosia seeds have sweet and cool properties, and are associated with the Liver meridian. Celosia seeds drain liver fire and clear wind which, in layman’s terms, basically means it cools the liver off and calms the nervous system down. The main ingredient in celosia is celosiaol, a chemical that dilates the pupil of the eye. Celosia seeds are used to treat eye-related disorders, such as impaired vision, blurred vision, nebula (a white spot or opacity of the cornea), and red
and painful eyes; some practitioners use the seeds to treat hypertension. This herb I feel is a specific for Retinal vein occlusion.
5. Rehmannia glutinosa/ RadixRehmanniae Glutinosae Conquitae/ Chinese
Foxglove/Di huang
Properties:sweet, slightly warm.
Channels entered:Liver, Kidney, Heart.
Di Huang tonifies the Blood: used for Deficient Blood patterns with such symptoms as a pallid face, dizziness, palpitations and insomnia. Also used for irregular menstruation, uterine bleeding, and postpartum bleeding. It nourishes the Yin, the moistening aspect of the body. It is used for kidney yin deficiency with such manifestations as night sweats, nocturnal emissions, and Wasting and Thirsting syndrome. It helps to strengthen the bones and tendons and to nourish the marrow. It is considered to be a tonic to the eyes
and ears. Raw rehmannia is said to be cooling to the blood and nourish the yin while the “prepared” rehmannia is warms a person especially during the cold months and nourishes the blood and yin.
6. Sophora Flower (huai hua)Flos Sophorae
Properties: bitter and slightly cold
Channels: liver stomach and large intestines
Because this herb moves the excess heat down it helps clear heat from the liver and large intestine, and from the blood thus helps stop bleeding. It is cooling to the liver and helps to improve eyesight. It is indicated for bleeding due to blood-heat, conjunctivitis (inflammation of the mucous membrane that lines the inner surface of the eyelid and the exposed surface of the eyeball.) and for bleeding hemorrhoids.
7. Red Peony root/ chi shao/ radix paeoniae rubra
Properties:Bitter in flavour, slightly cold in nature
Channels: primarily the liver
Its cold property has the function of removing heat from the blood, promoting blood circulation and purging fire from the liver. It is indicated for blood-heat, blood stasis and the syndromes caused by liver-fire. By removing pathogenic fire from the blood it dissipates blood stasis as well as relieves pain. It can be combined with other herbs for clearing heat to cool the blood such as rehmannia root or with herbs that promote blood circulation and relieving blood stasis such as Chinese lovage root (chuan xiong), tienchi ginseng, and Tang quai (Angelica sinensis).
8. Chrysanthemum flowers/flos chrysanthemi)/ Ju Hua
Properties: bitter, sweet and slightly cold
Channels: Liver and Lung channels.
Yellow Chrysanthemum has a beneficial action on headache and eye complaints. It has long been used as an eye tonic and can help relieve red, painful, dryness or excessive watering of the eyes. It is also used for blurry vision, dizziness and spots / floaters in front of the eyes. Chrysanthemum combined with Goji berry (Gou Qi Zi) and the Rehmania Six combination to make a great formula called Qi Ju Di Huang Wan.
Chrysanthemum is also used to clear headaches and fever associated with colds and flu. Its actions are antibacterial, antifungal, antiviral and anti-inflammatory. It also may help lower blood pressure and relaxes blood vessels. Ju hua cha - chrysanthemum flower tea is commonly consumed in China almost as much
as green tea, dueboth to itsmedicinal effects and its excellent taste!
9. Goji berries/Lycium chinensis/ Gou Qi Zi
Properties: Neutral, sweet
Channels: Liver, Kidney, Lung
Blood tonic
This fruit is known in Chinese medicine to be a great tonic for the liver and the blood. Goji berries increase vitality and brighten the eyes, especially improving night vision. It also calms the heart and nervous system. I’ve added it to my soups for years and have added it to many of my herbal formulas. Because of its nourishing nature to the kidneys and liver, it helps with blurred vision, dizziness pertaining to old age, diabetes, fatigue, loss of blood or anemia, and fluctuatingweight. For dizziness and blurred vision you can
make put one hand full of goji berries with two handfuls of dried chrysanthemum flowers into three cups of boiling water and let simmer with the lid on for 15 minutes. Drink two or three cups or more per day.
10. Tang kuei (dong quai) Radix angelica sinensis
Properties: warm, sweet, pungent
Channels: Heart, liver, Spleen, Kidney
Blood tonic
Dong quai warms the inner organs, improves circulation, hastens healing of cuts and wounds and helps with mild anemia. The whole root is said to harmonize the blood meaning that it contributes to the general nourishment of the blood and thus helps with vitality. It helps with stagnant blood situations and helps blood that is not moving in the vessels properly to do so.
Other things that I took:
Diosmin/ derived from Sweet Orange peel / one pill daily
On the recommendation Alan Tillotson, I got some Diomin, which he felt would be a helpful addition to my program. Diosmin is a potent bioflavonoid originating from citrus fruits and is closely related to other citrus bioflavonoids like rutin, quercetin, and hesperidin. Diosmin is widely celebrated for its ability to support the sufficiency and integrity of veins along with lymphatic flow. It is also useful for treating a number of vascular conditions and is transformed into diosmetin (the aglycone form) by the intestinal bacteria. Because of these qualities it has been found effective with bleeding disorders of the eyes.
If you research Diosmin you will find literature on how it is a very useful treatment for varicose veins. This natural supplement has been found to be safe for both short-term and long-term use with no adverse side effects or unfavorable interactions with foods, drugs, conditions, or diseases. Not only is it extremely safe, but Diosmin is a highly useful vein tonic and vascular protector that improves microcirculation and blood vessel elasticity.
Lifetime Brite Eyes™ With FloraGlo Lutein® Directions – I took one or two of these per day.
As a dietary supplement, adults take two (2) capsules daily, or as directed by your healthcare professional.
Supplement Facts
Serving Size: 2 Capsules
Servings per Container: 30
Amount Per Serving % Daily Value
Vitamin A (Beta Carotene) 25000 IU 500%
Vitamin C (Ascorbic acid) 500 mg 833%
Vitamin E (d-Alpha Tocopheryl Succinate) 400 IU1, 333%
Zinc (Oxide) 15 mg 100%
Copper (Gluconate) 2 mg 100%
Lutein (FloraGlo) 10% 10 mg*
Zeaxanthin 5% 1 mg*
Bilberry Fruit 4:1 Extract (vaccinium myrtillus)100 mg*
Eyebright Herb 4:1 (Euphrasia officinalis) 100 mg
Brite eyes 111 Eye drops
These drops are advertised for use with dry eyes. I have found them to be very soothing, clearing irritants from the eyes, and general discomfort of the eyes. It says on the literature it is for non- mature cataracts as well. Here is what the promo says; “As we get older, our eyes become vulnerable to a variety of insults that can cause irritation, dry eye, and structural problems. Applying lubricating eye drops several times a day can alleviate discomfort. The Brite Eyes III formula contains two proven lubricants (hydroxypropylmethylcellulose and glycerin) that are FDA-approved for ophthalmic use without irritation. The Brite Eyes III formula also contains N-acetyl-carnosine, which helps protect the active ingredients.” I use the drops 5 or 6 times a day. In addition to the above pre- made formulas, I also made my own tincture of the following herbs:
My Tincture
Tienchi ginseng, dan shen, Chinese hawthorn berries, bilberry, eyebright, arjuna. I took
about six or so droppers full per day.
I wanted to make sure I covered myself! The thought of loosing ones eyesight is terrifying and I felt that it was probably not a bad idea to take care of any possible underlying undiagnosed condition. (pre-pathological). This formula protects and clears the arteries, resolves blood clots, regulates the heart beat, opens the blood vessels. Fish oil – Nordic natural EFA – 2000 mg daily–I took one pill per day.
Back to the Ophthamologist
I went back to the ophthalmologist on November 6, 2012 about three and a half months after my diagnosis. I was nervous to say the least. My husband came with me again for support. As the doc looked into my eye with his machines I sat quiet with anticipation. He looked very carefully and thoroughly. Then he said if I had gone to another ophthalmologist who did not know I had had a problem he would not have found anything wrong with my eye. The doc said that he was looking very hard for some sign of
branch retinal vein occlusion and he could only find two very tiny specs. The blood clot had resolved and the retina and macular were no longer swollen or inflamed. He said that he has seen this condition heal before but never in this short of a period of time. He said “this is extraordinary.” I looked at my husband and said, Yes! Tienchi ginseng. We went out and celebrated with tea and ginger/molasses cake at a local restaurant.
Because this condition has a slightly higher chance of repeating itself I have stayed on the program but at half dose. I do check my eye site with an eye chart that I have and I also check my vision when I am driving (look out with one eye at a time at the signs). The Doc said I did not have to come back to see him again unless I had a problem but I have decided to go and get my eyes checked out at least once a year to keep on top of things. Just as an aside, I also went to my chiropractor once a week for a month to make sure my
upper vertebrae were in place. (C1 – C7) Blood to the eyes can become restricted when the neck is not aligned properly.
Diet:
I feel that not matter what condition a person has, diet is a major part of the healing of it. What I Don’t eat: Deep fried foods, Coffee, excess sugar or sweets, sodas, hydrogenated oils. I don’t drink alcohol (never developed a taste for it) even though some studies show that wine and beer in moderation are okay.) I rarely eat desserts.
What I do eat:
Dairy, meats, fish on occasion, eggs, vegetables, grains, bread, cheese (especially feta), kalamata olives, black tea, herbal teas, butter and olive oil and various spice blends. I have fruits such as bananas, apple, pears, mandarins, and lemon in my water. I try not to have iced drinks especially in the winter. When in season I eat avocados, strawberries and blueberries. I try to get organic food when available; and meats without hormones or antibiotics. In the summer I indulge in organic ice cream now
and again.
I hope this story about my eyes helps some of you out / or possibly your clients.