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MACULAR DEGENERATION

GENERAL

Clinical Manifestations	Macular degeneration, also known as age-related macular degeneration (AMD or ARMD), is a medical condition which may result in blurred or no vision in the center of the visual field. Early on there are often no symptoms. Over time, however, some people experience a gradual worsening of vision that may affect one or both eyes. While it does not result in complete blindness, loss of central vision can make it hard to recognize faces, drive, read, or perform other activities of daily life. Visual hallucinations may also occur and these do not represent a mental illness. Macular degeneration typically occurs in older people. Genetic factors and smoking also play a role. It is due to damage to the maculae of the retina. Diagnosis is by a complete eye exam. The severity is divided into early, intermediate, and late types. The late type is additionally divided into "dry" and "wet" forms with the dry form making up 90% of cases. Prevention includes exercising, eating well, and not smoking.
Treatment Principle
Herb Formulas
Points

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Decreased visual acuity Aversion to Cold Body cold Limbs icy Complexion white and shiny Tinnitus Dizziness Shortness of breath on slight exertion A faint or weak voice Fatigue Bodily weakness A poor appetite Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful Loose stools containing undigested food “Cock-crow” diarrhea (occurs at about 5 am) Edema of face and limbs Dysuria Frequent nocturnal urination Severe: Abdominal ascites T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow or Deep, thready and forceless
Treatment Principle	Warm and Reinforce the Spleen and Kidneys
Herb Formulas	Ba Wei Di Huang Wan modified
Points	Qiuhou, SP-6, ST-1, ST-36, UB-20, UB-21, UB-23 For more marked Spleen Deficiency: + SP-3 With Liver Qi Stagnation: + LI-4, LIV-3 With Blood Stasis: + LI-4 With severe Blood Stasis: + UB-17 With more marked Kidney Deficiency: + moxa or moxa needle DU-4, REN-4 Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23

KIDNEY AND LIVER YIN DEFICIENCY

Clinical Manifestations	Dry macular degeneration Dry eyes Diminished visual acuity Photophobia Tearing when exposed to Wind Painful eyes Blurred vision Lower back pain Weakness of the lower back, knees and extremities Spontaneous and nocturnal emissions Light-headedness Vertigo Tinnitus Diminished hearing Five Sole Heat Chronic dry, sore throat Toothache Wasting and thirsting disorder / Xiao Ke Decreased libido Maybe constipation Dizziness Muscular weakness Dry skin Deafness Steaming bones Tidal fevers Loose teeth Dripping urine Thirst Dry tongue Numbness and weakness at the waist and knees Urinary incontinence Heel pain Knee pain Night sweats T: Red C: Little or None P: Thready and rapid
Treatment Principle	Enrich Yin Nourish the Liver and Kidneys Brighten the eyes Enrich Blood
Herb Formulas	Qi Ju Di Huang Wan Ming Mu Di Huang Wan modified
Points	LI-3, SI-3, HT-8, SJ-3, SP-3, SP-6, KI-1, ST-36, UB-1, or UB-2, Yuyao, GB-14, Yintang KI-7, Qiuhou, SP-6, ST-1, UB-1 With night sweats: + LI-4 With dizziness and tinnitus: + GB-20 With insomnia and profuse dreams: + GB-20, HT-7 With Liver Qi Stagnation: + LI-4, LIV-3 Ear: Adrenal, Zero, Corpus Callosum Electro-acupuncture: UB-2 to Alt-point – 1 finger medial to ST-2, SJ-23 to Tongming(1/2 cun below GB-1)

QI AND BLOOD DEFICIENCY WITH QI AND BLOOD STAGNATION

Clinical Manifestations	Decreased visual acuity Dizziness Fatigue Weakness Shortness of breath A pale white, sallow yellow or dark, sooty facial complexion Irritability Depression Taciturnity Disinclination to move or speak Dry, scaly skin Brittle nails Dry, falling hair Itching Age spots Cherry hemangiomas Spider nevi or other varicosities Maybe constipation or Loose stools T: Pale, large and darkish with possible static maculae C: White P: Thready, forceless and wiry
Treatment Principle	Strengthen Qi Raise Yang Harmonize and dredge the Liver Nourish and invigorate the Blood Brighten the eyes
Herb Formulas	Yi Qi Feng Yang Bu Xue Fang
Points	LI-4, LIV-3, Qiuhou, SP-6, ST-1, ST-36, UB-1, UB-17, UB-18 With Phlegm Misting the Heart Orifices: + ST-40 For chest pain and oppression: + PC-6, REN-17 With more severe Liver Qi Stagnation: + GB-20, GB-37 With more severe Spleen Qi Deficiency: + SP-3

QI, BLOOD, YIN AND YANG DEFICIENCY

Clinical Manifestations	Decreased visual acuity which is worse at night and when fatigued A pale and possibly sallow, yellow complexion Fatigue Lack of strength Shortness of breath on slight exertion Dry skin Brittle nails Low back and knee weakness and pain, Tinnitus Dizziness Impaired memory Decreased hearing Decreased libido Cold hands and feet Chilliness of the upper back Aversion to Cold Nocturia Maybe seminal emission Constipation Spider Naevi Cherry hemangiomas or other varicosities Age spots T: Swollen, dry and pale or Swollen, dry and red C: Scanty Thready, deep and weak
Treatment Principle	Enrich the Kidneys Tonify Yang Nourish the Blood Tonify Qi Invigorate the Blood Unblock the channels
Herb Formulas	Wang Yi Jian
Points	KI-7, Qiuhou, SP-6, ST-36, UB-1, UB-17, UB-18, UB-20, UB-23 For marked Qi Deficiency: + SP-3 For marked Yang Deficiency: + moxa or moxa needle DU-4, REN-4

HEMORRHAGE

Clinical Manifestations	Wet macular degeneration (bleeding)
Treatment Principle
Herb Formulas	Yun Nan Bai Yao (patent)
Points	Laser treatment to cauterize Blood vessels (Western) If the bleeding is light: snail shell moxa