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Frequently Asked Questions (FAQ's) about Macular Degeneration and It's Treatment with Microcurrent Stimulation

DISCLAIMER

The data presented here has not been reviewed by the FDA, nor has it been peer reviewed. The microcurrent devices used are approved by the FDA for the treatment of pain, but they have not been approved for other uses. The use of a device for an off-label use by a physician is legal. The use of microcurrent stimulation discussed here is only one part of a comprehensive program for supporting visual health. Dr. Miller is not a manufacturer of these devices, and the material presented here is informational, and is not intended as simply a solicitation to sell devices.

If you have further questions about the work being done by Dr. Miller, please contact his office to arrange an appointment or consultation.

 

What Are the Treatments Available for Macular Degeneration?

The stories that people bring to this office are all too common. A person finds that their vision is deteriorating. Maybe they're having trouble reading, maybe they've failed the vision test on their driver's license exam, maybe they've noticed some odd distortions in their vision, or trouble with night vision, or difficulty seeing in bright sunlight. They go to see their ophthalmologist or optician, hoping that a new pair of glasses will make everything right, and they are told that they have macular degeneration, that their vision will just continue to get worse and that there is no cure, no treatment and no hope. People have reported that they were essentially told to go home and get ready to be blind. Worse yet are the stories of those people who have a very sudden, abrupt and profound loss of vision in one of their eyes. They rush to the emergency room or to their doctor's office and they are told that they have had bleeding in their retina and that they have macular degeneration. Sometimes people with this story report that their doctor has later told them that they had noticed some pigment loss and some loss of central vision and had suspected or made the diagnosis of macular degeneration, but had never told the patient, not wanting to worry them, because as far as the doctor was concerned, this was a hopeless disease with no treatment available.

But there is hope for people with macular degeneration. There are things that can be done that at the very least can slow the progression of the disease and there are therapies that in some people actually bring some improvement in vision. It is true that at this time there is no cure, no magic pill and no miracle surgery. But again, there are treatments and things that can be done to slow the disease and even bring improvement in vision.

What You Can Do Now:

In this office and in several other centers around the country, a great deal of work has been devoted to the treatment of macular degeneration and other retinal diseases using microcurrent stimulation, a very specific form of low current bioelectrical stimulation that with the current state of the technology can improve cellular metabolism and promote some healing in the retina. The use of microcurrent stimulation is one part of a comprehensive set of treatments. The results have been quite remarkable, with most of the people treated showing statistically significant improvement in one or both eyes. We have treated people with the dry and wet forms of macular degeneration, and younger people with Stargardt's disease, and all of these types have responded positively to the treatments. Please see the section, Results From the First 120 Patients Treated. Other centers where similar work is being done are reporting similar results. This treatment has proven to be remarkably safe, easily done, and painless.

There has been a tremendous amount of work done studying the effects that vitamins, supplements and certain foods have on the course of the disease of macular degeneration. Even the ophthalmologists tacitly acknowledge the importance of supplements, and they routinely hand out samples of vitamins containing zinc to people who have been newly diagnosed with macular degeneration. Some of the earliest work looking at the importance for adequate zinc intake for people with macular degeneration is over 30 years old, and there has been a great deal of work done, especially in the last 10 years, looking at the importance of vitamins and supplements, especially antioxidant vitamins. Recommendations for the supplements you should be taking now, based on the current state of knowledge, are made in the section on Supplements for People With Retinal Disease. This section also includes information about foods that should be included routinely in the diet. For people whose only treatment is to take vitamins and supplements, the best that can be expected, based on the results of the research, is that the progression of the disease will be slowed. There have been no studies that have shown a lasting improvement in vision in people who take supplements or combinations of supplements. Still, vitamins and supplements are very important.

The final thing a person can do is to start now to take excellent care of your eyes if you don't already do so. Don't go out of doors without glasses that provide excellent protection against ultraviolet light. If you smoke, stop. Alcohol is toxic to the brain and central nervous system, including the eye, and alcohol is best avoided. If you feel strongly that a glass of wine has benefits for your health in other ways, then certainly limit your consumption to one glass of wine per day. Exercise regularly, eat a balanced diet and get enough sleep. If you are under a great deal of stress, learn techniques for stress reduction. If your cholesterol is elevated and your HDL cholesterol ("good cholesterol") is low, see your doctor or herbalist to see how this can be corrected. If you have high blood pressure, keep it well controlled. If you have diabetes, which is notorious for its effects on the eyes, then keep your diabetes under very excellent control, and make sure that your doctor is following the blood level of your Hemoglobin A1-C. All of the above may seem like common sense, but you cannot separate the eye from the rest of the body, and your overall health is very important, and something that you can have an effect on today.

What is microcurrent stimulation?

It is the therapy that involves the application of a very precise, low current, tightly controlled electrical current to specific points on the body. The surface of the body is not uniform in terms of its electrical properties, and there are specific points on the body which have very low resistance and these are chosen as the points of treatment to allow a deeper penetration of these low current stimulations. These points of low electrical resistance correspond with classical acupuncture points, and some of the points that are used with microcurrent stimulation are chosen because it has been demonstrated that there is a benefit to stimulation of these acupuncture points. The procedure is safe, noninvasive and painless.

What is the technology that is involved?

The technology is quite sophisticated and complex. When properly designed, the technology can effect electrical properties at the level of the cell membrane resulting in an increase in the energy production of the cell by almost 1000%. Almost all of the centers that are using microcurrent stimulation therapy to treat retinal disease are using devices manufactured by MicroStim Technology, Incorporated. Theirs is a constant current device which tightly controls the delivery of current over a wide range of resistances, and incorporates some patented technology that allows these very low currents to penetrate very deeply into the tissues that are being treated without harm. The trick is to provide a very low current stimulation but to do it in such a way that you are treating more than just the surface of the skin. There are many devices that are marketed as microcurrent stimulators but that in reality are woefully inadequate for the treatment of retinal disease. Numerous people have come through this office who report that they have had their eyes treated with microcurrent stimulation with no positive results who were actually treated with inadequate technology and who did respond positively to further treatment with an appropriate stimulator.

How does microcurrent stimulation work?

Please go to the page "Mechanisms of Action of MCS"

Is This a New Technology?

The use of microcurrent stimulation for the treatment of retinal diseases is hardly new. The story begins with a woman named Grace Halloran. Her story is told in her book Amazing Grace, which is in print, published by North Star Publications. She was a woman with retinitis pigmentosa, a disease that typically presents earlier in life. Like macular degeneration, conventional medical wisdom holds that retinitis pigmentosa is a progressive disease that is untreatable. Grace is not a person who gives up easily, and in her search for alternative methods of treatment, she learned about work that was being done elsewhere in medicine with microcurrent stimulation. She found a physical therapist who owned a then top of the line microcurrent stimulator, and she convinced them to let her try treating her eyes with the unit. Grace had remarkable results, not only stopping the progression of her disease, but also bringing about amazing improvement in her vision. Grace Halloran has made it a life's work to help people with retinal disease.

An optometrist from South Dakota, Leland Michael, was visiting San Francisco, Grace's home town, when he learned of the work that Grace was doing. He set himself up to try her treatment with the patients that he saw with macular degeneration. He spent many years treating a group of people with macular degeneration, with great success, bringing some improvement in vision and significant slowing of the progression of the disease to the majority of the people he treated. Leland Michael unfortunately died, but he passed his work on before his death to another optometrist, John Jarding. Jarding has presented the results of the work begun by Leland Michael at conferences, and I first learned of their results and methods at the Fourth International Symposium on Biologically Closed Electric Circuits in 1997. I also first met Grace Halloran at this conference.

When I met John Jarding and Grace Halloran, they were both using microcurrent stimulators made by MicroStim Technology, Inc., a company that had been founded by Joel Rossen to manufacture stimulators that incorporated improvements in the technology that he had patented. Both of them felt that this was the best technology on the market. Dr. Miller had been trained with microcurrent stimulators developed in Japan for the treatment of musculoskeletal problems, and was using microcurrent stimulation in his work with patients. He obtained the best unit possible from Joel Rossen's company and set out to see what results he could obtain treating retinal disease.

The original selection of the points that were to be treated with microcurrent stimulation was based on work that had been done using acupuncture to treat retinal disease. Using his knowledge of acupuncture, and relying on advise from other experienced acupuncturists, he made some modifications to the protocols that had been developed for Grace Halloran. He felt that some minor changes in the points that were treated would make the treatment more effective. Recently, he has been adopting some of the work from Japanese acupuncturists, incorporating this into the work with people with macular degeneration. In addition, if people have other problems that are suitable for treatment with microcurrent stimulation such as arthritis, neck back or shoulder problems, then they are trained to use the home treatment unit that they have obtained for the treatment of their eyes to treat these other problems. The success in treating these other problems is often as important to people as the improvements they see in their eyes.

The results in treating people with macular degeneration in this office are as good or better than that reported by others. We are quite pleased with the success that comes from the use of microcurrent stimulation. The results from the treatment of the first 121 patients in this office are reported elsewhere in this document. In talking with others who have adopted these techniques in their own offices, there appears to be a certain constancy to the success that is obtained, and this is probably due in large part to the technology in the microcurrent stimulator manufactured by MicroStim, Inc. This technology, properly and conscientiously applied brings results in all of the centers where it has been adopted.

Microcurrent stimulation therapy is not a miracle cure for macular degeneration. It is a therapy in the form of a very specific and controlled type of electrical stimulation relying on some very sophisticated technology. In addition to this stimulation therapy, there is a need for certain supplements and vitamins that are beneficial for protecting the eye and assisting the eye in healing some of the damage that has been done. Like any disease, there is a need for the proper diet, exercise, and a healthy lifestyle if you want to control this disease and not have the disease control you.

About the Home Treatment Unit

The results from treatment with microcurrent stimulation have been very optimistic. Not all electrical stimulation is the same, and the improvements in vision seen with our current treatment protocol are felt to be due to refinements and improvements in the specific devices used. These devices deliver currents much closer to the level of currents found naturally in the body. Other devices use levels of current which are much stronger. The waveform and quality of the microcurrent output of this device seems particularly effective in stimulating the retina when the stimulation is applied to points around the eyes and points on the surface of the body related to the eye. This particular machine is "current-driven" rather than "voltage-driven." This means that this machine is able to adjust for varying resistance, and provide a stable level of current, whereas a "voltage-driven" machine, provides a current that is driven by voltage output without adjustment for varying resistance. Laboratory research has shown that the parameters for successful treatment involve tightly controlled levels of current, waveform and frequency. At the current time, all of the practitioners treating macular degeneration with microcurrent stimulation are using the devices manufactured by Microstim Technologies, Inc. The portable unit allows people to do the frequent treatments that are required at home. This sophisticated device is easy to use, durable and reliable, and safe. It is available only on the order of a physician.

Is it safe?

No side effects or adverse outcomes related to the procedure have been seen so far. Again, the number of people who have been treated has been small, and further work is needed before the real risks, if any, are known. Specifically, no increase in the conversion to the wet form of macular degeneration has been seen in those treated. This means, that although this treatment is thought to work by improving circulation, it has not been seen to increase any tendency to bleed or produce exudates. The National Institutes of Health recently published a Consensus Statement on Acupuncture (November, 1997) which included studies of treatments using microcurrent stimulation at acupuncture points for the treatment of pain and various musculoskeletal problems. The NIH Consensus Statement reports that, "One of the advantages……is that the incidence of adverse effects is substantially lower that of many drugs or other accepted medical procedures used for the same conditions." The complete document from the NIH may be found at:

NIH Consensus Statement on Acupuncture, 1997

What can I expect?

It is possible to experience an actual improvement in vision. Many report that their vision becomes clearer, brighter, after treatment. Some experience increased visual ability as measured on visual acuity tests (ability to read an eye chart). However, this is not true for everyone, and for those that experience an actual improvement in their vision, maintaining the improvements has required continuous treatment. Treatments are easily done at home with the portable treatment unit. Anyone thinking of undertaking this therapy needs to realize that they must commit themselves to what may be a lifelong therapy requiring some of their time several days each week after the initial six month period of daily treatment. When the treatments are successful and the vision improves, the results are not permanent. Treatment needs to be continued in order to maintain the improvements, and those who have had improvements in their vision and then stopped treatments have regressed. Even those people who have not experienced an improvement in vision, most report that their vision has stabilized. Their vision is no longer deteriorating at an accelerated rate.. Although everyone would love to experience improvement, with a disease such as macular degeneration, stabilization is a valuable gain. Indeed, if all that microcurrent stimulation accomplished was to slow or stop the progression of the disease, it would be a valuable treatment. Again, in order to maintain stabilization, treatment needs to be ongoing. It is thought that this treatment works by increasing blood flow and metabolism in the area being treated. When the treatments are stopped, it is thought that the improved blood flow and metabolism are also stopped. This is evidenced by the regression in vision experienced when treatment is stopped. This can be corrected again when treatment commences again. Microcurrent stimulation is not a cure. It is not a magic bullet, but when applied properly, using the best possible technology, it can bring at best real improvements in vision.

What is treatment like?

After learning in either a group or individual setting how to self-administer treatment, individuals treat themselves at home with the microcurrent home treatment unit. It is easy to learn and apply, and is not painful in any way. For the first six months, treamtment is done daily, with the body points treated weakly. The daily treatment takes fifteen to twenty minutes, and the weekly treatment takes about twenty-five minutes. Treatment needs to be continued in order for any improvements and stabilization of vision to be maintained.

Is treatment painful?

No.

For which patients is this treatment most likely to be successful?

We have been treating people with retinal disease in this office for two years now, and we have just analyzed the results from the first 120 patients that we have treated. The results have been quite gratifying. One surprise that we find in analyzing the data is how well the people with the wet form of aged-related macular degeneration have responded. The conventional wisdom that was given to Dr. Miller when he first started doing these procedures was that the patients with "wet" macular degeneration (exudative macular degeneration) did not respond as well as those with "dry" macular degeneration (non-exudative macular degeneration). This data shows that patients with exudative macular degeneration respond quite positively.

The data reflects improvements as measured in visual acuity testing. Many of these patients have also shown improvement in their visual fields and in scoring on color testing, but follow up data in these areas was not consistently available. Acuity testing was available for all the patients we have seen and so that is what we present here.

The other very pleasant surprise was how well the patients with Stargardt's Disease have responded to microcurrent stimulation therapy.

Can the "Wet" Form of Macular Degeneration be Treated?

Yes. Some people with the "wet" form of ARMD have benefited from this treatment, and we are currently treating both the wet and dry forms of macular degeneration. The damage caused to the retina by the exudates and bleeding can be so severe that the retina is permanently damaged, and if you have had laser procedures, there will be areas of permanent scarring in your retina. Still, the response to microcurrent stimulation therapy has been very good in those people we have treated with exudative or "wet" macular degeneration. If you have the "wet" form of macular degeneration in both eyes, we need to see the medical records from your recent eye exams, or arrange for an exam, to determine the extent of your disease before we can advise you if you should begin this treatment.


Why Doesn't My Ophthalmologist Know About Microcurrent Stimulation?

Western physicians have been using the technology of microcurrent stimulation since the 1960's to treat a variety of conditions. Some of the earliest work in the 60's involved the use of this type of electrical stimulation to promote the healing of bone fractures that were not otherwise healing. Microcurrent stimulation is used to promote healing in soft tissue wounds and pressure sores that are slow to heal. It is used extensively in Sports Medicine, it is used by the plastic surgeons in certain cases because of its ability to decrease the amount of scar that forms after surgery, it is used with good success in the treatment of carpal tunnel syndrome and in the treatment of tempero-mandibular joint syndrome (a disease of the jaw). Ophthalmologists do not typically read the literature associated with their colleagues in orthopedics, physical medicine, sports medicine, hand surgery or oral surgery, so they are usually unaware even that the technology exists. To date, the work that has been done to adapt this technology to the treatment of retinal disease has not been done by ophthalmologists in this country so there is no work published in the literature that they do read. There are research projects in their early stages that the ophthalmologists are putting together, but it could be years before there are any results published. There are unpublished results from the few physicians that are using this technology to treat the eye that are available. In addition there has been extensive work in Russia using microcurrent stimulation for the treatment of retinal disease and other eye disease that has been published in the Russian medical literature. This data can be made available to your eye care professional.

What Is Medical Science Doing To Address the Problem of Macular Degeneration?

Microcurrent stimulation and the use of various supplements and antioxidant vitamins attempt to improve the function of the cells in the retina that are responsible for vision, and to improve the poor blood flow that are the problems at the core of macular degeneration and other diseases of the retina.

The main tool that the ophthalmologist has to deal with the problem of macular degeneration is the laser. The feared complication in macular degeneration is bleeding in the retina. About 10% to 20% of people with macular degeneration will at some time during the course of their disease develop bleeding or leakage of fluid in the retina. The ophthalmologist can put a fluorescent dye into a vein, look into the eye and see where blood and fluid are leaking out and burn this area with a coagulating laser with sufficient power to cause a full thickness burn in the retina. This is analogous to using a hot poker to burn a bleeding vessel in a wound on your body. It's crude, but it works. Bleeding, once it begins is in itself very destructive and the use of the laser to stop a bleeding or leaking vessel is good medicine, and probably one of the only times when the use of the coagulating laser is still appropriate.

Ophthalmologists who have followed people with macular degeneration have observed that there are many abnormal small vessels that can form in the retina, probably as a response to the loss of normal blood flow that is a consequence of macular degeneration. They have also noticed that it is these small abnormal vessels that form where the leaking and bleeding occur, and there have been many attempts to find a way to destroy these abnormal small vessels before they bleed, in the hopes of preventing or lessening the risk of bleeding in the future. The earliest techniques used the coagulating laser to simply try and destroy these vessels, but this led to a great deal of scarring in the retina, left people with large and permanent blind spots, and in the end did not prove useful in preventing the risk of bleeding in the future. In fact, some studies have suggested that people who had these laser procedures in an attempt to prevent bleeding were actually more likely to bleed in the future. The reasons for this were never determined. Radiation, which is very destructive to blood vessels, was also used to try and destroy these small abnormal vessels, but to date these procedures with radiation have not proven useful, and in some cases are actually harmful.

There has been a tremendous interest in drugs that can actually prevent the formation of these small abnormal vessels. These are called anti-angiogenesis drugs and much of the research has been in the field of cancer therapies, where there is an interest in finding a way to prevent the body from growing the blood vessels that are needed to feed a tumor. You may have read about studies with thalidomide or newer experimental drugs for the treatment of macular degeneration, and they are all in this class of drugs. To date, none of these drugs have proven effective for the treatment of macular degeneration or other retinal diseases, but this is a hopeful area of study.

There has been a great deal of news recently in the popular press about a procedure called Photodynamic laser therapy. This is a refinement of the older techniques using the coagulating laser that caused a full thickness burn in the retina. In Photodynamic treatments, a lower power laser is used that by itself cannot burn the retina. A drug is put into the blood, and when the laser hits vessels that contain this drug, the drug is chemically changed into a substance that is very destructive and the vessels that contain the drug are destroyed. Again, the intention and purpose of this therapy, as stated in the research protocols, is to try and prevent the complication of bleeding and leakage that can occur from these abnormal vessels. There is no expectation stated that Photodynamic therapy will improve vision, and there is certainly nothing in the procedure that improves the underlying metabolic abnormalities that are so much a part of the disease of macular degeneration. Photodynamic therapy has at least proven to be relatively safe to date, but it will take years of follow-up to see if there is actually a decrease in the risk of bleeding in those who are treated. There are theoretical reasons to believe that combining Photodynamic therapy with microcurrent stimulation, which can improve the metabolism and functioning of the cells in the retina would provide a benefit greater than would come either of these therapies alone. One concern that has been voiced about Photodynamic therapy is that the increased tendency to bleed in the subgroup of people with earlier laser therapies was never adequately explained or understood, and obviously the people who are in the research trials for Photodynamic laser therapy will be followed carefully over the next 5, 10 and 15 years.

Finally, there are the surgical procedures that are being tried on people with macular degeneration. In the past, there have been attempts to surgically remove the abnormal small vessels that form, but the results varied from very poor to disastrous. More recently there has been a surgical technique called retinal translocation. The macula is in the center of the retina, and in this surgery a portion of the retina on the periphery that is less affected by the disease is surgically moved into the center of the retina to try and improve the central vision. The surgery does nothing to correct the underlying problem of macular degeneration, or improve metabolism or functioning of the cells of the retina, and one of the biggest problems that the surgeons have faced is that even after the surgery, the disease continues its progression. People may show improvement immediately after the surgery, but with continuing degeneration, the vision again deteriorates. At this time, people who are considering this surgery are told that they can expect a one-third chance that their vision will improve, a one-third chance that there will be no improvement, and a one-third chance that their vision will be worse after the surgery. They are also told that even if the surgery is successful, that their disease may continue to progress and that there is no guarantee made as to how long any improvement will last. The first attempt at this surgery on a human being was in December, 1998, and already several of the patients who showed initial improvement after surgery have reported to the press that their vision has deteriorated to where it was before the surgery. Also, they must continue to wear the special glasses that rotate the way the world looks to match the rotation in their retinas after surgery. This surgery is in its infancy and it is not recommended that you rush to try it until better results are reported and there has been follow-up for a longer time on the initial patients.

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From the Office of Damon P. Miller II, M.D., N.D.
Contact us at millermd@flash.net
Phone: (650) 948-5120
Fax: (650) 948-5360