Kimberly Burnham, IMTC, PhD Candidate

Essays and articles written by Kimberly Burnham, whose interests include Integrative Manual Therapy (IMT), CenterIMT, Neurodegenerative Disorders, Parkinson's Disease, Vision, VisionIMT, Eye Disorders, Travel, Languages, PhD Candidate, Westbrook University, Connecticut School of Integrative Manual Therapy.

Location: Bloomfield, Connecticut, United States

Sunday, November 28, 2004

Vision and Integrative Manual Therapy

Hands On Solutions for Visual Dysfunctions
by Kimberly Burnham, Director Vision IMT

Vision IMT, a department of the Connecticut School of Integrative Manual Therapy, combines the skills of many different health care practitioners, including massage therapists, physical therapists, occupational therapists, functional vision experts, behavioral optometrists, and more. All are working towards helping individuals improve their visual function, the performance of their eyes and the recovery of overall health.

Integrative Manual Therapy (IMT) clients include both adults and children with visual labels such as detached retina, lazy eye, strabismus, visual headaches, migraines with visual auras, nystagmus, cataracts, glaucoma, corneal ulcers, keratoconus, astigmatisms, dyslexia and vision related learning disabilities. IMT is also effective for clients with conditions involving an eye component, such as spinal cord injuries, multiple sclerosis, high blood pressure, seizures, tinnitus, Cerebral Palsy, autism and Down’s syndrome.

Therapists trained in Integrative Manual Therapy have a number of ways to work with the eyes. They draw on educational material from a variety of courses, including an advanced cranial course, which specifically focuses on eye health and addresses other systems in the body which affect the eyes.

There are advanced Strain and Counterstrain techniques that address the hypertonicity in the ocular muscles and the blood vessels supplying the eyes. As a number of studies have shown, relaxing the muscles of the eyes can significantly improve vision. These techniques address tension in skeletal muscles and the contractile aspect of visceral and vascular function throughout the cranium and body. This approach can be effective with vascular headaches and hand eye coordination. These hands on techniques improve blood flow and the healing capacity of the eye and surrounding tissues.

A range of approaches are used to address the cranial bones, the cranial sutures and joints of the head and neck, including specific techniques for the sphenobasilar joint which is located near the optic chiasm. Given the number of small bones that make up the orbit of the eye, trauma to the bony structure of the eye contributes to significant visual symptoms. The "bone bruise" technique is used to address orbital bone and cranial bone integrity. Therapists also look at the articular function of the joints. This biomechanical approach makes significant changes to the amount of space and movement in and around the eye. One way to focus on eye biomechanics and function is to look at how the different parts of the eye interface with each other. For example, consideration is given to the relationship between the frontals and the lacrimal bones as well as to the interface between the iris and the cornea.

Often addressed by IMT practitioners is the lining of the cranium, the dural or meningeal layers. From their attachment on the posterior aspect of the eye, the meningeal layers cover the optic nerve and other central nervous system tissue. Infections from the eye can be communicated to the rest of the brain and spinal cord via this route. Toxicity can also affect the eyes secondary to a spinal cord or brain tissue infection. There are several hands on techniques to address the health of the dura and membrane system of the eye, brain and spinal cord. An IMT practitioner may also use a variety of approaches to address immune system, lymphatic and toxicity issues which impact the eyes as well as the whole environment of the visual apparatus. IMT also provides expertise in ways to improve the circulation of cerebral spinal fluid and blood flow in the head. Good cranial drainage and adequate arterial blood flow as well as proper lymph and immune function can make a considerable difference in the healing of visual problems.

Work is done with a variety of brainstem mediated reflexes which releases the compression by the musculoskeletal tissue on the eyes, optic nerve, vasculature serving the eyes and the visual cortex. The eyes are also involved in a number of reflexes affecting balance, hand eye coordination and upright posture.

The neural tissue tension of the eye, optic nerve, optic chiasm, occipital lobe and other nervous system areas can be addressed by focusing on the circadian rhythms and biomechanics of the neural tissue. The ciliary ganglion and the stellate ganglion can both be influenced manually resulting in better nervous system function in the eyes.

In the advanced cranial course focused on the eye there are a number of techniques which address tear ducts and the tearing function of the eyes in a gentle hands on way. Tears have a significant lubricating and immune system function keeping the eyes irritation and infection free.

There is also a significant pressure component in many eye and vision dysfunctions. These pressure problems can be in the eye itself and can result in a detached retina or an abnormal pressure relationship between the eye and other body areas. For example the heart and high blood pressure can contribute to glaucoma. In Integrative Manual Therapy there are tools to work with balancing these pressures and reflex point to help in this process. The advanced IMT course for the eye includes a variety of reflex areas or synchronizers for improving function of the retina, cornea, iris, optic nerve and more. IMT practitioners also study nutrition as it relates to the eyes.

For more information on Vision IMT see

Strabismus / Lazy Eye and IMT
by Kimberly Burnham, Director of VisionIMT

One in 36 people in North America are estimated to have a squint, stabismus or lazy eye (

This is just one of the vision problems addressed with Integrative Manual Therapy (IMT). Therapists consider this primarily a problem of the interface between the cranial nerves (occulomotor, trochlear and abducens) and the muscles of the eye.

The original problem can be anywhere along the pathway of the nerves from the brainstem, along the cranial nerves, through the tentorium and other membranes of the head, through the back of the orbit of the eye to the muscles of the eye. As the nerves pass through the orbit, they can be irritated by bone bruises or damage to the bony structure of the eye. Bony damage can also distort the attachments of the muscles causing them to pull unevenly and cause a strabismus.

IMT therapists look all along the pathway for structural and physiological problems that might be contributing to tension and abnormal pulls. The structural problems, compression and tensions are worked with in a gentle hands on way as the client lays on a massage table.

The muscle tissue itself can be irritated by toxins that aren’t draining properly from the head, this is usually accompanied by allergies, congestion or puffiness around the eyes. There can also be disruptions of the nerve fibers and the muscle tissue that contribute to a lack of proper focusing power of the eyes.

This is one woman’s report on her daughter’s progress. "Just wanted to let you all know that the appointment with the optometrist went incredible yesterday. The optometrist is very excited to work with IMT and learn more about it. The biggest news was that since the intensive. Taylor's degree of eye turn has gone from an 85 degree turn to a 50 degree turn - solely from IMT. As soon as she gets her new prescription, which should be next week, she will start vision therapy."

Then a few months later: "Taylor's been making some progress. We got her fitted in some glasses that improved the rhythms in her eyes. She's been doing Vision therapy as well. Her degree of turn has gone from an 85 degree turn (before IMT treatment) to 45 degrees. Her prescription is also getting better. She was 80/60 and now she's 60/30."

See more vision related cases at and

Courses of interest to therapists who work with visual problems, lazy eye, strabismus, macular degeneration, cataracts, keratoconus, glaucoma and

Finding a Behavioral Optometrist

There are many reasons to see a Behavioral Optometrist. For more information talk to Kimberly Burnham, Director of VisionIMT (860-243-5220) or call your local CenterIMT therapist ( or contact NORA (
Neuro-Optometric Rehabilitation Association (NORA) is diverse group of professionals dedicated to advancing the art and science of habilitation rehabilitation of the neurologically and cognitively injured and disabled survivor population and their families.

NORA members are professionals who recognize the crucial role of vision in human performance. NORA emphasizes treatment modalities designed to optimize the frequently neglected visual-motor, visual-perceptual and visual information processing dysfunction in the neurologically affected person.

There exists, within the profession of optometry, a group of concerned and highly trained professionals uniquely skilled and experienced in the technologies of neuro-optometric rehabilitation/habilitation of the persons affected.

Integration of these unique Neuro-Optometric treatment modalities maximizes the potential of the rehabilitation team within a multidisciplinary approach.


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