Retinitis Pigmentosa

By W. H. Bates, M.D,

There are many cases of imperfect sight which are congenital. That is,
people are born with different diseases of the eye. Retinitis
pigmentosa is usually congenital. The condition is easily recognized
in most cases with the aid of the ophthalmoscope. In all cases, the
retina is covered more or less completely with black areas. These
black areas are about 1/30 of an inch in diameter. They are very
irregular in size and shape. In severe cases of retinitis pigmentosa,
the retina may be covered so thickly by these black specks that the
retina cannot be seen.

Most cases give a history of poor sight from birth. At first, only a
small number of black spots are visible, but after the child is twelve
years old or older, the number of these spots increases gradually.  At
the same time that these spots are increasing, there are serious
changes taking place in the back part of the eye. The optic nerve
becomes atrophied, but the atrophy does not increase sufficiently to
produce complete blindness. The middle coat of the eyeball, the
choroid, is inflamed and produces floating spots in the vitreous (one
of the fluids in the back part of the eye.)

All cases of retinitis pigmentosa acquire cataract before they are
thirty years old. There are exceptions to this rule, however. Some
patients acquire retinitis pigmentosa after they are fifty years old
or older. One characteristic of retinitis pigmentosa is that the
vision is always changing, sometimes for the better, sometimes for the
worse. One very common symptom that is usually present is night
blindness. Treatment for the cure of the night blindness helps
retinitis pigmentosa. In some cases myopia is present and it is of a
kind which is difficult to cure.

It is a prevailing belief that retinitis pigmentosa is incurable and
that when it becomes manifest in its early stages, the condition goes
on increasing and the blindness becomes more decided. Usually, the
blindness does not become permanent. One case of retinitis pigmentosa
with myopia was observed. The patient left town and was not seen again
for more than six months. She then came into the office to report. Her
first words were that her eyes were better.

A physician was calling on me at the same time, and he was asked,
"Would you like to see a case of retinitis pigmentosa?" He replied
that he would.

Before the doctor used the ophthalmoscope, I examined the eye myself.
I examined the right eye first and found that the nasal side of the
retina was not diseased. There were no black pigment spots anywhere to
be seen on the nasal side. Somewhat disturbed, I examined more
carefully the temporal side of the retina and again I was disappointed
because there were no black spots there. After a long and tedious
search for the black spots, I had to confess to my friend that the
patient had recovered from the retinitis pigmentosa, and accomplished
it unconsciously without practicing relaxation methods. The doctor
could not resist looking at me incredulously. I am quite sure he
thought I was not telling the truth. The atrophy of the optic nerve
had also disappeared and with its disappearance circulation of the
nerve was restored. The size and appearance of the nerve were normal.
The patient became able to read 20/20 without any trouble. It is very
interesting to observe in most cases of retinitis pigmentosa how much
damage can be done to the retina while the vision remains good.

Many physicians believe that night blindness cannot be cured. The
majority of these cases in my practice have usually recovered and
obtained not only normal vision, but they have become able to see
better than the average. All patients who were suffering from chronic
retinitis pigmentosa had changes in the optic nerve which were very
characteristic. In the first place the blood vessels were smaller than
in the normal eye and the veins just as small if not smaller than the
arteries which emerged from the center of the optic nerve. In most
cases the middle coat of the eyeball becomes inflamed and usually much
black material is found in the vitreous. There are well-marked changes
which take place in the crystalline lens. The back part of the lens
becomes cloudy and this cloudiness moves forward toward the center of
the lens and clouds all parts of it so that the vision is lowered by
the opacity of the lens as well as by the more serious changes which
occur behind the lens.

A patient sixty years old came to me for treatment. She said that the
doctors told her that she had retinitis pigmentosa and that she could
not be cured. Within the last few months her doctor had told her that
a cataract had formed. Her vision was zero in the right eye, which had
cataract. The vision of the left eye was about one-third of the normal
and was not improved by glasses. She had a well-marked case of
retinitis pigmentosa in which the retina of the left eye was
apparently covered almost completely by the pigment spots. In some
parts of the retina over an area of more than double the diameter of
the optic nerve, the retina could not be seen. The patient was very
anxious to have me do what I could for her sight. She said that her
husband was a business man and had occasion to travel all over the
United States, Canada, and Europe. He frequently took her with him,
and whenever they came to a large town where some prominent
ophthalmologist had his office, she would consult him about her eyes.

I found that the back part of the crystalline lens was covered by a
faint opacity which was sufficient to lessen her vision. The patient
was given a Snellen test card to practice with for the good eye. In
twenty-four hours the vision of the right eye had improved from no
perception of light to the ability to read some of the large letters
of the Snellen test card at five feet. Improvement in the vision of
the left eye was manifest. The great improvement in so short a time in
the vision of the right eye was unusual.

The treatment which improved the vision of this patient was palming,
swinging, and reading very fine print. This patient gave evidence that
retinitis pigmentosa is caused by a strain or an effort to see. The
fact that retinitis pigmentosa in the eyes of this patient was so
promptly relieved, benefited, or cured was evidence that the disease
was caused by strain.

The clinical reports of other cases of retinitis pigmentosa confirm
the fact that strain or an effort to see produces retinitis
pigmentosa. The efforts which are practiced by the patient can be
demonstrated in every case. When the patient makes an effort to
improve the vision, it can be demonstrated in every case that the
cause of the eye trouble is always due to this effort and the cure of
the disease is always obtained by relaxation methods.

I have found that among the methods of relaxation which secure the
best results are the memory or the imagination of perfect sight. If
the memory or the imagination is imperfect, the disease is not
completely relieved or benefited. When one letter of the Snellen test
card is seen perfectly, it can be remembered or imagined perfectly.
There is no procedure which yields better results in the cure of this
eye trouble than the memory of part of a letter, which the patient can
demonstrate. It is very interesting to observe that in these cases the
memory and imagination are capable of bringing about the absorption or
the disappearance of organic condition. This makes it possible for
this treatment to accomplish results readily, quickly, when all other
treatment is of no avail.

For example, a girl fifteen years old had suffered from retinitis
pigmentosa from birth. The disease was rapidly progressing and it did
not seem that any relief would be obtained by any form of treatment;
the patient was simultaneously suffering from progressive myopia.
Relaxation treatment, the correct use of her memory, and imagination
improved the progressive myopia and much to the delight of the
patient, the retinitis pigmentosa improved at the same time and
continued to improve until all traces of the disease were absent and
she was permanently cured.

It seems to be one of the peculiarities of the disease that it is
variable. Oftentimes it gets better for a short time when all of a
sudden, overnight perhaps, the disease will return with all its
accustomed forms of black pigment spots, atrophy of the optic nerve,
diminished circulation, and incipient cataract.

Retinitis pigmentosa has been observed in cases of glaucoma, chronic
cases which progressed with more or less rapidity until almost total
blindness was observed. In other cases, different parts of the choroid
would be destroyed, and there would be loss of vision in these areas.

The vision of children ten years old, suffering from this disease, has
been remarkably improved by swinging the child in a circular direction
several times daily repeated for many weeks. This promotes relaxation.
It is a mistake to dispose of cradles, rocking chairs, and other
methods of promoting the swing. The long swing, (described several
times in this magazine) is a very efficient method of obtaining
relaxation. Many people object that children have not sufficient
intelligence to practice the swing successfully. On the contrary,
children ten years old or under can practice the long swing as
successfully as many adults. It is a treatment that the patient enjoys
to a decided extent. Games of all kinds should also be encouraged. It
is well to protect the child from adults and others who make the child
nervous. Nervousness always causes strain. Laughter and good times are
relaxing. The kindergarten is a good place for all children at an
early age, because relaxation methods of the best kind are taught
there.

Before closing, reference should be made to a girl fourteen years old
who cured herself of retinitis pigmentosa by playing games and
engaging in sports that she enjoyed. In the summer time she enjoyed
swimming and diving from very great heights; in the winter time she
practiced skating, devoting long periods of time to this sport.
Besides the relaxation methods which I have described, it is worth the
trouble to teach children who have so-called incurable disease how to
enjoy themselves for long periods of time both winter and summer.
Their eyes as well as their bodies are kept in motion while playing
games or engaging in sports which relieve the stare and strain that
cause imperfect sight. It is so much more efficient than drugs.