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Hi, Michelle. Gellis here. I want to thank you for attending this AAC live presentation and thank you to the American Acupuncture council as well. Today, I am going to be talking about treating. I chose. And for those of you who don’t know me, I teach cosmetic and facial meaning neuromuscular acupuncture classes internationally.
So the topics for today are going to be how some possible techniques for treating eye TOSA. Looking at the etiology from an Eastern and a Western perspective and then different treatment techniques, including submuscular needling motor points. And I’m not going to get into scalp, acupuncture and cupping, but those are some other treatments that can be used.
To treat I ptosis. So what is ptosis of the eyes? I chose this is when the muscles that raise the eyelid and there are a few of them. So there’s the levator muscle and the superior tarsal muscles. And in some cases also the frontalis muscle, when these muscles are not strong in. One or both of the eyelids can droop.
So testers can affect one or both eyes. It can be congenital. It can be cause through disease or injury. It’s more common in the elderly as the eye muscles begin to weaken and deteriorate. And here are some pictures of different degrees of eyelid ptosis. So in this person here on the top left, it’s very mild and in the person right below them both of the eyelids are what is referred to as hooding, meaning the.
Eyelid itself is eclipsing the part of the eye that allows us to see, and this again, can happen with old age. It can happen due to disease or injury in the middle photo. We have a slightly. More pronounced degree of eyelid ptosis, and then in the photo on the far right. Someone who has severe ptosis.
And so I am going to go into, again, some of the etiology and treatment for the varying degrees of islet. So Don damage or trauma to the eye can happen through injury or anything that damages the third cranial nerve, which is the ocular motor nerve, which controls this muscle. If someone has Bell’s palsy stroke they something like this can happen from a brain tumor, even conditions like diabetes or my skin you gravis can cause ptosis of the another cause common cause of ptosis is Horner syndrome and that is a.
Nerve damage that occurs in the face and the eyes. And in that case, it most likely wouldn’t just be the eyelids, other sorts of brain injuries, spinal cord injuries cancer can cause harm. Syndrome and ptosis cluster headaches can also cause ptosis what a cluster headache is a severe headache that has a frequent pattern for a period of time.
And then it will go into recession from a cheese TCM perspective. Ptosis is due to a congenital deficiency. Either a deficiency of the spleen or the kidney or balls or an obstruction of the collaterals by wind flam, leading to some sort of malnourishment of the upper eyelids. When we’re looking at doing body points to.
TOSA is from a TCM perspective where you would differentiate between the spleen kidney deficiency with wind flam and points on the stomach. Bladder and spleen meridians are typically used in that instance. And some of the manifestations for. The deficiency of spleen and kidney is it’s typically bilateral.
There might be some soreness and weakness in the lower back and the knees, poor appetite, loose stools, and the tongue body would be pale with a white coating, deep, weak pulse. And so the treatment principle would be to reinforce the spleen, warm the kidney. And I’ve listed some possible points that you can do, and you might want to add in let her 20 and 25 use a mocks that are really tonify the spleen and the kidneys.
And then the explanation is listed here below.
for us spleen. Whoops, sorry for a spleen deficiency. With when phlegm, the manifestations would be more of a swelling and numbness in the upper eyelids, possibly difficulty moving the eyeball. Numbness of the limbs fatigue, poor appetite here, your tongue would have a pale body with a white and sticky coating.
The pulse is going to be soft and thready, and the tree treatment principles would be to reinforce the spleen and resolve the phlegm. And the primary points are listed. And then the explanation. For why you would do each one of these points is listed below. If we have time at the end, I’ll come back to this, but I’m always mindful of time when I’m doing this live presentations.
For a scalp acupuncture, I had mentioned that you can treat. Eyelid ptosis with scalp acupuncture. We don’t have time for a whole scalp acupuncture lecture, but needling the lower two fifths of the motor area on both sides. And. For doing motor point. So facial motor points, you could do the motor points for the and those are two motor points.
It’s the extra point show how, and you would do an oblique absurd insertion. And there’s also a motor point halfway between gallbladder one and Sanchez 23. Again, you would do an oblique insertion also for the corrugator because the corrugator muscles work in conjunction with the eyebrows and the eyelid.
So treating the corrugator muscle. By doing the motor point that is just lateral to bladder too. And also treating the motor point for the front desk. Because as I mentioned, the frontallis, which is which are these muscles right over your eyebrows, the frontallis raises the eyebrows. So doing the motor point for the frontallis, which has gallbladder 14.
And again, a bleak insertion, and you can also do facial cupping and guash Shaw gently around the orbicularis ocular a little bit inside the orbital Ram. You can even stimulate the acupuncture points, all the acupuncture points around the eye, stomach to gallbladder one, the X per point. Ladder to you?
Yeah. Sanjay 23. So gentle cupping, gentle guash Shaw stimulating the point. We’ll all work on the ambiguous virus. Oculus. And if you choose, you could even use a Derma roller around the outside of the eye area. You never Derma roll inside the orbital rim, but really stimulating that area can be very beneficial.
So I mentioned these three points, bladder to you yell and Sangyo 23 when I needle them, especially with you. Yeah. I will lift the brow up out of the way and I will needle straight. Yeah. Under the eyebrow and for you. Yeah. If you go in line with the pupil, as opposed to the center of the eyebrow, if you go in line with the pupil, you can catch the edge of the levator muscle Azure noodling, and it really helps to lift this entire area.
I think I have a video.
Let’s see if I can get this sleigh, like really this. What I’ll do is I’ll pull up, but for her, I would just use the two and push underneath the brow like that. So again, I’m not on the lid on underneath the brown. Okay. Where they call this you yet? Don’t you? Yeah.
So those of you who don’t know me I do teach cosmetic acupuncture classes, which is what all of these other points are. And I incorporate this in my cosmetic acupuncture classes because as we age for many people, the drooping eyelids is very much a concern. And I realized the video is a little jumpy, but a few go to my social media.
I have a lot of these short little videos. I do a facial acupuncture tip of the week. So you could see it a little more smoothly than than you just did,
like really another. That can be very beneficial is gallbladder 18. This is not a widely used point, but it is a fabulous point for treating the eye area. If you look at this drawing from a medical textbook, this shows right here, the supra orbital nerve, and. This runs right along the Gallia up and erotica, which links the subtle and frontal bellies of the occipital from talus muscle gallbladder 18 is in line with do 20.
And so do 20 is here. The bladder line is here and then gallbladder. The way you can find it is you go to a gallbladder 14 and then 15, and you’re going to follow it straight back till you get to 18 noodling. This affects the entire occipital frontalis muscle and helps to open up the eye area.
So I had talked about the motor points for the , which is the muscle that goes all around the outer side of the orbital rim here. And the two motor points of. Between gallbladder one and Sanjay 23. And then the extra point Q ho. And you would treat only the affected eye. If both eyes were affected, you would treat both eyes, but if it’s just one eye that was affected, you would just treat the one eye.
And here is a picture of gallbladder 18. You can see it is in line with do 20 and it is right along the gallbladder line. Another point. That I will thread actually is I start at bladder four and the way you find bladder four is you go to bladder two, you go straight up to bladder three, and then you are going to come over at 1.5 soon to.
Bladder for. And when you were at bladder for you thread, a long, the scout all the way back to ladder six. You can use a half inch needle or a one inch needle, but this added in with the other points here. Whoops. I have a little delay here. So if you add these points, gallbladder 14 and Gulf letter 15 all together,
along with some of these motor points and you leave them in for about 20 minutes or so, what I do is I would leave the points and I might include. Some scalp acupuncture and with the scalp acupuncture, you would come in every 10 minutes or so and stimulate the needle. Then you would take the face points out, continue to stimulate the scalp point.
Cause you want to leave that in for about 30 minutes and try to get your patient to lift their lid. And sometimes it helps. If you’re doing scalp acupuncture to have them sitting up, you hand them a mirror and have them really focus on lifting up their eyelids. If they can see in a mirror, it helps to connect the brain to the muscle group.
Once the noodles come out, then you would do your. Cupping and Guam Shaw and Derma rolling. And I also sell my patients a set of cups and I teach them how to use the small cup and the facial wash shot tool. And. That way in between treatments, they can be working on these muscles. It’s a great way to reinnervation the muscle to re educate the muscle.
Obviously your patients can not be needling themselves at home. Teaching them to work, these muscles at home can be. Very beneficial. And so the order would be you put in the body points, right? You’re going to treat the underlying condition. Then you’re going to do any points around the eyes and scalp.
And then once the eyes. Come out, continue with the scalp points, have them work the muscles, then the cupping and GWAS Shaw, and then the German walling.
This was a patient of mine. She was actually young. Sorry. She was actually young. She had come to me for. She was going to be getting married and she had ptosis of her left eyelid, her entire life. And she was concerned because when she got tired, It became more pronounced. It was more noticeable and she suspected, or if she was sick, it would become more pronounced and more noticeable.
And she was very concerned that moving forward that the day of her wedding in all of the wedding photo, That she would have this one, very droopy eyelid. So she came to me for about three months before the wedding. And. Worked very much. He had very deficient kidneys. I spoke to her about getting proper rest and drinking.
Plenty of water treated. Her kidneys, did a lot of work. And what I would do is I would do the points on her back. Lots of mocks, a heat lamp. Then I would turn her over. I would do the body points on the front of her body and treated her. Eyelids. And after about six treatments, she really started to notice a difference.
And then by the end of three months, the treatments were holding to the point where I only saw her from time to time and you can see the after photo. This was a close-up actually from one of the. Photos a day of the wedding. She did it before she put her makeup on her. Eyelid had opened up and she was very happy.
Think so worried about time. I talk really fast. Let’s go back to the beginning and I just want to run through the diagnosis. A little more thoroughly and then wrap it up. So for the actual points that you would use, if someone had a deficiency of spleen and kidney, the primary points would be the eye points that.
I spoke about, so gallbladder 14 bladder to tie on, which I didn’t mention. You could also do gallbladder one. You yell Joe 23, very gently manipulated, do 20 stomach, 36 spleen, six, kidney seven. And then the explanation is. Bladder 20 and spleen six reinforced the spleen and tonify that she bladder 23 warms the kidney yang, especially with moxa stomach 36 and do 20 reinforced.
She raised the yang and can help to lift things that are sunk in. Gallbladder 14 bladder to Ty young and you yeah. Are all local points. They helped to nourish the upper light eyelid and strengthen the local muscles for the spleen deficiency with wind phlegm, the primary points would be gallbladder 14, bladder two.
Ty young you. Yeah, again, so a lot of the same local point do 20 Sanchez, 23 and stomach 36. Again, spleen nines, blend three and stomach 40. So stomach 36 helps to reinforce the kid, the stomach chew spleen nine spleen three, reinforced the spleen and remove dampness stomach. 40 helps to transform phlegm, do 20 dispels the wind and gallbladder 14 also promotes a nourishment of the.
Upper lip. So I think that is everything. I don’t recall if we can do Q and a, but I don’t see any questions popping up. So I am just gonna conclude. This talk today. And next week we have Matt Callison and Brian Lau presenting live. And if you missed any part of this, or if you’re interested in seeing any of the other AAC, Facebook or Instagram live shows, they are available on YouTube and on the AAC.
So thank you again for coming and I look forward to seeing you again. .