Sunday, November 10, 2013

Convergence Insufficiency, new glasses and gravity

Recently a fabulous piece of research titled 'Association between reading speed, cycloplegic refractiveerror, and oculomotor function in reading disabled children versus controls' by Patrick Quaid and Trefford Simpson came to my attention. It, as many other optometric research, confirms in immaculate detail the importance of vision in reading and learning. It's great to see such valuable research being done by passionate optometrists on a voluntary basis. You heard that right,  for ZERO of your preferred currency! It does not take millions of $$$ to see the truth and change lives for the better.

In this research paper Patrick Quaid mentioned an interesting model he previously published in 2010 and which perfectly embodies my intuitive experience.

Original model did not include my yellow progress report

Because I have been using Optometric research as a mental anchor over the last few years in order not to lose my mind midst all the visual confusion I understood the fancy words. If you don't grasp some of them, it is a testament to your sanity so don't worry about it. Alright, hang on. I'm getting to my point.

Convergence Insufficiency

I started out almost exactly three years ago in what I would call a functionally blind state. Because of the steady degradation of my vision throughout my youth with as icing on the cake a total annihilation of any binocular skills through eye muscle surgery during young adulthood, I was left with just visual acuity. The lack of extra ocular muscle function resulted in constant double vision. I could use my vision not to bump into things but that was sort of it. I was in total shut down... Couldn't get through the day anymore, infections, ... One year after the last surgery I found out about VT and insisted on starting training however hopeless the situation seemed.  It took one year and eight months just to single out my vision briefly. As that ability improved, I could do it longer and longer and nowadays also while moving. Today I experience no more double vision unless when put under visual pressure such as reading engagements. Even though having traditionally been an esotrope and having an esotrope's brain, the surgery put me in an exotrope-ish body. In fact, there wasn't much of a coherent system when it came to my eye movements anymore. My eyes totally got out of control and the angle of my eyes depended on the viewing direction (position of gaze) among other things. Now, the beauty of my current situation is that I have gone from manifest constant strabismus and double vision to a more intermittent form of strabismus called convergence insufficiency (CI). Having put in ungodly amounts of effort and patience this is nonetheless already a great achievement even if it comes after three years of intense focus.

Where does this leave me in terms of managing my expectations and action plan? 
My initial goal of improving my vision was being able to read better. Once I found out about Susan Barry's Fixing my Gaze, I realized I was missing out on even more! One of the typical characteristics of CI is that it interferes with academic performance and reading. I can't begin to describe how bad things were before my newly found CI state... No one has any f*cking idea how 'simple' accommodative strabismus can grow into a full fledged brain injury when left untreated or badly treated. CI is still quite inhibiting but at least I know it is often treated in less than a year. If I can obtain the visual stamina to converge my eyes flawlessly while reading texts for extended periods of time I'm golden. Learn to read and you will be forever free. In terms of the above pyramid I have made it onto the 'fusional vergences' stage, which are the finer eye movements helping you to sensory fuse the percepts of each eye. I am pretty sure that sooner or later I will be experiencing stereo vision but, instead of frantically focusing on that more distant objective, I prefer to focus on ever improving convergence which will allow me to read more comfortably. It would be great to finally be able to fully indulge in my many interests. Nothing is more frustrating than having to refrain from learning and be condemned to mediocrity because of a failing vision care system. It's quite ingenious how OMDs take out their opposition by ruining their functional vision. Sadly for the ones who did this to me, three year into this quagmire I'm more hopeful than ever and have got the mental juice to take this to the very end. As Canadian optometrist Charles Boulet offhandedly said recently: 'Vision care is fundamental to human growth and freedom. As basic as shelter and food.' I can wholeheartedly confirm this is true while gearing up to eliminate  this remaining, 'milder' form of CI strabismus over the next year!

New Glasses

During my last two check-ups the astigmatism value of my left and traditionally lazy eye had changed and there was a need for better optical correction. I considered getting Shaw lenses for a while but since it's a hassle to import them into the EU and my anisometropia and consequently aniseikonia problem is limited, I settled for standard Essilor lenses. (Again, if you didn't get some of that... Good for you!) I didn't go for the overpriced 'anti-fatigue' and '360' options because I'm not sure whether these innovations would actually contribute to or rather confuse my  visual system. Having done my homework on this, I am convinced the Shaw Lens is an innovation which truly adds value to binocular vision and is even used to treat amblyopia without patches. Whether other companies are just applying some new technologies without a clear purpose or they too are actually 'getting it', I don't know. So in the end, I kept it simple by choosing standard lenses. Both of my eyes have a +2.5 spherical value with a pinch of astigmatism to my left eye. A nice touch however are the rimless frames. I like them. Stylish and great for letting your peripheral vision have a go without restrictions.

Note to self: upload a better picture


I went to see the movie 'Gravity' in 3D with my brother. As my brother is my binocular guinea pig, he could tell me this was one of the better made 3D films he had seen up until now. Cinematographers are getting the hang of it maybe. Even though I didn't see any 3D yet,  I've made some interesting observations about myself. I'm not suppressing because occasionally the view went a little double around the edges. Then I would pull myself together and consciously make it single again. In my defense, it was late. Aside from that, my brain is picking up on something. I might not consciously be aware of any stereo vision yet but it feels more intense inside my head. When those bolts and space objects flew all around, it FELT different from a normal 2D movie. I found myself flinching at times, thinking stuff was going to hit me in the face. It might just be the monocular cues but I did FEEL like it was something more though... No matter, time will tell.

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