Thursday, June 5, 2014

Can standing on your head result in better vision? Please read before you go around breaking your neck.

"My lazy eye turned on on New Years Day, I don't have amblyopia anymore and I do have depth perception for the first time in my life. The whole world is more beautiful than I ever could have imagined. I will be 70 years old in the fall. 

Last June I started standing on my head every morning as a fitness exercise. It wakes up and tones the muscles all up and down my body, why not my eye muscles, too? I can't say for sure that's what turned the eye on, but try it. Even if it doesn't fix your eyes it will still be good for your body.

Bill Johnston."

LOVED this story! A seventy year old man standing on his head and boldly going where he'd never gone before. Hell yes. I'm not implying we should all go standing on our heads to recover our vision, much less do I want to be held responsible for any aneurysms resulting from it. I did want to explain why this, however strange it might sound, is a totally reasonable quote from a neurological standpoint. I'm sure most doctors will already be getting in line to say there is no scientific basis for any of this but that's just because they are not interested in looking for one. In the early days neurologists went around calling synesthetes crazy, whereas we know now there are very valid neurological explanations for eg. seeing sounds and hearing colors!

So why might standing on his head have contributed to BJ's visual recovery? Because it works on the integration of (what I randomly call) the holy trinity of Vision Therapy: (eye) muscle tone, visual input and balance.

1. (Eye) muscle tone - Proprioception
Standing on your head radically changes the demands for muscle tone and no muscle in the body is exempt from this. Everything has to be re-calibrated which might induce lasting changes and more flexibility in the  contraction of muscles. Your eyes don't move in isolation and shouldn't have individual agendas. Ideally they move seamlessly and harmoniously in accord with the rest of your body. This daily re-calibration might contribute to this overall effect.

2. Visual input
Standing on your head puts your worldview upside down. That reminds me of a study I read about earlier.

"Incredible plasticity in the adult visual system has been demonstrated in psychology experiments by application of inverting prism in normal adults. Initially when wearing these prisms, the world appears upside down and backward. However, after wearing the prisms for several days, the world returns to its normal appearance, demonstrating the amazing plasticity of the visual-perceptual apparatus, as well as the vestibular-ocular reflex, which must also invert. Upon removing the prisms, the world is again, upside down and backward until the visual and vestibular systems reorient." - Vision Rehabilitation

Thus standing on your head taps into the same measure of adaptation and will enhance visual plasticity. This change, this call upon action due to frequent (daily) new environmental demands, might have reinforced the connection between the visual system and vestibular system (sense of balance). This might have created the need for his vision to become more binocular and in turn activate the 'lazy' or amblyopic eye. Contrary to popular believe amblyopia is not so much about the reduced acuity in the 'lazy' eye as it is about reduced overall SPATIAL vision. Amblyopia is a disorder of spatial vision first and a visual acuity disorder second. Integrate the amblyopic eye into the binocular team using the 'vestibular back door' and the acuity will catch up as a consequence as happened in Mr. BJ's case. Nothing we do in life goes without neurological consequences.

3. Balance - Vestibular System
Sense of balance can be the 'secret' VT weapon spurring on our binocular vision to get better in order to successfully cope with a balancing assignment. Standing on your head clearly puts your vestibular system to the test and is similar to the use of yoked prisms in VT. Yoked prisms also work on the three factors mentioned here. They shift the perceived image in a certain direction changing visual and muscle tone feedback. This makes it considerably harder to move through space and maintain balance. Coordination of movements and sense of balance are highly dependent on steady visual input so messing with that input will result in a challenge. I'd say standing on your head can compete with yoked prism training. Likely, it's even harder! Go seventy year old Mr BJ!

In short, standing on your head is a great way to integrate these three essential elements needed for good vision. I would say however it is something for the later stages of therapy, if at all. Standing on your head is not for everyone but  there are definitely compelling reasons to believe this kind of gymnastics contributed to BJ's visual rehab. In this case, the underlying neurological and environmental conditions were such that standing on his head  further integrated motor and visual skills and took Mr BJ from monocular vision to stereo vision. Brave new world!

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