November 29th, 2010: 14 degrees* ESO**, no fusion, no stereovision
April 7th, 2011: 8 degrees ESO, peripheral fusion, no stereovision
September 28th, 2011: 4 degrees ESO, peripheral fusion, upcoming central fusion, no stereovision
March 29th, 2012: 3 degrees ESO, peripheral fusion, central fusion, no stereovision
September 6th, 2012: aligned eyes, peripheral fusion, central fusion, double vision in daily life is gradually declining, no stereovision
May 2nd, 2013: aligned eyes, fusional area expanding, double vision usually absent, no stereo vision
October 3th, 2013: aligned eyes also increasingly while being in motion, double vision almost entirely absent except during reading, no stereo vision (even though I read a stereogram correctly 'by chance' so maybe I'm close)
April 1st, 2014: aligned eye posture increasingly solid; remaining convergence insufficiency while reading (double vision); stereo tests reveal latent ability to perceive some kind of depth but no conscious stereo vision; need for more speed, accuracy and consistency in ocular motor skills to fully unfold sensory modalities
"Nothing in biology
makes sense except in the light of evolution." ,- Theodosius Dobzhansky
In the first half of the book Lieberman kicks off with a detailed history of how we got to be Homo Sapiens and how every mutation came into being and why. Oftentimes it was climate change or some other major event our hominin ancestors managed to survive at the time. It also magnificently reveals why we are the way we are and why we move the way we move. I leave it up to you to read the book if you want the full story on that. What stood out to me is how seemingly random it all happened and how the evolution of the modern human was not inevitable. It's like we 'won the lottery'. I will leave the philosophical debates up to you, but if you can't handle the fact that we are bipedal primates the book is not going to be much fun for you. A great quality of his narrative is that he doesn't try to oversell and clearly states what actually can be known by examining the evidence and what are merely hypotheses. For instance, one of the many cool fun facts is that even though Neanderthals have died out, 5% of the DNA we carry has Neanderthal origins due to interbreeding. Also notable, and something every human ought to know, is the fact that we are a genetically homogenous species and apparent differences in looks are literally only skin deep.
In short, it's been an interesting last 6 million years and you are the result. Compared to the entire duration of human evolution, the agricultural revolution and later the industrial revolution are merely blinks of the eye. Agriculture was only invented around 11,000 years ago. Farming is often viewed as an old-fashioned way of life, but from an evolutionary perspective, it is a recent, unique, and comparatively bizarre way to live. This new cultural revolution occurred for good and valid reasons and were mostly beneficial at first. The best way to investigate the effect of past events on the human body is by comparing bodily remains of hunter gatherers and early farmers. Initially height and health of farmers increased. Later on, because of various reasons one of which is population increase, farming was still a boon for the human species as a whole but became a mixed blessing for the individual. Over time farming exposed people to dangerous situations like famine, living of solely one crop and a much higher rate of infectious disease due to higher population and animal densities. In other words, the unfortunate irony of agricultural intensification is that even though farmers produced more food overall, the energy available for each child to grow diminished, probably because they were spending relatively more energy fighting infections, coping with occasional shortages of food, and toiling long hours in the fields.
Ever since the agricultural revolution culture has undergone increasingly rapid change to this day. Through cultural evolution rather than natural selection we have learned how to cope with many of the unfortunate side effects of our new farming life style. The book goes on to describe the industrial revolution and how new divides between our biology and cultural evolution came to be and how medical advance often spectacularly helped mitigate the effects of many mismatches. The author also provides interesting insights in how the modern food industry originated and works. We are further removed from our 'normal' habitat than ever before and without looking at our own biology through an evolutionary lens we are unaware of the possible risks this entails. Not because I consider something 'normal', it is actually normal. Humans have a habit of making new habits without even knowing it. In fact, cultural evolution is taking on such speeds that what was normal to my grand parents and even parents is vastly different from what I consider normal. Increasingly we are creating novel environments for which our ancient genes did not evolve. Even though natural selection is still ongoing, there is no way it can keep up with the blistering pace at which our environments are changing. However smart we are, or we think we are ,we are still a bunch of monkeys whose proliferation and cultural development got 'out of hand'. Now, the good news is that at this time in history we can start relearning some of our monkey ways to combat health problems our body is developing in response to this profoundly new and weird environment. How awesome is that!
We therefore have much to gain by using the lens of evolution to consider shifting gene-environment interactions that have occurred since the Paleolithic ended. How well do the genes and bodies we inherited from our early modern human ancestors fare in the novel environments to which we subject them? And how can an evolutionary perspective on these changes be of practical use?...
The emerging and important new field of evolutionary medicine proposes that,despite much progress since the Paleolithic, we have become like that (out of place) animal in some respects. As innovation has accelerated, especially since farming began, we have devised or adopted a growing list of novel cultural practices that have had conflicting effects on our bodies. On the one hand, many relatively recent developments have been beneficial: farming led to more food, and modern sanitation and scientific medicine led to lower infant mortality and increased longevity. On the other hand, numerous cultural changes have altered interactions between our genes and our environments in ways that contribute to a wide range of health problems. These illnesses are mismatch diseases, defined as diseases that result from our Paleolithic bodies being poorly or inadequately adapted to certain modern behaviors and conditions....
The most basic interactions between culture and your body’s biology are the ways that learned behaviors—the foods you eat, the clothes you wear, the activities you do—alter your body’s environment, thus influencing how your body grows and functions.
To be clear, this book does not propose to resort back to our caves and give up advances that have allowed people to survive throughout human history. Today 800 million people are often still struggling to get sufficient food. Yet at this time the number of obese people world wide has exceeded one billion. Affluence seems to have its own risks since we did not develop to deal with abundance and nowadays healthy food is more expensive than junk food. So those of us fortunate enough to live in the developed world are developing all kinds of new problems. Because people have no idea anymore about what is 'normal' our daily activities and foods without moderation can lead to debilitating illnesses.
Another application of evolutionary medicine is to recognize that many symptoms are actually adaptations, thus helping doctors and patients rethink the way we treat some illnesses and injuries. How often do you take an over-the-counter medication at the first sign of fever, nausea, diarrhea, or just aches and pains? These discomforts are widely regarded as symptoms to alleviate, but evolutionary perspectives indicate that they can be adaptations to heed and put into service. Fevers help your body fight infections, joint and muscle pains can be signals to cause you to cease doing something harmful like running incorrectly, and nausea and diarrhea assist you in purging harmful bugs and toxins.
Quick fix solutions can be great when dealing with acute health problems, but we could do a far better job in preventing most of those ailments to begin with. Lieberman does not discard the impressive medical advances accomplished during the last centuries and how they enable us to survive acute health problems. He just points out we can have best of both worlds. If we start being aware of the risks of some modern behaviors and know how to manage them adequately we could be much better off. When illness logically finds you because of the way your biology interacts with some behavior or foods, many doctors often deal with the symptom, rather than come up with a structural solution, starting costly negative feed back loops aggravating the problem in the long haul. While as a matter of fact some ailments can simply be prevented or treated by changing behavior.
(Some medical treatments) are not so much solutions as Band-Aids that treat only the symptoms of mismatch conditions. Such palliative responses can create a problem, because treating the symptoms rather than causes of mismatch diseases sometimes provokes a pernicious feedback loop, which I term dysevolution, that allows the disease to persist or even intensify. ...
Many medications are available for treating hypertension, but the best treatment is also the best form of prevention: good oldfashioned diet and exercise. Therefore, like cavities, high blood pressure is a common case of dysevolution because even though we know how to lessen its prevalence, our culture creates and passes on the environmental factors that cause the condition and keep it common. As chapters 10 through 12 explore, similar feedback loops help explain the incidence of type 2 diabetes, heart disease, some forms of cancer, malocclusions, myopia, flat feet, and many other common mismatch diseases.
To get the full benefit of the illuminating descriptions of mechanisms through which very 'normal' or common behaviors might contribute to those ailments I recommend for you to read this book. When reading some books I really feel privileged to acquire the knowledge offered by that particular book and this is one of those books. I'm happy to have learned this information so I can make informed decisions in the future. Nevertheless I will come back to myopia later in this review.
Towards the end the author points out this shift in health care is not going to be easy. It's very profitable to sell comfortable objects and foods we instinctively 'can't get enough of'. Moreover, the medical system is skewed in such a way that it promotes all kinds of accommodating gear, medication and expensive surgeries. Behavioral change is much less profitable and harder to sell. One often has to be really well-informed and have a healthy dose of skepticism towards doctors to find out about more structural long term solutions. Clearly this is no different in the vision care business. In the final chapter, he proposes various policy adjustments and how he thinks they would play out in trying to improve general prevention efforts taking into account our ancient cravings for comfort and 'unhealthy' foods and our new environment. Sadly much money is being spent on keeping negative feedback loops going rather than preventing them from occurring. Preventive medicine is not only the best kind of medicine, it's also the cheapest kind.
The dramatic successes of pediatrics during the twentieth century prove that preventive medicine really is the best medicine. My (the author's) grandfather (who was a doctor)died in the early 1980s, but I am sure he would despair at the state of preventive medical care for children today in the United States. The majority of American children still get regular checkups, inoculations, and dental care, but 10 percent of them don’t because of poverty and poor access to health care. The percentage of low birth weight babies, now 8.2 percent, has not declined in decades and in fact has been rising recently, even though low birth weight substantially increases a child’s risk of dozens of short-term and long-term health problems. In 1900, Americans were, on average, the tallest people in the world, but today they tend to be shorter than most Europeans.
STRABISMUS CONSIDERED AS A MISMATCH DISEASE "It is virtually impossible to see how biology works outside the context of environment.", - Robert Sapolsky, Stanford University
To me binocular problems or strabismus are one of the most clear cases of a mismatch disease. I have a very hard time believing one could have genes that predispose you 100% to be cross-eyed. I have some papers lined up about strabismus and genetics but I doubt that they will be very earth-shaking in that respect. Even if there is such a thing as a 100% genetically predisposed strabismic, it will be a small minority among the actual strabismics.
A good point about using an evolutionary perspective is that when studying a phenomenon we shouldn't compare someone with a particular disease to a supposedly healthy person who grew up in an industrial environment. To really get an idea of what is 'healthy and normal' we should try to learn from the bodily evidence that our paleolithic ancestors left us. That would be a whole other story since nothing in biology makes sense unless seen in light of evolution.
For instance, the visual system must have evolved over millions of years in order to make us excellent hunter gatherers. Distinguishing colors, having a good panoramic overview of landscapes, judging distance, interacting vigorously with the world resulting in an agile and flexible visual system. I'm working on a blog entry on 'loading', meaning the application of learned visual skills during Vision Therapy in real life activities. I think hunting and gathering would be an excellent form of 'loading'.
Knowing this, writing and reading are a fairly 'risky' new behaviors and was only invented 6,000 years ago. In his book 'The Mind's Eye' Oliver Sacks ponders the question how we managed to invent script, reading and writing from a neurological perspective. He proposes that we didn't evolve to read and write but rather that we 'recruited' brain areas that evolved for other practical uses which eventually enabled us to invent something completely new by combining them. I am the first person to marvel at such ingenuity but advanced behavior like reading are are not really 'normal' in the evolutionary sense of the word. Obviously the benefits of reading outweigh the risks and it has brought us plenty of good. Nonetheless reading could be even more beneficial to mankind if we learned how to manage the risks it brings to the human visual system. A problem can be caused by environment and behavior so it can also be solved by environment and behavior such as visual training.
The author did mention the myopia epidemic that sweeps the globe as a result of intensified reading and electronics use. He clearly understood the idea of how and why vision changes. But I would almost say myopia is a 'beneficial' adaptation to our new environment which in general leads to easier reading, higher income and more socio-economic success. So it is clear our new environment brings out more myopia in those genetically predisposed to it and cultural innovation like glasses and invisible contacts help them cope. However, extreme myopia too can be managed through accommodation training and life style changes.
That being said, Lieberman didn't seem to realize there are far more crippling and fundamental evolutionary vision mismatches in our day and age. Myopia is basically cramping of the ciliary muscle in the eye making it hard for one to adjust his eye lens. My point being that the problem is situated 'mostly in the eye', which is just the tip of the iceberg of the visual system. Things do get much worse when novel environments inhibit normal binocular brain development and vision development goes rogue. In fact people who are genetically predisposed for clear viewing at mid and long distances often experience visual overload when they try reading at a young age without appropriate glasses. This often leads to amblyopia and/or strabismus. These are brain disorders. The brain is the core of a person so you don't want to mess with that or more trouble is in store for you and society. Without managing those risks associated with long hours of short distance viewing, people with a good 'hunter gatherer vision' predisposition undergo abnormal vision development because of cultural pressures and can eventually even be excluded from society of it. I often mention the added risk of strabismus for farsighted people or hyperopes but myopes can also be at risk.
Frankly, I have a very hard time believing that one could develop strabismus when having to live a hunter gatherer life style. Vision Therapy actually includes training many basic visual skills that would be crucial to hunting and gathering. Even if you were 'born cross-eyed' one would have to grow out of it and strengthen the visual system similar to Vision Therapy. Now, THAT is a really interesting evolutionary mismatch that affects one in five people. Taking into account both those who are suffering from manifest and intermittent strabismus. We consider this the new 'normal' but if we start using our brains we can reinvent what's normal and drastically reduce binocular vision problems. It will not only be better for our health and productivity but it will also be cheaper for society in the long run. I am not the first one to notice or realize this by the way. Look at this excerpt from 'Optometric clinical practice guidlines for the care of patients with accommodative and vergence dysfunction' by the American Optometric Association.
In previous generations, when survival depended on the ability to hunt, fish, and farm, the visual system had to respond to constantly changing, distant stimuli. Good distance visual acuity and stereoscopic vision were of paramount importance. Today, the emphasis has shifted from distance to two-dimensional near vision tasks such as reading, desk work, and computer viewing. In some persons, the visual system is incapable of performing these types of activities efficiently either because these tasks lack the stereoscopic cues required for accurate vergence responses or because the tasks require accommodative and vergence functioning that is accurate and sustained without fatigue. When persons who lack appropriate vergence or accommodative abilities try to accomplish near vision tasks, they may develop ocular discomfort or become fatigued, further reducing visual performance.
Accommodative and vergence dysfunctions are diverse visual anomalies. Any of these dysfunctions can interfere with a child's school performance, prevent an athlete from performing at his or her highest level of ability, or impair one's ability to function efficiently at work. Those persons who perform considerable amounts of close work or reading, or who use computers extensively, are more prone to develop signs and symptoms related to accommodative or vergence dysfunction.
Symptoms commonly associated with accommodative and vergence anomalies include blurred vision, headache, ocular discomfort, ocular or systemic fatigue, diplopia, motion sickness, and loss of concentration during a task performance. The prevalence of accommodative and vergence disorders, combined with their impact on everyday activities, makes this a significant area of concern.
As I see it, strabismus is a mismatch disease to be monitored and treated when the visual system exhibits deviation from its healthy developmental trajectory. Often children develop strabismus and the suppression of one of both eyes as a temporary adaptation helping them cope with a stressful visual task in the here and now but when this way of seeing persists over the long haul it will have serious drawbacks. If not treated, vision imbalances in the brain will often lead to imbalances in body posture. Examples of these are people tilting their head in odd angles, turning their body to one side, cramping facial muscles in an attempt to compensate for their unstable vision. Another indication that strabismus doesn't just magically appears but it develops in response to environmental demands. Sadly today most doctors still don't understand this and keep the negative, expensive feedback loops going. Strabismus is curable and when talking about accommodative strabismus it is downright preventable.
Earlier passages from the book mentioned in this review definitely apply to the vision care system or, as I like to call it, the strab-business. The medical system is skewed towards treating the symptoms (eye muscle surgery, ADD medications, ...) rather than causes and it will take a while before people's minds can be changed and we can fully enact this paradigm shift. Strabismus is not so much a medical mystery anymore,as it is a structural social problem. Sure, we don't know every little detail about strabismus (even though we know a lot already) but that shouldn't stop us from using common sense and do the right thing. Not treating strabismus based on what we already know about the brain and only fiddling with its aesthetics leads to what Lieberman calls dysevolution. The word is very accurate in describing the process. It's very cruel to subject children or adults in need of vision help to dysevolution especially when it can easily be avoided. When someone suffers from a disease we don't know how to cure, it's a tragedy. But if someone suffers from a disease we know how to prevent and cure, it's a disgrace. The majority of vision care professionals can do better and should do better.
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'Keep Calm and Carry On' was a motivational poster produced by the British government in 1939 several months before the beginning of the Second World War, intended to raise the morale of the British public in the aftermath of widely predicted mass air attacks on major cities It had only limited distribution with no public display, and thus was little known. It was believed there were only two known surviving examples of the poster outside government archives until a collection of 20 originals was brought in to the Antiques Roadshow in 2012 by the daughter of an ex-Royal Observer Corps member.
Time to bring out this iconic poster once more! Too many children with visible and invisible vision issues are going undiagnosed or are being misdiagnosed with behavioral problems. Even in case they are diagnosed with the correct binocular vision issue, they are often left untreated or mistreated. Curable eye teaming and perceptual problems are jeopardizing their future. People seem to like those retro looking posters so get them into your doctor's offices, schools, optician's stores, hospitals, ... Automatically people will be drawn to them and upon reading ask themselves the right questions.
My fine ocular motor skills keep improving making head on anti-suppression exercise the main focus now. No 'luster' yet, but I am not disheartened. It is really unbelievable that after 2,5 years of dedication to my vision read brain, my motor control still keeps getting more refined. It's hard to believe how badly I was doing back then, isn't it? I can't blame people for not understanding me because I almost take every improvement for granted instantly... I would compare it to having accumulated this this huge amount of debt (health wise) starting at the age of three which had seemed impossible to pay back at the age of twenty making every small reimbursement (VT effort) seem insignificant. However, that's just a one sided metaphor falling short of describing this life crushing stuff... So yesterday I said jokingly 'It's starting to look like I'm going to be able make up for 20 years of medical negligence and abuse in more or less three years, so I can't complain.' Eat that VT skeptics. The best is yet to come.
Session 47: Before I blogged about Syntonic Light therapy as a way to enhance and possibly accelerate vision therapy progress and I was very excited about trying it. Seems like the road is going to be a bit bumpier than expected, but I'll find a way... So more on that later.
Aside from that disappointment todays session was pretty good. Still slow and steady progress notwithstanding the constant battle with fatigue, a chronic sinus infection, the tendency to go back to double vision when tired and the hardest part of all: not to take out mood swings on other people because of the former. Earlier I wrote about the similarities and differences between MS and strabismus and recently I read (Suddenly successful: how behavioral optometry helps you overcome learning, heatlh and behavior problems - Book review) that vision imbalances are not a cause but rather a symptom of deficits in the function and performance between two major nerve systems in the body: the autonomic and motor nerve systems. Makes all the sense in the world to me... You are unable to do exactly what you intent to do and if you try real hard it will cost you a lot more energy than normally necessary and possibly damage your body because of the extraordinary pressures. It's hard to navigate this ship... The earlier (or whenever) this deficit is caught and corrected by optometric vision therapy, the more you will be able to live up to your potential and stay on course without slowly sinking.
A general observation I made during the past few months is the fact that I am starting to understand why people have trouble with small print. If accommodation and vergence have to work together you can't just say 'I'm not going to point my eyes correctly and zoom in on that small front using accommodation all the way'. It isn't exactly a decision but that's the way I did/do it. Not very balanced and not very productive in the long haul... But now I'm trying to learn how to do both and it's starting to work pretty well on big letters... I can really make them into one nice letter/word and not two letters on top off each other. That's not possible for small print yet... If I have to read those I just resert to double vision and try to focuss on one of them. Funny business, I know... I think in 2013 the last two years of training will come into its own so I'm looking forward to that. Patiently...
A couple of years ago, before I knew about Vision Therapy and I was very down because of studying with double vision without any solution in sight, I entered a musical instruments store. I wanted to get a book to teach myself how to play the guitar in order to possibly find ways to relieve my eyes and my obsessive brain. At the counter I had a nice chat with the sales person who himself was a musician and I started telling him about my condition. About how I was slowly losing control of my eyes resulting in double vision and how the harder I tried to do well academically the worse it got. He was very interested in how I dealt because it turned out the guy had Multiple Sclerosis. I am not an expert on this condition but it’s an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged. He had suffered various attacks and after every attack it takes a long time to recover, sometimes without full gain of function. A person with MS can suffer almost any neurological symptom, double vision is only one of the possible symptoms that can occur.
Source: Wikipedia
It's a very serious illness. Again, I’m no expert on MS but I think that currently there is no cure and it slowly progresses over the years. I don’t know exactly how long he had been suffering but he told me some days were really bad. Some days he lost the ability to play the piano which is what he loved doing most of all. It was quite an unexpected and magical encounter that day and the true meaning didn't actually occur to me until recently. I think some strabismics will not completely relate to what I am about to say but the ‘advantage’ of being a severe case is that some symptoms are much clearer. Strabismus is a neuromuscular dysfunction and, being a neurological symptom, can be part of MS. However, longstanding childhood strabismus starts out at an early age when you don’t learn how to use your eyes correctly. Problems occur immediately but get worse over time. Because the problem occurs at such a young age the experience is quite different from a sudden onset of strabismus later in life as the brain is very adaptable during that developmental stage called the 'critical period'. In the case of childhood strabismus the brain develops with a built in flaw, which is deplorable knowing that doesn't have to happen with the right external stimulation such as vision therapy. The neuromuscular connections that did develop despite misaligned eyes often degenerate over time and when put under too much pressure making your vision worse. Trying to do well academically was increasing my neuromuscular dysfunction because of the pressure put on my visual system. I could relate to him in the sense that I was slowly losing the ability to do what I love most: to read, to learn and to master new things. Also the central symptoms as stated in the above image are awfully familiar to me. The good news is that, unlike with strabismus that is caused by underlying and progressing MS, you can reverse this neuromuscular degeneration by relieving yourself of certain pressures and retrain these connections and even gain stereovision in most cases. I cannot repeat this enough:
"Patients should be advised that many accommodative and vergence anomalies are neuromuscular problems and not refractive problems. Thus, the most effective treatment relies on not only spectacles, but active vision therapy to eliminate neuromuscular dysfunction. Patients should also be told that treatment (vision therapy) improves accommodative and vergence reflexes. Proper management usually results in improvement, due to changes in the slow vergence system. When the patient is cooperative, the prognosis for the elimination of accommodative and vergence dysfunction is excellent."
American Optometric Association
That’s why it should not be accepted that any child with this neuromuscular problem should slip through the net and has to deal with long lasting problems when it is perfectly avoidable. To go back to my story, I never did actually learn how to play the guitar because I was too busy ruining my eyes to obtain that degree after all… That didn’t turn out so well either. I wonder how that man would be doing now...
Youtube keeps suggesting videos to me and I looove this one. This double vision case was not caused by long standing strabismus but is the consequence of a brain aneurysm. Because of the totally different cause and the severeness of his brain injury this is not treatable with vision therapy as it is in cases of strabismus. Notwithstanding the double vision is just the same... Maybe I should even be happy I can work on my problem through vision therapy. Take a look at this amazing testimony :)
We practiced doing some exercises we've done before already, trying to take it further. Since my flatfusing abilities are quite good, we are trying to get fusion going with two slightly different images to finally end up in the 3D spectrum. No big 3D epiphanies yet.
Further we talked about passed progress and where progress is heading and in which time frame. For people with constant double vision (as opposed to suppressors) it takes longer to achieve a cure because they are already seeing the two images but in an unhealthy, disturbing way. Based on the few double vision stories I have it takes between 2 and 3 years and a lot of perseverence. Looking at the past and the possible future we are going to hit that time frame and I should put my mind on spring next year more or less. We were also baring in mind the period I fell back a bit due to 'emotional problems' caused by incomprehensive family members and what not. So realistically speaking the final verdict is spring next year if people allow me to live in a drama free environment. So let's go :)
PS: Normally I should reach a comfortable zero degree angle next thursday during my check up appointment, hopefully I'll be well rested!
After missing my previous appointment due to a sick optometrist we are back in business :) In the meantime I discovered that an everlasting toothache turns out to be a sinus infection (since the tooth in gone now). After the extraction of the tooth, things seemed to improve somewhat for a while untill the wound healed and the pain reoccured along with a new exhaustion wave. These new developments have crippled my eye game somewhat but the good news is that now I know what is ailing me. So I'll get on it...
Anyways, so what about yesterdays training? No mindblowing improvements but no setbacks either, which is not too bad given the infection hitting hard. At a short distance I'm getting quite good as I said before but it's not an automatism yet... So now we are extending the distance up to two meters. You might think that if you can do it close up, the switch to longer distances might come quite easy... That doesn't seem to be true. The position of your eyes might be the same at some point but the lens accomodation has to be more relaxed. So I should learn to look more widely WHILE relaxing my lens... Basically, I can't point my eyes correctly if I don't relax that lens. Which is not that evident (for me haha). She said 'the hardest part for you is relaxing those muscles/lense, it's the relaxing part that's mostly missing. Your eyes are too tense.' (and the efforts I do make are being used incorrectly since you never used my eyes correctly, draining energy and being tense...) I was like 'Story of my life woman, always trying too hard' Hahah. It does make sense though, in order for any movement to be fluent you need to be able to relax that muscle or bodypart too. Some things can't be resolved by adding more power, you need to let go... All that crap about 'Perfection is not only about control, it's also about dancing to the music', well there you have it... :) It's like fighting polution by burning more combustion fluids. What we need is cleaner technology haha. A dozen other metaphores do apply but let's not bore you guys out... Bottom line, bring on those chill pills.
Last thing I learned yesterday is that it's easier to heal after suppressing the second image, like I did for most of my life. Once you have conscious double vision as I have since the faulty operation it's way harder. Because you are already using both eyes but in an incorrect fashion meaning you are even further from home. In case of suppression you ''just'' need to add the second eye. So once again it's clear that the idiots failed to detect a lifelong window of opportunity untill the day of the operation and almost closed the window for good... Be that as it may... I'm not dead yet so let's try it.
What struck me most about this documentary was the bit starting from minute 18 about a Spanish woman with diplopia. This is the first case I found that I can really relate to, because most strabismic people suppress the second image like I did before age 18. Diplopia is harder to overcome than suppressing, because you already use both eyes but in a faulty manner so you are even further from home... Since the gravity of her case and the description of her symptoms is very similar to mine, I was happy to hear she acquired stereo vision after two to three years of vision therapy. Slow and steady wins the race.
I was in a good mood today. Went to the turkish bakery and embarked on another session, an aniversary session I'd say haha. The last two weeks the computer exercises went very well. I did them sitting, standing still, walking... The whole lot. And the images themselves moved on the screen too. Being able to do all this, means that my fusion is getting better. My accomodation and vergence system are getting more flexible. This time we made the exercises even more challenging to keep making progress. Aside from that I did an exercise that is rather hard to explain. It was a circling display with a twocoloured spiral, partly red and partly green. With the red and green glasses there was the illusion of depth. Or you would see a cone or you would see a 'hole'. Now by fixating on the center or the periphery, you are able to switch between these two perspectives. Really interesting, I am tempted to use the word 'mindfucking' but I won't :) Being able to switch rapidly between the two indicates visual and mental flexibility necessary for a fully functioning and flexible visual system. Guess I could manage but I need more practice :) Looking back at the previous 30 sessions there has been improvement, but I won't give in till a full cure has been achieved. Only a full cure has a lasting effect. This thursday new measurement will be done during the check up meeting. Curious much :)
In previous generations, when survival depended on the ability to hunt, fish, and farm, the visual system had to respond to constantly changing, distant stimuli. Good distance visual acuity and stereoscopic vision were of paramount importance. Today, the emphasis has shifted from distance to two-dimensional near vision tasks such as reading, desk work, and computer viewing. In some persons, the visual system is incapable of performing these types of activities efficiently either because these tasks lack the stereoscopic cues required for accurate vergence responses or because the tasks require accommodative and vergence functioning that is accurate and sustained without fatigue. When persons who lack appropriate vergence or accommodative abilities try to accomplish near vision tasks, they may develop ocular discomfort or become fatigued, further reducing visual performance.
Accommodative and vergence dysfunctions are diverse visual anomalies. Any of these dysfunctions can interfere with a child's school performance, prevent an athlete from performing at his or her highest level of ability, or impair one's ability to function efficiently at work. Those persons who perform considerable amounts of close work or reading, or who use computers extensively, are more prone to develop signs and symptoms related to accommodative or vergence dysfunction.
Symptoms commonly associated with accommodative and vergence anomalies include blurred vision, headache, ocular discomfort, ocular or systemic fatigue, diplopia, motion sickness, and loss of concentration during a task performance. The prevalence of accommodative and vergence disorders, combined with their impact on everyday activities, makes this a significant area of concern.
This is the introduction of the guidelines for the treatment of vergence and accommodative disorders by the American Optometric Association. More about this text in later a later post!
I was quite
tired today due to some DIY adventures at home, so I wasn't expecting anything
remarkable during my training session today. In fact some exercises were harder
because of this. However, one computer procedure with the 3D glasses had an
interesting effect on me. I put on the red green glasses and gazed at the
screen. I had instant fusion, which is great but not new. Then my optometrist
started clicking to move the red and green images on the screen. I heard the
clicking but didn't see any movement on the screen. In fact, this is kind of
awesome since it means my eyes and brain are adjusting by itself without me
noticing. A new reflex, albeit in a very artificial setting. The computer
images moved and my eyes instantly compensated for this movement. This might be
a tiny start...
According
to my research traditional amblyopia treatment (patching the dominant eye) is not beneficial for
eye teaming and what it might do for the acuity in a lazy eye it will destroy on the binocular front. Moreover, improvements in acuity will often only be of a temporary nature and be lost once patching treatment is stopped because the visual system will go back to its old ways and mostly ignore that particular eye's input. Patching is as ineffective as it is impractical.
So what's to be done? If you want to promote integrating the
amblyopic eye into the visual system, you have to use it while putting the dominant eye in a disadvantage
BUT NOT FULLY OCCLUDING IT. This in combination with other exercise will
promote eye coordination because both eyes are opened. Allowing light to enter both eyes is very important.
More advanced techniques of treating amblyopia allow patients, especially children, to have faster and better results with little or no eye patching. One technique illustrated below called 'piercing a straw' works on eye-hand coordination while using various prism glasses. This is only one of many techniques based on the latest neuroscience that could be used to integrate a lazy eye into the visual system with minimal patching.
Source: Wow vision therapy - Dr Fortenbacher
Once someone understands the underlying principles of the visual system and binocular vision the possibilities of practicing those are endless. Amblyopia is caused by a disruption in binocular vision in infancy and/or early toddlerhood. The latest research shows that the brain of an amblyopic person functions as though they are only a "one-eyed" person. The goal is to properly integrate the inferior eye in the visual system of the brain and with a tad of creativity necessity can be combined with pleasure.
This video is produced by Dr. Fortenbacher and his Wow Vision Therapy practice. Check him out on www.wowvision.net or http://www.facebook.com/wowvisiontherapy. He does an excellent job explaining his work in an accessible fashion.
A while later another video was published on the Wow Vision Therapy facebook page showing the same little girl experience 3D vision for the very first time in her life. It's just awesome. At session 17, Caroline's treatment has effectively "removed the brakes from her strabismic flat vision". Office-based optometric vision therapy has stimulated the development of her visual brain enough to enable her to experience "stereopsis" for the first time in her life in a 3-D movie. Prior to her treatment, Caroline came to us with a unilateral strabismus, right esotropia and amblyopia. She suppressed her right eye and was stereo blind. While vision therapy is not simply about looking at 3-D movies, this example is showing how Caroline is able to transfer her developing binocular vision ability into seeing the depth in a 3-D movie. Therefore, Caroline is enjoying seeing images popping off the screen of a 3-D movie as the reward of having binocular vision.
Since possibilities are infinite, I came up with my own modest way of stimulating my inferior eye. Every so often I put a RYSER FILTER on my glasses blurring my dominant right eye and consequently forcing my inferior eye in a more prominent position. Although my inferior eye is also quite good, otherwise I
wouldn't be having double vision, applying the filter on my glasses feels kind of funny. It's a lot more tiring to function this way, so even though I have double vision the right eye still mostly runs the bingo. Doing this I try to insert some balance into my visual brain and produce equitable binocular vision over time.
I only do this for a limited amount of time because it is
just too exhausting after a while and forcing doesn't help. Vision therapy takes time and patience, especially with adults.
In the
summer of 2011 I was going to graduate. As any graduate has a 'what now'
moment, mine had announced itself well in advance and it was not going to be
pretty. I always knew this disastrous scenario was going to present itself and
warned my family saying 'Even if I manage to graduate like this, it is
not going to be okay'. But their understanding was a luxury I was not going to
earn easily. One year earlier I had found out about optometry and vision
therapy but after 8 months of training a solution was nowhere in sight. I wrote
a long e-mail with my personal eye history to 'Fixing my gaze' author Susan
Barry which I will attach to this post. Her answer was helpful, supportive and
confirmed everything I had learned so far. It was going to take a lot more
patience, rest, will power and lots of time.
Let’s start
at the beginning… I was born on 17 December 1989. Then at the age of three I
started being cross-eyed (horizontal deviation), also I was experiencing
learning difficulties in nursery school. So they started doing batteries of
tests to figure out ‘what is wrong with me’. Their conclusion was that I
was long-sighted and they would try to
fix the strabismus applying eye patches to reactivate the lazy (left)eye. In
addition they prescribed me some +3 eye glasses. My learning progress more or
less caught up, even though lasting problems with out loud reading. I remained
to be a slow reader but at least I would not lose my concentration as fast as
before… The glasses corrected the strabismus to some extent but the ability to
coordinate my eyes and having 3D vision was permanently lost. Corrective
surgery was never mentioned by that doctor.
This way the situation was stable until 2006. I kept wearing my glasses,
feeling there was something latently present that was bothering me but not sure
what it was. In 2006 I went on my yearly ophthalmologist visit to check on my
eyes. It was a new eye doctor in the same practice and he started talking to me
about the possibility of corrective surgery. I was 16 at the time and I’d liked
to have better eye alignment, but was not really informed about the risks
involved. I agreed. The operation initially appeared to be a success: wearing
my glasses the squint was barely noticeable. I was not experiencing apparent
double vision. All I had to do was to wear the glasses and everything would be
‘fine’. On another note, because of increasing study loads and the slow reading
issue I shifted branch of study in my high school from ‘Economics, Mathematics’
to ‘Economics, Living languages’. This has postponed upcoming problems, looking
back on it.
In September 2007 I started studying Economics at the university of Leuven even
though my arrears with regard to mathematics. Increased study pressure led to
having to study every day quite intensively, straining my eyes for hours. This
had two simultaneous effects. Firstly I started to hold my hand in front of my
left eye because I had trouble focussing. Sort of starting latent double
vision. This combined with stress, obviously, caused me to scratch my face with
all its consequences for my skin. Secondly,
my long-sightedness was getting better by ‘training’ my eyes meaning
that my glasses were getting too strong in relation to my eyes. I had a harder
time trying to read black boards or just far away objects in general. So I went
for less powerful glasses and tried lenses for a while. Changing the position
and the angle my eyes and my brain were accustomed to. My left eye was also
getting ‘reactivated’ or ‘less lazy’, according to my personal experience. I now only had like +1 at both eyes. I
started seeing my nose in combination with photophobia (sunglasses were often
necessary). Both conditions made me extremely miserable. In short, at the end of my first year of
university my eye situation had changed dramatically.
October
2008: After consulting my eye doctor, we decided that the only way out of this
deadlock would be to take a chance and undergo a second strabismus operation.
(Which I should not have without consulting other doctors or optometrists for
that matter, but I was desperate to get out of this ‘nose vision’ situation.) I
woke up in a far worse situation. I had gone from being slightly cross-eyed to
being wall-eyed. I had way less power over the coordination of my eyes, making
me very insecure in my movements and making it impossible to read without
occluding one of my eyes. The operation even messed up the vertical alignment
of my eyes which had never been deviating vertically before. The major problem
is that patching one eye gave me tremendous headaches while studying. But
I had no choice if I wanted to complete my year, so I carried on doing this.
Studying was literally painful. I used all sorts of remedies to alleviate the
pain (drinking wine while studying, putting ice on my head, paracetamol,
chewing coca leaves…) It is needless to
say I reached rock bottom. I have considered ‘escaping’ several times, if you
know what I mean. Me and my parents started seeing other specialists in the
meanwhile. Most of them were sceptical about the possibility of improving my
position by operating again. During the exams in June 2009 I started to
experience more problems: I felt like my left ear was getting increasingly
stuffed. I had no time to go to the doctor because of the exams, the only thing
I did was apply pressure on my ears till it finally ‘popped’. Feeling liquids
coming free I slept with that particular ear down, discovering the next morning
blood had dripped out of it. This episode is to be continued, because my ear/
jaw still didn’t feel right.
One physician truly believed he could help me and I let him convince me. In
August 2009 I got operated on my eyes for the third time. Given the
circumstances, he did a good job. I still have double vision but I have more
control over my eyes. So if I am looking at something holding my eyes in the
same position I can keep it that way and quite effectively shut out the second
image for a limited amount of time. The problem is, yet again, the reading.
Because this includes a lot of left right movements which I can’t execute
properly holding my eyes in the same angle making it impossible for me to shut
out the second image. A big improvement is that I don’t have to patch my eyes
every time I want to read something. I still have problems having a short
concentration span and having to hold my hand beneath to my left eye to
suppress the second pair of letters I see. But overall, have my eyes improved
since before August 2009.This brings
me to my ear/jaw problem. The previously mentioned full ear never really
recovered to its previous state. It feels different inside, compared to the
other side of my face. The specialist I saw for this told me this is caused by
excessive muscle straining around my jaw, which sounds like a logical
explanation. I went to a physiotherapist to relax the muscles, but this does
not really help me permanently. It always comes down to the eye problemSo at the
beginning of this academic year (2010-2011) I discovered about vision therapy
thanks to the book ‘Fixing my gaze’ by Susan Barry and some websites. I went to
an optometrist in Antwerp (Berchem) named Guy Naegels. He wasn’t really hopeful
about the chances of success but agreed to take me on for some training
sessions. I’ve been going there since November last year and have completed 25
sessions. I’m not sure whether I’m making a lot of progress but there is
definitely an evolution in my vision. I will try to describe my experience. My
gaze has been somewhat steadier and individual eye tracking movements have
improved over time... Although the major problem remains to be the fact that
when looking right or left the angle in which my eyes are positioned changes,
making the second image move in comparison to the ‘main one’. That’s why my
brain can’t get used to the situation, I guess. This results in a very confusing
and nerve-racking perception, especially annoying while reading. Every ten
training sessions I had a check-up to record my progress. The measurements show
that my angle is decreasing and I feel like I am starting to have fusion of the
two images every so often.
As far as
fusion is concerned, I do believe I have fusion at certain particular moments
melting the two images. Using the green and red glasses in combination with the
green and red transparent sheets, I can make stuff into one although I’m not completely
sure I’m seeing the right thing. Half of the figure is still red and the other
half is green, and I cannot sustain the view very long. My peripheral fusion
seems to be better than my central fusion. Attempts to enlarge my range of
fusion have been rather unsuccessful up until now. Very short distance is hard
or even impossible as well as long distance, medium distance works better. It
has to be said that aside from being in therapy I have been studying on a very
regular basis inducing my suppression system (as far as it still functions)
meaning I might have undone my efforts to achieve fusion to some extent by
straining my eyes. I plan to take on a rather physical job for the year to
come, giving my eyes a chance of relative rest and visual exercises.The
situation you described in your book reminds me of the time I was still able to
suppress the second image. I was
reasoning since I already saw the second image I just have to be able to bring
them together, so I figured I was already half way. I just hope the relatively
recent dates of the operations didn’t mess up the actual agility of the eye
muscles. Individually my eyes can assume any position, even though the joint
coordination habits seem to be hard to break.Not being
able to freely live my life because of the limitations double vision brings
along, is literally eating me away. It was hard enough to have my academic
performance smashed to pieces, but now having to start to work I feel very
constraint option wise. I’ve been losing
weight for a few months now and am losing hope for the future. If some things
are unclear or you need more specifics, I'd be more than happy to provide them.
I would greatly appreciate any advice you could offer me!
