Wide-eyed Wonder: an artist's musings on three-dimensional vision

Some are color blind. I am stereo blind.

Archive for the ‘BRAO’ Category

No Better Than a Placebo

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New research is tracking brain changes in patients who undergo binocular vision therapy. Combine objective fMRI data and the many blog posts by adult therapy patients, and you have exponential evidence that vision therapy works for adult patients, and is getting better and better at targeting each patient’s unique visual needs to generate success.

All you need, therefore, is a therapist with an interest in helping the adult patient with the newest cutting edge stuff like Oculus Rift who happens to be passionate about binocular vision and works with adult patients within 100 miles.

My own home-based VT with a little help from an optometrist in my village pretty much ground to a halt in October. I even cancelled my monthly visit, acting out a deplorable level of avoidance behavior I am ashamed to admit. I did manage to make a 15 minute visit in November to confess I had done nothing since September. I did not commit to more monthly visits, as I’ve not been doing any exercises.

This week’s post at The VisionHelp Blog  detailed the new neural research with a link to a TED talk by Tara Alvarez, Ph.D. In the midst of the good news was a succinct explanation for my own self-imposed hiatus:

… in the video she notes that in the landmark CITT study … home-alone therapy was no better than (a) placebo.  A significant reason for this, she speculates is that the currently available home-alone therapy is gosh-awful boring and compliance is therefore lacking.  Another potential reason is  the patient may not be doing the therapy optimally because of lack of feedback from a therapist.

Boredom plus lack of solid feedback are indeed primary causes for throwing in the towel. In addition, the exercises exhaust me. I recently read of another patient’s progress at the Mindsight blog and he/she continually admits to the need for SLEEP. I battle feeling totally fried after just 2 minutes of Brock staring. Even looking at motion parallax while my husband drives places cooks my noodle on a good day. And, while this patient is making measurable progress, I lack any measurement but my own guesstimates, and wonder if they are even accurate.

Where do I go from here? Three years ago, the Vision Therapist working under my Developmental Optometrist offered to stay in touch via email, because she is a fellow adult strabismic and was undergoing Vision Therapy to gain binocular vision at the time. I’m curious to know if she has made progress. Curious enough to contact her.

Meanwhile, I have my “Map of Fellows” grabbed from the “Locate a Doctor” search at covd.org … the closest Fellow is the Developmental Optometrist I worked with before my BRAO in 2010-11 where the aforementioned strabismic VT works. In 2010 that Fellow was somewhat reluctant to take me on (due to the dearth of data confirming adult success) and suggested a more progressive Fellow in Cleveland. My sudden blindness in March 2011 put frosting on that reluctance cake.

Cleveland is far, but a less stressful drive than going to Pittsburgh through the hills on back roads and  secondary highways. But my driving back home from Cleveland through Akron and Canton for over an hour, fighting heavy traffic AFTER the weekly brain-frying session? No. No. No. Not safe …

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And so, my hiatus remains. But my interest is still on fire. That may never change.

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Brock Exercise Notes

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June 27 – afternoon. my first time to Brock in a long long time. I was amazed that I could start out at 12 inches. I was also amazed that when looking softly over the yellow center bead I could get the double image of the rear red bead.

June 28 – afternoon. After a tiring day at work. Again I was able to successfully see the yellow bead at 12″with an “X” through it. But not much took place after that.

July 4 – late morning. More rested. I was able right away to nail yellow Bead it 12 inches. Then briefly, I could back it off to about 18 inches. But this only lasted for a millisecond. Then the whole thing deteriorated.
My other observation is that the right string image is always stronger in front of the bead I am converging on and the left string image is completely strong behind it. This confirms what I felt initially after the BRAO that my brain is vertically aligning upper and lower images from both eyes.

0719brocklog July 9 – walked by my Brock string for the umpteenth time and told myself “Look— it will only take three minutes!” This time I decided not place the yellow bead at a specific place but just grab the first 12” mark near the front green bead and look. I was surprised that I could converge at 21”!

July 10 – late morning, right after massage. Right off the bat I got 25”. Then things got a little wobbly. I got interrupted, but I was able to regroup and see the bead at 20”. I would call that an improvement!

Later that day or the day after, I see my fingers for the first time in 3-D. They were interlaced on my lap, with tips popping out toward me, and looking physically SOLID. It was so awesome I unlaced my right hand and just stoked those solid looking fingertips and then re-laced them once or twice. “So this is what REAL fingers look like.”

It was an almost spiritual experience, making this new connection with my own hands, and so I gave thanks for this new vision I didn’t even ask for. Grace …

July 14 – evening, after a long day on the road. Only managed 15″ convergence and that with only half the X: the right eye image of the string in front and left eye image of string in back of the center bead.
I decided after this poor “X” showing to pick blueberries for visual and emotional therapy. “Fast Cars” from U2’s How to Dismantle an Atomic Bomb played in my head. It fit my anxious mood in a happy U2 sort of way. The tomato plants were begging to be tied in the garden behind me, and the piles of laundry and dirty dishes were waiting inside. It all made my head pop.
But, during that forever time picking, I thought “the whole diplopia experience isn’t needed in real life, so maybe a half an X is ok and a whole X is not the ultimate goal with me.” I know my eyes are converging with just that half an X …

July 16– 2:30 in the afternoon seems to be the best time. I once again was able to see the bead at 19” then things got wobbly. I also could not get myself to see the red bead. But after that, a quick second attempt to see the yellow be succeeded at 24 inches. Doing this more frequently definitely has its advantages.

July 19– 8am just before headed out to my landscaping job, I decide a 10-second “goose” before a visually demanding day would be a good thing. I converged and diverged easily between the near green bead at 8″ and the yellow at 15″ — this is a first.

Seven brief sessions in three weeks, not 21 or more. 3x day is my goal …

Even with only those seven brief sessions, a couple of amazing things happened at my optometry appointment this afternoon. But that’s another blog post!

“Why Don’t You Ask Me?”

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I can’t begin to describe my emotions. This desire to keep working at vision therapy in some fashion has never left me over the last five years, since the March 2011 Branch Retinal Artery Occlusion brought my program with my Developmental Optometrist to an irreversible halt. “You are not binocular” I was informed one year out, with what felt like a firm, conversation-ending “period.” Even so, I sat there and meekly persisted to ask about doing vision therapy exercises, although the visual field in my half-blind right eye had not changed. “You can play around with it …” she offered. Whether this was her intent or not, I received this withering assessment as hopeless, and allowed hopelessness to bury my desire.

But desire simply squirmed in rebellion from time to time at the bottom of its grave. This deep inner writhing has occurred, without fail, every spring when my work outdoors brings fresh binocular-like quales, those take-your-breath-away sightings of something more.

Am a really so hopelessly “not binocular”? Isn’t binocularity a continuum? Are my quales perhaps peripheral fusion or ARC? Can’t I work to become a wee bit binocular?

Who has stopped me from working at it? No one.

Not even God, Himself.

Shortly after the “You are not binocular.” office visit, I suffered a painful irony: In June 2012, my artwork had earned a “People’s Choice” prize that cut me to the quick.

I had to make a special trip out to the gallery to pick up my prize, which turned out not be the badly needed cash I was anticipating (we were tied up with two homes at the time), but a “how to paint” DVD of some smiling unknown artist with his simple barn painting.

About half way home, when I stopped to pick up groceries, I swallowed my “I painted a better barn at this competition!” vanity and opened myself up to the idea that maybe, as an artist, I could learn something from this particular barn-painting demonstration. So I read the back. In all caps, this unknown artist stated:

I LOVE TO PAINT. I LOVE TO CAPTURE THE ESSENCE OF A THREE DIMENSIONAL SCENE IN TWO DIMENSIONS. IT’S MY PASSION.

I don’t cry often, but this was an astounding dart to my heart from the blue. I fought back the tears, threw the DVD on the seat and went grocery shopping.

Enroute home, about 100’ from my driveway, I sputter at God in a howl “What is this, some kind of cosmic JOKE? You KNOW I can’t see three dimensions!!!” This Creator gave me a brain that prefers alternating esotropia. This Creator allowed that tiny blood clot to enter the branch artery of my dominant right eye and stay there. What was He thinking?

As I brought the car to a stop, a question invaded the wound in my heart: “Why don’t you ask Me?”

And so I have continued to ask, haltingly, not for an answer to what this Creator is doing, but to see more with the two eyes He has given me, more than I ever have seen before.

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“Kishman’s Barn” oil on canvas by Lynda Rimke. Painted “en plein air” June 2012

Shuffle Foot!

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In the last year that I’ve worn base-right prism I wasn’t completely sure if it made any difference. Until my glasses broke on Saturday.

The first thing I noticed was my left foot resumed it’s turn out. Then my left hip joint started clicking when I walked. Then it became apparent, very subtly so, that my head is pretty much turned left just a bit. All. The. Time. Which stretches the right side of my neck. In a previous post (many moons ago) I called the phenomenon “my 11 o’clock nose.”

This is the opposite of my initial visceral response exiting my Developmental Optometrist’s office the day I got the new lenses. As I stepped outside and headed to the car, I felt a corrective “shove” from the left. “Oh wow,” I thought “That’s where the car is!” Interesting.

My response when my doctor first put the prism on in her office and had me walk was interesting as well. “Oh wow, THIS is what a smooth gait feels like!” The very same traverse across the office just before felt like a horrible weaving sort of gait in comparison to my princess walk with the lenses.

In grad school, a fellow student from Taiwan had a pet name for me: “Shuffle-foot.” (Say it in your head with a Taiwanese accent: shuffle fOOOOOOOt!) I had never noticed what the long polished hallways of academia made obvious: I drag my feet. All. The. Time.

It took me about three months to adjust to the prism and only 3 days to regress to my life-long “normal.”

Tomorrow’s task: get out the super glue and try to put my glasses frame in temporary working order, and call for an eye-exam.

Although it was fun to dig out older glasses and compare, I was completely lost with my old progressive lenses, which I tried out first. Things looked ok and I was liking them better than the bifocals I’ve been using with the prism, perhaps because I didn’t have to suppress the lower part of my visual field when walking. Then I went to make a smoothie and poured the frozen blueberries from the bag, not into the blender, but onto the counter just to the right of it! (Which was totally weird, as this was also a shove from the left. Maybe residual?)

Next pair to dust off (since I didn’t trust myself with the progressives) were my glasses of 10 years ago, before I became presbyopic and was merely myopic. I am enjoying the clarity of just having distance vision and could probably get by with this script, except for that danged left foot way of walking.Image

Prism is like training wheels that never come off. I shall remain a prismer … it’s either that or the ball and chain of “shuffle foot.”Image

Written by Lynda Rimke

February 27, 2014 at 11:17 pm

When Surrender Resurrects Desire

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In May, after five months of quasi-resignation from a less-than-encouraging January Optometrist’s appointment, I attempted a third and final self-portrait of my Vision Therapy journey where I would express my acceptance of my fate and diagnosis: “You are not binocular.”

It didn’t work. I couldn’t let go of hope.

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As much as I wanted to depict “Meh,” an attitude of perturbed acceptance of a life without stereo vision, my feelings before the show were much more intense. The triptych was hung above my eye level, which was intensely upsetting to me. My negative reaction was above and beyond reasonable: it felt like someone had smacked a scab on my brain. Why the super-sensitivity?

My brain was talking to me: “This area is not healed yet. Don’t treat the stereo-blindness in your visual center as permanent. This is not scar tissue, Dearie. We’re not done yet.”

A local art critic, Tom Wachunas, summed up the crux of the matter in four short sentences:

Among the more resonant works here are three self- portraits in pencil by Lynda Rimke. They’re simple yet disarmingly candid explorations of her medical condition called stereo-blindness. I get the sense that she’s not looking out at the viewer so much as carefully navigating the act of seeing. The mirror becomes her lens on an inward journey. (1)

And so it is. In spite of my cravings for resignation and closure, I am still trying to “navigate the act of seeing.”

Indeed, 3D-ish quales have returned now that outdoor tasks demand stereopsis from me. The first occurred in late May while pruning the Rose of Sharon: I saw the branches at eye level and below reach out to me. This may have been a protective reaction, as one branch came very close to my right eye, which is blind in the upper inner quadrant of my visual field.

This was just the beginning of several outdoor gardening events, where I experienced enhanced depth while hoeing a row that has to be 1-2″ deep for corn or beans, while weeding, while transplanting.

I am committing to shorter and more frequent blog posts of these experiences, as there is lots to share … for what it’s worth.

Dance of the Red and Green

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I was inspired today to open my desk drawer of vision therapy tools and dust off my red-green anaglyph glasses. Why? Because NOVA recently featured Sue Barry in their “Secret Lives of Scientists” program, and put out this wonderful teaser of Sue on her trampoline, grinning and staring at a Marsden Ball with her anaglyph glasses as “Clue #1: A Trampoline, a Ball and Hipster Glasses?!”

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Oi! Those glasses have been put away for about a year. I recall the craziness of what I saw through them after losing the vision in half my right retina as almost unbearable, but that was when my vision loss was still fresh. I drove myself crazy with them, trying to get confirmation of some fusion in the lower half of my vision in what Dr. Leonard Press referred to as luster: a luminescent glow of combined red and green as seen by both eyes.

But instead of trying to “get luster,” today I am simply wearing them for a few hours and seeing what happens. Dr. Barry has inspired my curiosity!

My strabby friend Sally is also partly responsible for the inspiration to dust off and try again. She also took a hiatus and discovered vision therapy works, and blogged about it. So I got brave and put on the glasses.

As I suspected, when I really want to focus on, examine and “see” something, the thing is solid green. This is because the central vision in my “red” right eye was compromised by the BRAO. So, while eating lunch, my lunch went green when I scraped my bowl for the last bits of Indian food. Reading also was solid green to the right of and including each word I was reading.

I also expect and do see red on the extreme right, where I still have retina and peripheral vision in my right eye that my left eye does not see (because it is blocked by the bridge of my nose)

However I am surprised by the amount of red dancing around, just to the left of where I am writing and all underneath. It comes and goes in split seconds, but it is there, like a dancing sunbeam.

This is more red than I expected. I’ve been pretty certain my left eye was thoroughly suppressing my half-blind right eye ALL the time, because I see no indication of my right eye’s blind condition. I expected a solid-green confirmation of my half blind eye’s total non-use. Instead, I am using both eyes constantly!

This explains the very rare and thrilling experiences of magic that just “happen” on occasion. If sheer thrill could be made empirical, I would bet my bottom dollar the magic is stereo vision. At some point, I will devote an entry to my “sightings” which I record on my iPhone just after each happens.

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My most recently “sighting” occurred after finishing a plein air painting session during Paint Oglebay. I worked a solid three hours trying to catch and record a sunlit path in watercolor. As I hauled myself and my gear back up the trail, I felt brain-drained but happy, and said to myself about my empty-headedness “This is when I see stereo.” Instantly, the leaves under my feet appeared cupped. I stopped and enjoyed a hundred little leaf sculptures that were more real than I could imagine. I didn’t need or want to touch them, just look at them in this new reality. Then, slowly, I resumed walking. The movement of the delicate weeds on either side of the path appeared fairy-like. I became completely immersed and enchanted by the world under my feet with sculpted leaves and waving fronds … all moving in what Dr. Sue Barry calls “palpable space.” How can things feel so grounded and yet moving? It was like the best sort of movie depicting a fantasy world with tangible magic in the air. Unforgettable!

Shortly after this experience, I made an appointment for an eye exam with my Developmental Optometrist who had given me 6 months of vision therapy in 2010-11. I haven’t had my eyes examined since the BRAO occurred 18 months ago for reasons mostly financial and partly emotional. I’m now committed to biting the bullet!

I hope to determine whether some vertical prism in the right lens will help my right eye to see more, and improve my chances of gaining some stereo in my central vision. My optometrist had used vertical prism in my first appointment just after the BRAO, and my ability to focus on the Brock string was dramatically improved. Time to find out if an investment is in the cards.

I do have at least one cheerleader: that grinning scientist with a secret who encouraged me in a May 10, 2011 comment on my BRAO post on the Vision Therapy social network Sovoto:

Dear Lynda – brave lady,

    I’m sorry the retinal specialist had such bad news, but the brain can do amazing things.  With vision, we take current sensory input and combine it with past experience and expectation so, while part of the retina may be dead, how the brain will re-interpret your remaining visual input is an open question.  You may see better than the dead tissue would suggest…  If you learn to see in 3D in the lower half of your visual field, perhaps the brain will “fill in” that information to some extent in the upper half.  In other words, you’ll have a richer view of the upper visual field than predicted.  With your resilience and powers of observation, things could be better than the retinal specialist suggests.

    Best,
    Sue

You can link to all the Secret Life of Scientist clips of Dr. Sue Barry here: http://www.pbs.org/wgbh/nova/secretlife/scientists/susan-barry/

Postscript: at the end of writing this blog post, the dancing red and green have calmed down at times into into a blended red and green that is neither red nor green but lighter, yellower shades of each. Maybe I’m getting some “anti-suppression therapy” happening! One can always hope!

BRAO prevention

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Before updating on my journey from Flatland, I must diverge. My loss of vision in my right eye was entirely preventable, and I posted a note titled “Blood Clot Prevention” on Facebook on the one-year anniversary of my loss, with the goal of educating women everywhere about the dangers of BHRT (bio-identical hormone replacement therapy):

One year ago, I went to the emergency room thinking I was having a retinal detachment in my right eye, and that I was catching it early and would be “spot welded” and have fully restored vision. Not so. Over the next 12 hours, I watched a brown cloud descend where the blood supply to my retina was blocked by a blood clot that had plugged my artery. The lost blood supply was to a little over half of my retina, affecting my central vision. (A full explanation was posted to my vision therapy friends here http://.sovoto.com/group/adultstrabismicpatientsforum/forum/topics/brao-my-new-challenge )

One year later, the “window shade” remains almost as low as it had descended. Lesson learned: while the percentage of women who throw clots from bio-identical hormone therapy is very small, it’s still a risk.

To honor the anniversary, I flushed the rest of my unused Women’s International Pharmacy BHRT pills down the toilet (after peeing on them. Yep.) I quit taking them the day I lost my vision. A few days later, I called the pharmacist to report my BRAO and she simply said “I’m sorry.” I doubt Women’s International Pharmacy is keeping track of their “statistics” which is extremely unfortunate.

I tried to quit my BHRT  at age 50, and went to my primary care doctor 6 weeks later for what I thought was a horrible case of hemorrhoids. Not the case. Apparently one in ten post-menopausal women (which I have been since age 35) can develop a hideous auto-immune disease called “lichen schlerosis.”

My doctor said “Get back on your estrogen.” When I expressed concern about the risk, she quoted the bio-identical propaganda that there was next to zero risk and I could take the same dose the rest of my life. So what if I had taken it for 15 years already? The prospect of living with lichen sclerosis was 100%. I dutifully went back on my BHRT at the full dose for a 35 year old and the LS cleared up.

Two and a half years later, I throw the rogue clot and … BRAO! Not only did I lose half a retina, but I gained the prospect of untold LS misery without the estrogen. All subsequent hospital tests came back negative, so the BHRT was the sole cause of my clot.

My “catch 22” was a teaching moment for the wonderful residents at Summa hospital, as I had to quit the estrogen cold turkey and discuss alternative treatments for the painful and unmentionable LS. The internal medicine specialist Dr. Rex Wilford was amazingly supportive, and explored another suspect auto-immune enhancing disorder with me: gluten.

“You will have to eat wheat” he said (for any gluten intolerance bloodwork to show up positive.) I had cut back on wheat about a year earlier after reading a Scientific American article on Celiac disease  as a possible cause for my three un-related auto-immune diseases: Hashimoto’s (hypothyroidism), rheumatoid arthritis flare ups and lichen schlerosis.

For two weeks, I ate all the bread I wanted (including Einstein’s bagels, woot, woot!) and could hardly walk from the lichen schlerosis flare-up. $200 worth of ineffective prescription creams later, I got my blood draw (which tested positive for Celiac) and immediately went off wheat. The schlerosis cleared up within 48 hours!

Hindsight is always 20-20. NEVER take a prescription drug that pushes nature around when simple dietary changes are what my body is asking for.

Had I known this, I would probably still be in vision therapy making steady progress towards seeing the world with two whole eyes.

Written by Lynda Rimke

March 31, 2012 at 6:57 pm