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

Some are color blind. I am stereo blind.

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Yoga Relaxes My Gaze

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I am still on self-imposed sabbatical from any DIY VT sessions. The red-green glasses, tubes, bird-on-a-stick and Brock String still reside in their basket on the hall stand, gathering dust. Apparently, the break is not hurting my “progress.” Instead, it seems to be another form of letting-go that might be helping.

Giving my Brain some Space

Last post I wrote about consciously giving my brain permission to use both eyes. However, this often unconsciously happens during my weekly yoga exercise session at the local Methodist church. There is something about the combination of dim lighting, soothing music and diffusion of lavender that helps my mind let go while going through and holding different yoga poses for an hour or so. About half way into the session, when I gaze rather vacantly at the ceiling, one of the ceiling fixtures will double in my central vision.

My consciously unsuppressed, permitted diplopia continues all the way through to the final 5-to-10 minute “savasana” rest time, when our instructor tells us to relax our feet and legs, torso and arms, shoulders, neck and head, including the face and eyes.

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Last week, after I relaxed my eye muscles, the dancing double images of the ceiling vent directly above me fused into a nebulous whole. It wasn’t the 3D, popped-out vent I desire, but more of an elliptical shape that was a bit wider than a circle, shifting it’s shape a bit like it was under water.

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The best part was that the watery-looking but whole ceiling vent didn’t slide back to double, nor did my brain suppress one eye to see it more clearly— what usually happens!

In my last post I shared that “Letting go also requires giving myself permission to allow a new way of seeing to emerge, to be visually open-minded.”

Yoga is making this possible , and I am thankful.

Oh to be so care-free all the day long! I must learn to cast away care “without ceasing” as a heart attitude.

Casting all your care upon Him, for He cares for you.  – 1 Peter 5:7

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Relax. Let go. Give your brain permission.

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I’ve been following this VT patient’s progress reports with interest. Today’s post “Stop trying so hard and just SEE” mentions a common hurdle to diverging our eyes, the ability to RELAX those rogue eye turn-in muscles! “Stop LOOKING” my VT would often say. LOOKING to isolate something normally fixates both eyes on an object, or in my case, unconsciously fixates one eye while turning in and suppressing the out-of-alignment image of the other. “Soften your gaze” was another frequent VT exhortation.

1218randotLast week, random dots did the trick of NOT LOOKING for this VT patient, and I think I understand why. The randomness of the thing viewed eliminates the worry about getting a “right” answer, and therefore is less stressful than “Is the elephant or the fly popping out for you?” which can trigger frantic LOOKING.

Randomness is the opposite of representation, therefore the brain lets go of the need to comprehend and interpret an object. As an artist who strives to accurately represent objects, a good dose of randomness may be exactly what my brain needs to stop trying so hard.

This is why, for me, letting go also requires giving myself permission to allow a new way of seeing to emerge, to be visually open-minded.

I’m rejoicing that random dot stereograms are working for this patient to overcome her eye turn-in along with the many awesome mind-opening exercises her Vision Therapist is tailoring to wake up her brain.

By letting go and giving herself permission to see a new way, her world is opening up into the third dimension I long to experience.

 

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.

Never Play to the Gallery

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Words of wisdom from a man who maximized his unusual eyes:

David Bowie’s unique appearance was the result of an accidental injury to his left eye during a tussle with a friend as a teen. The friend’s punch landed close enough to his eye to cause the pupil to become permanently enlarged, a rare condition called anisocoria.

Read more about David Bowie’s anisocoria here.

What I noticed more than the difference in pupil/iris appearance in this clip was that he also appeared to have exotropia. His angle of eye deviation is so severe, it’s hard to tell if he’s looking at the camera, or at an interviewer to his right … or both. It has a crazy way of driving his message home.

It would make sense that his brain would suppress the eye with the dysfunctional pupil. I could not find an article to verify his strabismus, but strabismus in the form of exotropia, where the suppressed eye is turned out, is my educated guess. He may have even patched his right eye in the 70’s in an effort to correct amblyopia that developed in the dysfunctional left eye, and used the patch to good effect!

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David Bowie, 1974     |     Credit:AVRO

As a person with strabismus, I found his “Don’t play to the gallery” philosophy doubly inspiring. I can easily make the connection between his way of seeing everything differently and his commitment to remain true to his inner vision, no matter what others thought during his life.

It’s clear he did not let his unusual eyes get in the way of relating to people on stage or in interviews. If anything, his eye conditions informed his outlook on life and his music, as well as his other-worldly stage presence.

Bravo! Olé!

Written by Lynda Rimke

September 16, 2016 at 4:09 pm

Eyes Contact Redux (or what happened in the optometrist’s office, part 1)

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“The Colors of Relating” 19 x 24″ pastel on Canson paper by Lynda Rimke, 2009 Akron Society of Artists Open Model Night for Akron ArtWalk 

During my vision therapy hiatus, I would from time to time succeed at looking at both my eyes in the mirror in the way most people make eye contact, “the act of looking directly into one another’s eyes.” 1

My felt need for mirror-practice is because “Strabismus … interferes with normal eye contact: a person whose eyes are not aligned usually makes full eye contact with one eye only, while the orientation of the other eye deviates slightly or more.” 2 I wrote more about this in 2010 where I had recently discovered the difference:

“Most people make two-eyed contact, with right eyes gazing into left and left into right. Al enlighted me of this fact only last week. It’s really eyes contact.” 3

While mirror practice is really right to right eye and left to left, softening my gaze to see both eyes at the same time achieves the same purpose. Since starting back on the Brock String in late June, I have been practicing in the mirror more.

When I explained this to my optometrist on Tuesday, he wanted to see if I could pull it off. For a second or so I couldn’t get it, then I tilted my head just slightly to the right. Then it happened: my first full connection with another human being— Real. Full. Eye Contact.

“You tilted your head,” he noted, and then warmly related how sometimes his vision doubles and head tilting is a way to get binocular function back. While I am not happy that this is happening to him, I am comforted in that whatever research he will be doing for me may also be of benefit to him.

I also used the Brock String with him holding the other end. My nervousness and the angle of the string, and difficult overhead office lighting made for less than ideal conditions. I think I got the “magic X” through the yellow center bead only for a millisecond or two at 15” and was not able to converge and diverge between the closer green bead and yellow bead.

But I digress. The actual genuine eye contact was THE huge milestone with psychological and social significance. I fake genuine eye contact pretty well, as my misalignment is now so slight as to be practically imperceptible to others. But I am always missing the connection by half. To have made that full connection, even for clinical purposes, is huge.

I mentioned this at dinner, after taking in a 3D movie with my folks and husband on Saturday. Dad, who claims to have always had a “lazy eye” took immediate interest, and we attempted genuine eye contact. I was surprised when he told me he was alternating, and I (and my husband next to me) could see his eyes doing it! We’ve suspected that my condition runs through his family, but this was an “Aha!” moment to see his alternating esophoria (or tropia) in action. We laughed at our struggle and then lovingly made left “good” eye to left “good” eye contact.

My husband has become the next victim, as I will not let go of my goal to improve my newfound full-eye-contact skills, and he happens to be the most handy human being around. We normally do a lot of talking with occasional face contact. He too, grew up with an impairment to real eye contact: congenital cataracts and coke-bottle glasses. I’m sure this is what made him easy to be around at first, as this made him undemanding in the eye contact arena. I did not mind tunneling down through his glasses with my one good eye. While the pop-bottle lenses are long gone, gaining that full eye connection has been a challenge, because face contact has been nothing less than eye contact in his mind his whole life and all that I felt I could easily accomplish. But he is patiently putting up with me, and why not? Every enduring marriage needs a little magic!

Written by Lynda Rimke

July 24, 2016 at 2:22 pm

“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

Schools Need Binocular Vision Screening

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I read about an appeal to write my congressman from the “Let Them See Clearly Campaign” to add binocular vision screening to a bill, as posted in a DIY Vision Therapy Group I belong to on Facebook.

I emailed a rather lengthy letter to my House Representative about three weeks ago, using the campaign’s information, and adding my own research and brief personal story. I haven’t heard back, but hope to. It seems to me that adding binocular vision screening to this bill would be a good fit.  Here’s why (Although I just learned after posting that the writers want to create a separate bill*):

To the Honorable ….

re. H.R 3535 the “Alice Cogswell and Anne Sullivan Macy Act” in Committee

Dear …..

H.R 3535 should add screening for binocular vision (BV) impairment to the vision screening protocol to identify students with visual disabilities.* BV is tested via an assessment of eye focusing, eye teaming, and eye movement abilities (accommodation, binocular vision, ocular motility.)**

Under the “Categories of Disability Under IDEA” (Individuals with Disabilities Education Act), “Visual Impairment Including Blindness means an impairment in vision that, even with correction, adversely affects a child’s educational performance.”(1)

The Visual Impairment definition further states: “Most of us are familiar with visual impairments such as near-sightedness and far-sightedness. Less familiar visual impairments include: strabismus, where the eyes look in different directions and do not focus simultaneously on a single point…” (2)

Strabismus (Esotropia and Exotropia) is just one of many Binocular Vision impairments. More common ailments are:

Convergence Insufficiency, where the eyes fail to team together to see things up close. “Convergence is the coordinated movement and focus of our two eyes inward on close objects, including phones, tablets, computers, and books.”

Amblyopia or “lazy eye” where the brain suppresses the image from one eye because the image is different than that of the other eye.

Diplopia or double vision

Esophoria or exophoria, where the suppression of one eye is intermittent.

Strabismus, as either Esotropia (“crossed eyes”) or Exotropia (“wall eyes”), occurs when the suppression of one eye is well established.(3)

Undiagnosed Binocular Vision Impairments are increasingly triggered in children by our convergent-based technology, which requires turned-in eye-teaming on phones, tablets and computers, with little outdoor play to aid binocular vision development. (4)

Unfortunately, at the same time, children in school are being misdiagnosed in IEP’s when binocular vision problems inhibit learning. These children can and should receive an early diagnosis and, hence, the opportunity to pursue certified optometric vision therapy and/or recommendations from an Opthalmalogist to normalize visual processing and improve learning ability and quality of life.

Furthermore, IEPs must include accommodations necessary to aid the child undergoing optometric vision therapy as advised by their Doctor of Developmental Optometry, in order to not undo progress made under vision therapy. This may include not forcing the child to read, for example, until her unstable convergence issues are resolved.

-13 to 20% of the population have impaired binocular vision that is 75% curable according to a double blind study by NEI (5)

-Studies by ADHD and vision experts show 20 -25% are misdiagnosed and have binocular vision impairments (6)

-Autism.com says studies show that 21 to 50% of autistic children also have binocular vision impairments. (7)

“Binocular vision impairments are more common than you may think. Just one type of binocular impairment, amblyopia (“lazy eye”), affects approximately 3% of the population. At least 12% of the population has some type of problem with binocular vision.” (8)

As an adult with alternating esotropia, a form of strabismus (crossed-eyes), I can’t begin to tell you how much better my quality of life would have been if my condition had been diagnosed and treated while I was a child in the 1960s. My parents gladly spent money to straighten my teeth, not realizing that all their harping about my feet turning out and my poor posture was due to my eyes not teaming to create a visual center-line for my posture and gait. This of course made gym class excruciating, as I was always the last to be picked for any team (imagine trying to catch a fly ball without any sense of depth) and also made socialization difficult as other children did not know if I was looking at them or something else.

Instead of learning how to use both eyes together, in early childhood my brain spent extra energy suppressing the vision of one eye or the other to avoid double vision. While my early well-established suppression allowed me to read without difficulty in 1st grade, it has lasted for a lifetime.

The extra energy expended by the brain to suppress vision and live and move by monocular depth cues, instead of fusing vision from both eyes to see palpable space and distance, limits one’s ability to: multitask on any level (how many jobs require this?); drive well during demanding depth needs (e.g. driving multiple sized vehicles on the job); work in food service, landscaping, auto-mechanics, carpentry, etc.; participate in sports or recreation (eg. yoga, dance, catching or hitting a ball); or watch 3D movies (the latter is impossible.)

Please, please, make screening for binocular vision issues a goal, so that 12% of the population can benefit from early vision therapy intervention to avoid the everyday pitfalls this hidden, subtile disability creates, which must be endured for one’s entire life.

Respectfully
Lynda Rimke
https://leavingflatland.wordpress.com
*For reference:
Title II—IMPROVING THE EFFECTIVENESS OF SPECIAL EDUCATION AND RELATED SERVICES FOR STUDENTS WITH VISUAL DISABILITIES
Subtitle A—General Provisions
Sec. 201. Identifying students with visual disabilities.
https://www.govtrack.us/congress/bills/114/hr3535/text/ih

** https://covd.site-ym.com/?page=Exam

(1) http://www.parentcenterhub.org/repository/categories/

(2) http://www.parentcenterhub.org/repository/visualimpairment/

(3) http://www.covd.org/?page=VisionConditions

(4) https://nei.nih.gov/sites/default/files/nei-pdfs/VisionResearch2012.pdf p50 “spending time in bright outdoor light appears to be important for normal eye development…In 1972, approximately 25 percent of the U.S. population, 12–54 years of age, were nearsighted, compared to 42 percent 30 years later”

The Binocular Vision Dysfunction Pandemic http://c.ymcdn.com/sites/www.covd.org/resource/resmgr/ovd41-1/editorial_binocularpandemic.pdf

(5) https://nei.nih.gov/news/pressreleases/101308

(6) http://www.add-adhd.org/vision_therapy_FAQ.html

(7) https://www.autism.com/treating_vision

(8) http://www.children-special-needs.org/questions.html

For further reading:

American Academy of Optometry Binocular Vision, Perception, and Pediatric Optometry Position Paper on Optometric Care of the Struggling Student For parents, educators, and other professionals August 2013
http://c.ymcdn.com/sites/www.covd.org/resource/resmgr/position_papers/revised_oct_18_bvppo_positio.pdf

http://www.covd.org/?page=VisionConditions

http://www.covd.org/?page=Vision_Therapy

* Let Them See Clearly Campaign LTSCC just commented on my Facebook share today: After meeting the HR 3535 writers from the American Federation for the Blind, they thought that though HR 3535 should pass that BVD needs its own bill. They said it was a statement piece that the extras may bog down my efforts and never pass. I do think a BVD on its own would be best and will talk to my legislation writer and my rep contacts about options. Thanks for the blog. HR 3535 should pass and will help with BVD along with a comprehensive bill. Working on that. :) Thx for your help

I replied: Let’s hope for the best. I’m going to add your comment to my post. Thanks.

And then, later: I’ve been thinking about this. I’m not happy they think comprehensive screening isn’t part of the bill. I mean, come on, how hard is it to add a simple cover uncover test and use a pen light? https://www.youtube.com/watch?v=ZErvGS1EqyM

And just now: Ok, I remember— those two tests only discover well-established strabismus and not other binocular vision issues such as convergence insufficiency, which is far more common. Maybe a full bill just for Binocular Vision Disorders is the better idea … if it ever gets written!