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Archive for the ‘amblyopia’ Category

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

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!

 

Stereo Vision Survey

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Exciting news! Bruce Bridgeman, the gentleman who gained stereo vision after watching Hugo, has teamed up with Sue Barry of Fixing My Gaze to create a long crowd-sourced research project in search of those who have experienced increased stereo vision after watching 3D movies.

Although my stereo experiences are limited and have not yet been scientifically verified, there seems to be room for even me to take this survey, as there is a comment section at the end of three different sections where I can plug in additional information. (In my case, how BRAO has affected my vision.)

I encourage all strabismic adults to at least read the survey, which is instructive in itself. If you have had a stereoscopic experience after watching a 3D movie, share your experience in the survey.

The survey also takes into account if you have had any vision therapy or had your stereo-awareness measured by a professional.

The VisionHelp Blog

If either you, a family member, or any patients you encounter have developed stereo vision as an adult – even intermittent or weak stereo vision – please complete this survey developed by Sue Barry and Bruce Bridgeman:

http://bit.ly/1vThYaM

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The survey and its background were just published on page 13 of the new journal, Vision Development & Rehabilitation.  Through crowdsourcing of this nature, Drs. Barry and Bridgeman may be able to provide evidence to support that the viewing of stereoscopic 3D movies and similar modalities can be therapeutic for certain individuals.  We blogged about that possibility here last year, and this survey is an important step in that direction.

Completing the survey is entirely voluntary. You do not need to answer every question before submitting it. Your answers are sent to a spreadsheet which simply tabulates your answers with no other identifying information.  Thank you in advance!

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Arr— Avast with the “weird eye” Matey!

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Johnny Depp as buccanneer Jack Sparrow

Johnny Depp, starring actor in the latest 3D release of Pirates of the Carribbean, cannot see the special effects in the movie:

“.. Johnny Depp’s vision isn’t exactly shipshape, ‘I’m unable to see in 3-D. I can’t — my eyes don’t see in 3-D. I have a weird eye,’ Depp told Access Hollywood. ” [1]

“Weird eye” … “Lazy Eye”… How many adults have simply been conditioned to create our own miserable self-diagnosis due to gross lack of correct information and a wee touch of pride?

These terms belittle the problem and remove it from medical discussion. The correct term is “stereoblindness” due to any number of medical conditions that hinder binocular vision, like amblyopia and strabismus.

Depp explained further “It may come as a surprise to you, but I’ve never seen things normally—” (elicits a laugh) “— as normal people … because one of my eyes, you know, doesn’t see (waves left hand beside his face) very much.” View the interview here.

Depp’s “weird” eye is not deviating enough to reveal mis-aligned catchlights in any of his published photos. A catchlight falling on different parts of the iris of each eye is the most reliable visual indication of eye mis-alignment or strabismus.

My own photos, like Depp’s, do not reveal misalignment; and I did not think of myself as cross-eyed or strabismic until I was diagnosed in 2010. I was as reluctant as Depp to explain why. It was easier to keep it under the radar, even to myself.

My guess is Depp is either alternating and his misalignment is slight, like Keira Knightly, or his left eye has amblyopia. However, if he was patched like a pirate for amblyopia as a child, he didn’t mention it …

Thankfully, the 3D movies and other 3D media are exposing and increasing awareness of the many types of stereoblindness adults and children have experienced all their lives.

Hopefully Mr. Depp, who is known for his generosity, will be generous enough to himself one day to investigate exactly why his eye is “weird” and what he can do about it.

Perhaps he should start with purchasing the story of Sue Barry, who brilliantly describes her own 3D awakening in her fourties in her book, Fixing My Gaze. Sue was recently featured in Oliver Sack’s documentary, Imagine: The Man Who Forgot How to Read and Other Stories (3/4 starting at 11 min 30 sec), happily interacting with the very 3D in Depp’s film that he cannot see!

Then, he could visit an optometrist trained in developmental vision therapy for an eye exam to find out why his eye is “wierd..” Many adults are regaining vision in a “lazy” eye (amblyopia) through vision therapy, like my blogging friend “Strabbie”, who had measurable improvement after only 12 weeks:

So I’ve been chugging along with my vision therapy, and at my 12-week appointment, I had an eye evaluation by my optometrist. I am delighted to share that the subjective feeling I have, that my left eye is open and working, has been measured, and my left amblyopic eye which could see 20/30 corrected now sees 20/20 (+ or -) which means my left eye sees TWO LINES BETTER on the eye chart now! [2]

Kudos to Dr. Nathan Bonilla-Warford for posting here and on Facebook.

Pirate speak, courtesy of http://www.yarr.org.uk/talk/

To find out if this child is dressed for Halloween, or is patched for amblyopia, click here.

Written by Lynda Rimke

May 19, 2011 at 8:10 pm