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

Some are color blind. I am stereo blind.

“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.

1306lyndarimkebarn

“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!

 

Playing At Last

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It’s been five years since my BRAO and two years since choosing to keep the same base-right prism for my second set of glasses. At that office visit with my Developmental Optometrist, I could not walk a straight line with the prism, with more prism or without prism. I simply went with the same strength based on my own observations here.

From time to time, I have put on my red-green glasses, and the amount of red I have seen clearly shows me that I still use my half blind right eye with my left by default as I described here.

But I have not done anything in the way of Vision Therapy. That is about to change.

This spring I began to fervently wish, once again, for NO prism other than something to help my half-blind right eye: the kind of prism that was used in an office visit just after my BRAO in 2011 to help me see the Brock string a little better.

My fervor deepened into what felt like rebellion:

  • I wanted to “take off the training wheels” by going back to NO prism.
  • I wanted to take ownership for what was wrong in my head.
  • I wanted to work on my posture to align with true center with the balance board, yoga  exercises and massage therapy
  • I wanted to revisit the Brock String, hang on to that “X” that marks my true center with BOTH eyes, and push it further.

This June, I got an eye exam from another optometrist who had no objections to going without base-right prism. He prescribed new progressive glasses, with a bit more magnification for reading and NO prism. Furthermore, he was willing to work with me to possibly prescribe a stick-on prism so that I can experiment with the Brock string. I have an appointment to assess what amount of prism, if any, would be helpful on July 19 and to discuss my vision goals. I get to bring in my Brock String! I am as excited as a kid in a candy shop at the thought of having possible access to a few new Bernell toys to play with.

Today, after five years, I got out my Brock String, now slightly yellowed, and tied one end to a doorknob and checked my fusional area in the hallway. There is no denying I still have a fusional area! Just as before, I could line up the “X” the string images from each eye make around the yellow bead (this time at 12”)

How my New Brock String appears

How my Brock String appeared in April 2011

But, instead of seeing the string disappear behind the bead due to the blind area in my right retina, I could see some string, flickering in an out! A full “X” image! Furthermore, if I looked at the “X” around the yellow bead AND the red bead that was 12” behind it (the big picture?) I could easily see and hold the image of those two red beads in back!

160627brock

How my Brock String looked today

Resurrection, unburying my desire, has been a long process of facing my very deep personal hang ups and fears, and moving back to that place of risk-taking.

But I am doing it!

Written by Lynda Rimke

June 27, 2016 at 3:09 pm

Posted in Uncategorized

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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Can 3D Movies Be Therapeutic?

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The “depth script” … some are more life-like than others. Still sorry I missed “Hugo” …

The VisionHelp Blog

Hugo-3d-3dguy-al

The concept of using S3D movies therapeutically was advanced by Bruce Bridgeman, a PhD from California, who experienced a stereoscopic awakening, as originally detailed in this CNN coverage last year.  This month’s issue of Optometry and Vision Science has a great article authored by Dr. Bridgeman on his personal experiences.  Although because of copyright laws I can only provide you with the abstract, I’d strongly encourage you to obtain the entire article.  It is a very insightful and delightful read because of Dr. Bridgeman’s personal involvement in vision research related to prism adaptation and other key aspects of binocular vision research.

Dr. Bridgeman gives some advantages of using S3D movies as therapy.  They include continuous motion images within very natural viewing scenes in a complex field.  Now before we get carried away about substituting S3D movies for optometric vision therapy, let’s realize that this particularly movie represents the creme-de-la-creme…

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Written by Lynda Rimke

June 10, 2014 at 4:10 pm

Posted in Uncategorized

Connecting More Dots In Strabismus

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I just introduced myself as strabismic to a perfect stranger on Wednesday. As Greg fetched an end table in the store for me, and offered an additional discount for the floor model, I noticed a strong turn-in on his right eye. I told him I was also strabismic and asked if he alternates use of his eyes. Both eyes lit up and he cheerfully reported “No— I can barely see out of this eye.”

He said it never used to bother him, but lately he was considering surgery if he could even get enough money together. I told him to hold off and consider vision therapy and gave him my blog address where he can connect to Strabby, who has improved her vision in her lazy eye.

Added bonus: this week’s article by Dr. Press about creating more synergy with vision therapy before and after possible strabismus surgery!

The VisionHelp Blog

yes-no Is strabismus surgery a cosmetic procedure?  The simple answer, believe it or not, can be yes, no, or maybe.  Let’s begin by connecting more of the dots that we put down on paper in our previous blog regarding strabismus as a head-to-toe problem .  It has become clear over the past few years that the deficits involved in strabismus extend well beyond misaligned eyes, evident by scrolling through the many blog posts in which we’ve addressed these issues.  Is it reasonable to consider strabismus surgery as more than a cosmetic procedure?

Burton Kushner is a pediatric ophthalmologist in Wisconsin who has written a great deal on this subject.  In particular he has addressed the topic regarding adults, who have the disposable income and life perspective on making an elective decision about undergoing strabismus surgery.  What prompts us to think about this more is Dr. Kushner’s article in the May issue…

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Written by Lynda Rimke

April 25, 2014 at 10:17 am

Posted in Uncategorized

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