The Space Between

Today’s guest blogger is Dr. Robin Price. Dr. Price practices in Pleasant Grove, Utah.  He and his associate, Dr. Jarrod Davies, are the only Board Certified Fellows of COVD in Utah!  In fact, Dr. Price just completed a term on the Board of Directors of COVD.  He enjoys working with patients of all ages to help them overcome their visual problems but especially children with learning problems. 

A Google search for “The Space Between” brings up a song written by the Dave Matthews band. “The Space Between” I am referring to is a chapter in Fixing My Gaze: A Scientist’s Journey Into Seeing in Three Dimensions. In this book, Susan Barry, a neuroscientist and professor of neurobiology, describes how she went from perceiving space as rather flat and two-dimensional to developing the ability to see in 3-D.

“Space was very contracted and compacted. So if I looked at a tree, the leaves or the branches would appear to overlap one in front of another. But I didn’t actually see the pockets of space between the actual branches. So the world was actually smaller and more contracted before my vision changed.”

After working with a developmental optometrist in a program of office-based vision therapy, Dr. Barry developed stereopsis, or 3-D vision. A critical part of appreciating stereopsis is seeing the space between objects.  She describes seeing a snowfall for the first time in 3-D as follows:

One winter day, I was racing from the classroom to the deli for a quick lunch. After taking only a few steps from the classroom building, I stopped short. The snow was falling lazily around me in large, wet flakes. I could see the space between each flake, and all the flakes together produced a beautiful three-dimensional dance. In the past, the snow would have appeared to fall in a flat sheet in one plane slightly in front of me. I would have felt like I was looking in on the snowfall. But now, I felt myself within the snowfall, among the snowflakes. Lunch forgotten, I watched the snow fall for several minutes, and, as I watched, I was overcome with a deep sense of joy. A snowfall can be quite beautiful—especially when you see it for the first time.

You can listen to Dr. Barry describe her new visual experiences here:

http://bigthink.com/ideas/43690

Dr. Barry was recently profiled by the PBS program The Secret Life of Scientists & Engineers. You can watch her here:

http://www.pbs.org/wgbh/nova/secretlife/scientists/susan-barry/

I had the privilege of attending a seminar in Atlanta, Georgia a few years ago with Dr. Barry. As part of the seminar, I stood side by side with Dr. Barry as we were viewing the Spirangle vectogram projected onto a wall. We both had 3-D glasses on, but our experiences were very different. Dr. Barry was saying how certain letters were popping out from the wall and others were in a space behind the plane of the wall. I, however, could see some letters popping out slightly, but none appeared to be behind the wall to me. Dr. Barry could see the space between; I could not. I have always had “normal” vision, but Dr. Barry’s appreciation of depth was greater than mine. Since then I have worked to appreciate the space between objects, and my depth perception has improved.

Now, we recently returned from the annual meeting of the College of Optometrists in Vision Development (COVD). It was a wonderful gathering of developmental optometrists and vision therapists from all over the world. It was wonderful to be together with such a large group of dedicated professionals who understand the neurology of binocular vision and how to help patients like Susan Barry. But now we’ve returned home to our lives and practices, and often feel isolated in our science. It will be another year until we gather again. So my question is: How are you going to take advantage of the “space between” to promote developmental optometry and optometric vision therapy? Will you take the messages from the meeting back to your patients? Will you put in place the principles you learned to educate the public? Will you keep in touch with your colleagues from the College of Optometrists in Vision Development to continue learning throughout the year? Can you appreciate the “space between”?

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We Can Get Better at Everything

Dr. Sue Barry was recently interviewed by NPR for their NOVA web series called “The Secret Life of Scientists and Engineers.”  Her experiences with vision therapy and learning to see in 3-D were life-changing.  Neuroplasticity is the mechanism through which we CAN get better at everything.  Anyone. Any age.

Watch Dr. Sue Barry: The Secret Life of Scientists

Read more about neuroplasticity here and here.

 

Then watch Dr. Barry tell a joke.

 

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Diary of a Strabismic Kid (part 1)

I have another set of entries outside of the Science and Splash that I would like to share.  I affectionately call it “Diary of a Strabismic Kid.”  As a developmental optometrist that works with Strabismus (eye turns), I get a glimpse into the world of what it is like to have a turned eye or lazy eye. I have learned so much from these patients over the last few months that I would like to share what I am learning with all of you.

Most of us only see what can be seen on the outside.  In many cases, it is very easy to see when someone’s eye is turning.  This can be very devastating to a strabismic person.  More than most of us realize.

One of my patients was a 15 year old named Tyler who had had 3 eye surgeries to correct his eye turn.  When he came to me he was contemplating going in for a fourth eye surgery.  I prescribed vision therapy to address the eye turn.  I remember working with him one day in the therapy room.  We were doing this technique using 3D glasses like they use in today’s movie theaters.  We were asking him to watch himself in the mirror to see if he could get both eyes to point straight.  All of the sudden he got it and his eyes were pointing straight and he said it felt “really wierd.”  I told him that was great and to remember what that feeling was like.  After the vision therapy session, I was talking to his mother about the gains we had made in therapy that day and I looked over at Tyler  who was very intensely pointing both of his straight at me. I said, “Tyler your eyes are straight!”  With a very direct tone of voice he replied, “I know.”

This presents a common misconception about eye turns.  Well, if you have an eye turn, why don’t you just get surgery to straighten it.  The truth is that it is very difficult for eye alignment to last with eye surgery,  because the underlying cause of the eye turn was never treated.  So even if the eyes are surgically aligned, these patients don’t know how to use the two eyes together.  Unfortunately, these patients are rarely sent to learn how to use their eyes in tandem.  By simply hoping for the best, a disconcerting 50% of the time these patients need multiple surgeries because the individual goes back to what he or she knows – turn the eye.  This is never a conscious decision.

With Tyler I remember the first time I examined him, I asked him if he knew where the other eye was turning.  He said he didn’t.  There were times when the eye was turned more and when it was turned less and I asked him if he could purposely make his eye turn more or less – again he told me he could not.  You see, it is a very difficult thing for the brain to learn for the first time how to get the two eyes to point to the same place.  How often do you think about where your eyes are pointing?  But through the expertise and research of many years, developmental optometrists have many tools to teach people how to use the eyes together and in turn straighten them.

Tyler was a very bright and talented young man.  He was a straight “A” student with a resolve to go places and do something with his life.  Though he was a little reserved, I don’t think anyone really felt his eye turn was holding him back in anyway.  Yet listen to what he wrote about his experience.

“Since I was a kid I have had a lazy eye.  Over the years, I was ridiculed and made fun of daily.  People would tell me to “look at them” or ask “What are you looking at?” and then laugh at me.  My self-esteem and confidence started to dwindle.  I had a great sense of inferiority.  I had three cosmetic surgeries in Seattle to fix the alignment of my eyes but sometimes one eye still “looks” off.  Over time, I developed defense mechanisms to try to hide my eye.  I would not look directly at someone, but slightly off to the side so they wouldn’t notice my eyes.

Vision Therapy has helped me get more control of my eye alignment and make better use of my right eye, which used to turn off.  Each time I go to therapy, I feel as if I’m making my eyes better.  I don’t just notice physical changes either, but visual perception and personality changes too.  I am more positive about myself.  My self-esteem and confidence has given me a better feeling of doing well in sports and I am more comfortable socializing with peers.  My Optometrist/Vision Therapist, Dr. Winters, and the therapy program have given me a better outlook on life and myself.  I no longer need my defense mechanisms because of what Vision Therapy is doing for me.”

This gives us a glimpse into what life is like for those who have eye turns.  But, unfortunately, it is only part of the story.  People who do not have good alignment of the eyes are almost always stereo blind.  Stereo blind is the term used for individuals that have not developed stereopsis or depth perception.  Tune in next time to hear more about the far-reaching impact stereo blindness can have on an individual.

If you or someone you know struggles with strabismus, a lazy eye, or an eye turn, contact your local developmental optometrist.  To find one near you click here.

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See Well Learn Well

Don’t miss this public health report, 3-D in the Classroom.  3-D imagery is becoming more commonplace, especially in classrooms.  These new 3-D displays are quickly becoming an exciting new tool for teachers and learners across the learning spectrum–from kindergarten through graduate school.  Think about the possibilities……. Geometry, architecture, anatomy, engineering, sculpture, biology, geology.  Pick one of these subjects and imagine what you might do if you could use 3-D images in your lesson plan.  The possibilities are limitless!  Now move beyond the classroom, because 3-D vision, or stereopsis, is becoming a requirement for many careers and vocations.  Teaching with 3-D technology will be a requirement in order to prepare students to practice with that technology.

And now, imagine a child who cannot perceive 3-D images because of a vision problem.  These children will be at a distinct disadvantage, not only in the classroom, but in life!

The good news is that help is available.  Dr. Dori Carlson, the president of the American Optometric Association, points out that “for the estimated 1 in 4 children that have underlying issues with overall vision, 3-D viewing can unmask previously undiagnosed deficiencies and help identify and even treat these problems….If deficiencies are identified the student can be directed to care consisting of a comprehensive eye exam and treatment with glasses and/or individualized rehabilitative vision therapy.  As an added benefit, this course of action may also assist the child in most all reading and learning tasks.  Overall these 3-D viewing potentials, tied to enhanced and protected vision, provide increased assurance that no child will be denied lifetime opportunities and an equal chance to succeed in school and later in life.”

The ability (or inability) to perceive 3-D images may provide a more sensitive assessment than a standard eye chart in the identification of children with vision disorders! What are some of these vision disorders that can reduce stereopsis and perception of 3-D images?

• Refractive problems, such as myopia (nearsightedness) and hyperopia (farsightedness).
• Strabismus, or an eye that turns in or out, all of the time or some of the time.
• Amblyopia, or lazy eye, when one eye does not see or perform visual tasks as well as the other.
• Binocular deficits, such as convergence insufficiency, can can cause significant discomfort and even double vision, in addition to poor 3-D viewing.
• Accommodative deficits, or poor focusing skills can cause blur and discomfort during 3-D viewing.

The time is now, make sure your children have the visual skills they need to perform both inside and outside the classroom.  Take your kids to see a 3-D movie! If your child doesn’t seem to appreciate the 3-D effects, consider this a blessing in disguise….next stop is a comprehensive eye examination.

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Leaving Flatland

I remember the phone conversation I had with Greg when I referred him to Dr. Len Press for vision therapy many months ago.  Imagine my delight when I received this email from him a few days ago…….

I just left you a thank you message and thought I might get choked up when leaving it, which I did. My therapy with Leonard Press has been wonderful, thanks to your recommending that I consider looking him up when I called you 5 months ago asking for help. My therapy has taken 46 sessions to date. Dr. Press’s office has been such a wonderful and supportive place. They even included a mention about me and my blog in their most recent newsletter.  I’ve now woken in stereo for the past 4 days and remained in stereo the entire time.

I can see 3D movies for the first time in my 59 years, though they are hardly the only payoff in my effort to see in stereo. Our world is an amazing place… I find it hard to believe that I lived 59 years of my life in flatland. I still have a ways to go – I can go much deeper in stereo with a little Brock string or other exercise, even reading small text on my iPhone brings me into deep 3D. No headaches and no double vision during any of my sessions or for the pat 5 months – that was my greatest fear. It’s hard to admit that I almost cancelled starting VT for fear of those damn headaches.

I might not pass all the clinical tests – I still have a hard time finding the symbols in the stipple squares so many show to determine whether someone has stereopsis. As Dr. Press says, that’s a special skill not utilized much in real life so I shouldn’t lose sleep over it. I have another progress evaluation on Monday – I’m curious what that will bring.

I’m constantly telling my story to anyone who will listen.  I’ve put together a starter kit for those I run in to who might benefit, like my brother-in-law (stick, straw, eye patch, Hart chart and Lora’s card). I contacting my former optometrists to share with them my progress – sadly, they weren’t at all interested. Not to worry, I’m continuing my blog and hope that my next children’s book will be on vision therapy.

Thank you, thank you, thank you. If you ever need my help in any way, please don’t hesitate to call.

Greg

Greg Voth
is leaving Flatland

http://www.sovoto.com/profile/GregVoth

There are so many things about this email that make me happy!  Obviously it is about a man who was helped with vision therapy, at an age when many would have said don’t bother, he is way beyond the “critical period” when visual problems can be overcome.  And this man has become an advocate of this brand of optometry, reaching out to other people who might benefit from vision therapy.  It also makes me happy because somehow, despite everything that is wrong with our healthcare system, I was able to play a part in getting Greg the help he needed.

What makes me happiest about this email is feeling Greg’s joy every morning when he awakes in stereo.   Yes, the world is an amazing place, it’s a 3-D movie 24/7, and you don’t need special glasses.  I tried to imagine what it would be like to experience stereo for the first time after living in Flatland for over 50 years!  I tried to think about where I would go, what I would try to re-experience.  I thought about the Grand Canyon, or Times Square or just going to a football game.   And then I thought about the simpler things in life like taking a walk in the woods, parking a car, or looking at my reflection in a mirror.  EVERYTHING must be different when you leave Flatland.

Congratulations Greg on leaving Flatland, and thanks for the wonderful email.  Even though I have had binocular vision and stereoscopic depth perception for my entire life, I am looking at the world a little differently today.

Read about Greg’s journey here.

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3D in the Classroom: See Well, Learn Well

The American Optometric Association, with the assistance of numerous experts in the field, released this factsheet on 3D in the Classroom…

3 D in the Classroom: See Well, Learn Well

View more documents from Dominick Maino

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A Blessing in Disguise

The American Optometric Association and the 3-D@Home Consortium have signed a Memorandum of Understanding to improve the understanding of stereoscopic/3-D viewing as a safe and appropriate technology for children and adults of all ages.  The two organizations hope to collaborate on clinical research and develop strategies for promoting an enhanced 3-D experience through thoughtful consideration of human vision development and perceptual processes.

The 3-D@Home Consortium is working to accelerate the adoption of 3-D technology in the home.  Through conversations with the AOA, the Consortium has come to understand that vision and eye health are a large component of the consumers’ ability to view 3-D images and to ultimately increase their use of 3-D technology.  And through conversations with the Consortium, the AOA has come to understand that the adoption of 3-D technology is a new opportunity to screen children for undetected vision problems such as strabismus and amblyopia.  These vision disorders, if left undiagnosed, not only interfere with the 3-D viewing experience, but also have the potential to cause the “3-Ds of 3-D viewing”: discomfort, dizziness and lack of depth.

At a symposium on 3-D technology presented at the State College of Optometry in NYC, Dr. Michael Duenas* explained the deficiencies of the current system of providing eyecare to America’s children.  Vision screenings do not do a very good job of identifying children with vision problems.  Even when identified, very few children receive the comprehensive eye exam that is required to diagnose the condition and initiate treatment.  Too many students are sitting in classrooms without the visual skills required for learning.  Often, the results are poor academic performance, a diagnosis of a learning disability or ADHD, or even behavioral issues that could lead to juvenile deliquency.  What if those children could be identified by giving them the opportunity to view a 3-D movie in the school auditorium?

3-D technology is not only about entertainment.  There is a new world evolving, and it is based on the application of 3-D technology in new and exciting ways.  Education is using 3-D content in classrooms.  Imagine an astronomy lesson presented in 3-D, with the planets orbiting the sun.  The use of 3-D technology is becoming so integral to surgery that medical students without the required visual skills may have to consider other specialties.  Optometrists and optometry students understand the importance of 3-D viewing when using the biomicroscope or binocular ophthalmoscope to evaluate ocular structures.  Nanotechnology, fluid dynamics, biochemistry, engineering, aviation, architecture, the military…… all these professions and fields of study are using 3-D technology in design, simulations, research, production, and education.  This list is likely to expand as the technology improves and more creative applications are developed.  As Chris Haws** explained at the symposium, society will be enhanced by the application of 3-D technology far beyond entertainment.  It makes sense to identify those individuals who cannot perceive 3-D images due to undetected visual problems as early as possible.  Treatment will enable them to take full advantage of these applications which are becoming more embedded in their daily lives.

What can we expect as a result of this new partnership?  Educational materials are being developed by both organizations to improve public health and vision and eye health.  In the not too distant future, this partnership may develop public service announcements to be viewed before or after 3-D movies and TV shows.  The public needs more education concerning the importance of 3-D vision to a comfortable and enjoyable experience, the visual problems that can disrupt this experience and the importance of comprehensive vision examinations for children and adults of all ages.

In the meantime, take your children to see a 3-D movie.  If any of them experience any of the Ds of 3-D viewing, consider this a ‘blessing in disguise.”  He or she may have an undiagnosed vision problem which has the potential to negatively impact their lives, in and out of the classroom.  Make sure that child has a comprehensive vision examination.  The sooner these vision problems are diagnosed and treatment is initiated, the better the outcomes.

Here is more information about 3-D viewing:

AOA Press Release on this new partnership

3-D Vision and Eye Health

3-D University

3-D Vision Syndrome or ADHD?

*Michael R. Duenas, O.D. is the Associate Director Health Sciences and Policy for the American Optometric Association, Washington, D.C.

**Mr. Chris Law is a psychologist, filmmaker, and producer with significant 3-D experience.  He is an advisor to the 3D@Home Consortium’s  Human Factors Steering Committee.

 

 

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In the News…… 3-D Vision and Health Symposium

There has been a lot of news about the effects of 3D viewing devices on the eyes, especially the eyes of young children.

Through a joint effort of the American Optometric Association and the 3D@Home Consortium, prominent filmmakers and vision researchers will hold a first-of-its-kind symposium on the topic at SUNY College of Optometry, next Tuesday, March 15.

As a practitioner, you may find the symposium interesting and have some compelling questions for the panelists about how the optometric profession can help patients better enjoy 3D viewing, and discuss those eye conditions that can compromise the viewing experience.

The event is free. Find further details and register at http://www.3dathome.org/clinical-symposium-20110315-registration.aspx

More information about 3-D Media and Vision:

Why some people cannot appreciate 3-D movies

Alice in Wonderland and stereoblindness

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Hope for the Amblyopic

This post was written by Dr. Robin Price.  Dr. Price practices in Pleasant Grove, Utah.  He is a member of the Board of Directors of the College of Optometrists in Vision Development (COVD).

Yes, Nicholas, there is hope for a lazy eye!

A few years ago Dr. Susan Barry, author of the book “Fixing My Gaze: A Scientist’s Journey into Seeing in Three Dimensions,” wrote of the danger of false hopelessness.

“False hopelessness is just as bad as false hope. When a person in authority tells you that something is impossible, then you are set up to fail,” she wrote. Dr. Barry speaks of the damage that can be done when doctors sometimes tell patients that there is no remedy, there is no cure, or there is no hope.

Nick was just such a patient. He had been diagnosed with amblyopia at age 6. Amblyopia is the medical term used when the vision in one of the eyes is reduced because the eye and the brain are not working together properly. The eye itself looks normal, but it is not being used normally because the brain is favoring the other eye. This condition is also sometimes called lazy eye. Nick had been patching one eye off and on for two years. His visual acuity would improve somewhat, they would reduce or stop patching, then his visual acuity in the amblyopic eye would regress. His doctor would have them re-commence patching, only to have the same result over and over again. In addition, he was never able to appreciate stereovision, or 3-D vision. His brain would suppress, or ignore, the image from one eye, leaving the world two-dimensional to him. After two years of this patching-only regimen, his eye doctor told him that nothing more could be done. He also told him that he would never be able to do things like fly a plane that required good visual acuity and binocular vision. Not only did Nick feel that he failed at making his amblyopic eye better, but now someone had also taken away his dream of being a pilot.

Fortunately for Nick, his parents did not give up. They researched various treatments for amblyopia, and found studies by the National Eye Institute showing that amblyopia could be treated successfully beyond age 8, even into adulthood. They found that research was being done comparing other forms of treatment besides patching only.

After their research, they sought out our clinic for optometric vision therapy. Vision therapy is a doctor-prescribed and supervised regimen of activities and exercises designed to correct vision problems that cannot be adequately treated by glasses, contact lenses, or surgery. Just as there is physical therapy and speech therapy, there is vision therapy—exercises for the eyes and brain designed to help a patient develop his or her visual skills.

An important part of Nick’s therapy was helping his brain learn to use both eyes together as a team. These types of exercises have been part of optometric vision therapy for decades, and the concept is illustrated in the following article, entitled Effectively Reducing Sensory Eye Dominance with a Push-Pull Perceptual Learning Protocol. Published in the well-regarded journal, Current Biology, the article discusses the effects of “push-only” training vs. “push-pull” training.  Push-only would be patching only in which the amblyopic eye is stimulated, but the other eye is completely patched. Push-pull involves activities designed to stimulate the amblyopic eye while the other eye is still seeing. In other words, the amblyopic eye is forced to see the detail while the other eye still is able to see the background information.

This helps explain why Nick’s progress was never sustained after discontinuing patching. The results of this research support the need for binocular activities in order to have long-lasting outcomes in the treatment of amblyopia.  After 4 months of optometric vision therapy, Nick’s visual acuity was stable, and in addition, he was now seeing 3-D! He passed all the stereovision tests, and as a bonus he was able to go to a 3-D movie and actually appreciate things flying out at him!

So yes, Nick, there is hope. And don’t give up on any of your dreams. The sky’s the limit!

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Help for 3-D Vision Syndrome

Congratulations to Dr. Dominick Maino, who is helping to spread the word about how optometry can help people suffering from “3-D Vision Syndrome.”  Do you (or your child) suffer from headaches, double vision, nausea or other symptoms when you watch a 3-D movie?  You may be a candidate for vision therapy to improve your binocular vision.  In addition to being able to appreciate 3-D movies, you might discover improvements in other activities, in school, at work, and in sports.

Read more in this article in Techlicious.

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