Sunday, January 30, 2011

Double Vision ~ Double Prism







The months of vision therapy have gone quickly. I started out working on strengthening my weak, amblyopic eye ~ engaging in a variety of daily exercises to awaken my suppressed vision and attempt to strengthen my acuity. Although I could progress through various levels on my amblyopia computer game, eventually I came to a point where I could no longer move forward. After rechecking my vision, Dr. T agreed that my right eye does not seem to be responding well to the monocular vision therapy. As I mentioned before in my blog, my periphial vision is alive and well, but there is something seriously wrong with the fovia in my right eye and I am unable to focus on anything clearly. This accounts for the "black holes" I see in my vision when I look out of my right eye.


With the monocular vision therapy came tracking exercises. I worked to track objects with my weak eye - left and right - left and right in zigzag patterns. I could feel the muscles in my eye working. Learning to sense the movements of my eye is an important step in therapy. When doing therapy at the clinic, my vision therapist, Sammy, always asks me how my eyes feel. I am learning how to control the muscles ~ to a certain degree.

After realizing that the acuity in my right eye has not been sharpening as much as hoped, Dr. T decided that we would incorporate some binocular vision training ~ maximizing on the periphial vision I do have in that eye. Sammy introduced me to the Brock string. Using a few blocks on a string placed at varying distances from the end of the string, a person holds the string up to their nose and focuses on a block about a foot from their face. Then they focus on the second block about two feet away. Then back to the first block again. An interesting thing happens ~ the string begins to double and appears to form a V that converges at the block. Then it diverges and looks like it forms an X ~ crossing right at the block that is the focus. Doing the Brock string exercises helped me realize that I am able to see binocularly.

This was quite an amazing realization. Now, I could not make the string double except for at the closest distance from my nose, but I was seeing out of two eyes. When I would use the Brock string with red and green glasses, I would see the two strings in different colors. This way I could tell which string was being viewed from my left eye and which one was looking out of the right. In contrast to the perfect vision I have in my left eye, the objects I can see out of my right eye appear like a ghostly image in comparison (see picture at beginning of blog).

Upon realizing that I was able to "turn both eyes on" at the same time, I began to learn how to do this using different objects. I learned how to "look soft" at an object ~ almost like looking through the object ~ to activate the vision in my weak eye. However since my eyes are not fully aligned, each time I am able to see out of right eye, I see double. The object that I see out of that eye is down and to the right of where it is in reality. In the picture at the beginning of this blog, the double vision I experience is called "horizontal and vertical diplopia." That is because my right eye turns in and is slightly pointed up in relation to my left eye. When I see double, I see a mirror image of what I am actually seeing. The image is down and to the left - it is opposite of where my eye is actually pointing.

One way my doctor has tried to correct the diplopia (double vision) has been to prescribe me double the amount of prism in my eyeglass lenses. He started out with a minimal amount of prism to see how my eyes respond. I now have double that amount ~ a total of 9 or 4.5 in each eye. It has been two weeks since I got my new prism lenses and my eyes are still adjusting to them. I see just fine at close up distances, but have blurred vision at long distances. Because my eyes are better aligned vertically, my double vision is now mainly horizontal (see above - like the picture of the man) instead of both horizontal and vertical. I also find it more difficult to see double "on command." With my old prism glasses I could tell my brain to turn on the vision in my right eye and I would immediately see double. For some reason, perhaps my brain needs more training, it is harder for me to see double anymore. The double image is fainter than it used to be.

My vision therapist and I have been engaging in a discussion about my progress. I seem to be at a standstill with my therapy because I am unable to get the two images I see out of each eye to converge (align). Without the ability to do this, I cannot do many of the binocular training exercises. We hope that the lenses will help, but ultimately, I really need my two eyes to point at the same place at the same time.

That is what has led me to my next step in my journey. Tomorrow I am going to see a doctor of opthamology ~ an eye surgeon ~ who specializes adults with strabismus. I am going to see if there is any hope of surgically aligning my eyes. If my eyes could be perfectly aligned, I feel quite confident that I could regain 3D vision (also called steropsis). I could get both of my eyes to work together!

To be quite honest, I am scared out of my mind. The notion of eye surgery frightens me to no end. I worry about the risks. I worry about the outcomes. I worry about what could go wrong. I certainly do not want to live with regrets...but if I don't pursue this option, I may never know if it would have actually worked. I must at least inquire.

So here I go. I'm holding my breath and taking another leap of faith!

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