Thursday, March 17, 2011

My left eye - a VT update

(I've lost track of the weeks. They're just flying by!)

The theme for my vision therapy lately has been "back to basics." My vision therapist and I were talking, and we decided that we skipped over some important stuff in the beginning. With new patients, she normally starts out with a lot of monocular patched activities, tracking, pursuits, body bilaterality, and so on. But in my case, I was very eager and kept being like, "Wow! Is that a cheiroscope? I read about that. Can I take that home?" And so we got a little ahead of ourselves.

As I've been progressing and starting to really get a feel for my eyes, I've been realizing the importance of those beginning foundational activities. I'm becoming very aware of how unequal my eyes are, and I can see how much of a hindrance that can be. Therefore, for the past few weeks, we've been going back to those basic beginning activities.

Specifically, I've been working on my left eye - the amblyopic and frequently turned eye. Here is what I have noticed about it:

1. It is terrible at pursuits, especially going from right to left. It prefers a quick succession of saccades, or what Dr. Len Press told us are "catch-up ballistic saccades." My eye thinks that it's tricking me with these saccades, and that I won't notice that they aren't real pursuits. You're wrong, eye!

2. It has trouble knowing where it's pointing. I sometimes think that I am using the center of my eye to track something, but really I have stopped moving my eye (because the object has moved to a place where it's hard to move my eye smoothly) and I'm just seeing it my peripheral vision. My eye feels like that is "good enough" and doesn't realize that it's not even tracking anymore.

3. It doesn't like to initiate movement or be the leader. It just wants to follow what my right eye is doing.

4. It has trouble maintaining a stable gaze. When I try to fixate on something for more than just a second, my eye jitters around the target. I've witnessed this using the MIT and seeing the Haidinger brush dance around the target that I was (trying to) fixate on.

5. It's even nystagmus-y on occasion. Sometimes when I wake up in the morning and my right eye is occluded by the pillow, I will look at the alarm clock with my left eye and the image of the clock will jerk back and forth over and over.

(and I'm sure I'll discover more as time goes on)

Amazingly, I had no awareness of any of this until very recently. How could I not notice all these years?

Now that I have noticed, I have been busy working away on my monocular skills with activities like:

tracking / pursuits with the monster
word searches with progressively smaller letters
marsden ball tracking
MIT mazes
tracking while keeping something in a circular afterimage
and so on...

And of course I've been throwing in some physiological diplopia and antisuppression exercises, because life would be boring with without them.


  1. Hey Josh!
    It's a fellow, left-eye amblyopic! I'm sitting in an airport and catching up on all my favorite Strabby blogs! I can relate to your frustration of the monocular exercises and eagerness to graduate to "harder homework!" Yesterday, I completed my 2nd VT appointment, and (of course) all of my exercises are patched. And, like you, I've also learned a lot about my individual eyes, including my left eye's tendency to "float" ... as you mention in #4, it's hard to keep a stable gaze on an object. Yet, I don't have the same problems with my right eye. Weird.
    I have no idea when I'll be able to work on binocular exercises, but thank you for reminding me of the importance to be patient, sticking to the basics and letting the process work as it's intended.
    Good luck! Looking foward to your next update ...


  2. Hi Tracy,
    I'm glad to hear that you've started VT! Yeah, the monocular activities can be really boring, and in the beginning I didn't really even understand why I needed them. They need to make some sort of pamphlet that explains that yes, these are boring, but you need to do them and here are the reasons why.

    Anyway, good luck! You'll be wearing red/green glasses before you know it :)


  3. Oh yeah! Boring they can be. I know. Do you remember the scene in Karate Kid where the kid has to wash the car and later on he learns that the lessons his muscles learned in washing the car helped him with his karate movements? These repetitive and BORING exercises are our version of "wax on" and "wax off".

  4. That's true! Thanks for that wonderful reference. That should go into the imaginary pamphlet of "Why you need to do these boring mono activites" that I mentioned on Traci's comment.

  5. indeed, Josh...we have a lot of 'remedial' work to get done, to advance our eyes to the teamed, tracking awesomeness that most 1-year-olds possess.

    In the meantime, ahoy matey! ArrrrrrrrrRR!