Definition of Optometric Vision Therapy
(from the American Optometric Association)
Optometric Vision Therapy is an individualized treatment regimen prescribed for a patient in order to:
- Provide medically necessary treatment for diagnosed visual dysfunctions;
- Prevent the development of visual problems; or
- Enhance visual performance to meet defined needs of the patient.
Optometric Vision Therapy is appropriate treatment for visual conditions which include, but are not limited to:
- Strabismic and non-strabismic binocular dysfunctions;
- Accommodative dysfunctions;
- Ocular motor dysfunctions;
- Visual motor disorders; and
- Visual perceptual (visual information processing) disorders.
The systematic use of lenses, prisms, filters, occlusion and other appropriate materials, modalities, equipment and procedures is integral to optometric Vision Therapy. The goals of the prescribed treatment regimen are to alleviate the signs and symptoms, achieve desired visual outcomes, meet the patient’s needs and improve the patient’s quality of life.
Vision Therapy, it turns out, is regarded with skepticism by some vision professionals — ophthalmologists in particular I suspect, who consider it ineffective at best and a sham at worst. VT got a bad reputation from its unfortunate association with The Bates Method, a therapy reputed to rid patients of the need for glasses by means of eye exercises and little else. So far as I know, this Method was not very effective, despite the claims. Vision Therapy as defined above, on the other hand, can be. Is, in my case. But more on that later. First, let me tell you a little more about it.
First of all, after I had the prisms put into my corrected lenses, I went to see Dr D, the Vision Therapy optometrist, who did another exhaustive exam. When she had ruled out everything but what she called intermittent exophoria (“nearly constant in your case”) she recommended vision therapy, which I agreed to try for 2-3 months of once a week sessions, then re-evaluate at that time. Therapy, I soon discovered, involved using special glasses, polarized and red/green lenses to look at specialized pictures, and exercises meant to strengthen my ability to converge my eyes, something that was essential to my learning to see in stereo and which even my ophthalmologist grudgingly granted might help me. There were other exercises I did, using blocks and my fingers, trying to train my brain in a different way. At first, simple things like keeping my eyes on a pencil as I brought it towards my nose (the trick was to use red and green glasses and keep the pencil in sight of both colors and a single, not doubled image) were beyond my powers. But gradually I found I could not only do that with ease, but could even make a face magically appear between two other faces drawn on a piece of paper. Then I could converge my eyes in such a way as to have it appear in 3-D and be able to look at this from different angles.
Yet I failed most of the time to perceive the real world in 3-D, in stereo. I knew this because I knew precisely when I did see 3D, knew from the sheer beauty of whatever I looked at that I was using stereovision. I had learned that if I had to ask myself, Am I seeing with stereopsis, then almost by definition, I was not. it was clear to me that I knew immediately and without questioning when I was. I could also tell the difference, if I wanted to, by testing myself on the palm tree in my apartment. I knew from past experience that when I saw it properly, each leaf stood out in relief, in its own plane and that I could pick each spear out, pick each one up separately. But when I could not see in 3-D the leaves became jumbled in green, a mess of intersecting lines and overlapping “things” I could not quite distinguish even as leaves.
I was so discouraged by this — not once all the week before had stereopsis come upon me spontaneously, and even when I worked on using it, it had a forced quality that made depth perception tenuous at best — I was so discouraged that yesterday I decided to give up and not do it any longer, or at least to re-evaluate where I was and where I wanted to go. Though I knew I was not actually seeing in stereo ordinarily, despite my success on tests, Dr D suggested that perhaps I saw more depth than I knew, and that the effect was more subtle once one got used to it…that the shocking beauty of it faded once it became a common occurence in one’s life. Fearing that what I was seeing was indeed 3-D somehow, and that the magic was indeed already lost, I told her that I had to take some time off to decide if I wanted to continue VT. At the very least I needed to define my goals in continuing. I left, feeling empty and deflated, certain that both my time and my money had been largely wasted…
Then, voila, as if all I needed was a few days of good sleep, today “it” appeared, stereopsis and the magic late this afternoon. Then again this evening. Even as I am writing this, I have a bowl of yogurt next to me, and the very lumps of it look so exquisitely bumpy, defined by the space that surrounds them, that I cannot bear to disturb them by eating, except that taking a bite changes the configuration and thereby brings new bumps into view! If I turn, I can see Dr John Jumoke, my sculpture, standing next to my chair, and he looks completely different in 3D. His hand in space, reaching out, has a surreal, magnificence – words literally fail me in trying to describe this – the curves of his fingers, the drape of his shirt… all leave me speechless at their beauty.
The extension of any hand or a palm leaf in space is a marvel …indescribable at best, since I am aware that this must seem at best silly to most of you who have had stereo vision since birth, and incomprehensible to those of you who lack it now…The way I can best say it is perhaps what I wrote to a friend last night when drunk with Xyrem and sleep: “one of the gifts of this double vision problem has paradoxically been that learning I didn’t have 3d vision meant I could discover what 3D vision was like, newly acquired. And the world in 3d is gorgeous, magnificent, purely lovely…But no one else understands just how much so, because they do not see this loveliness…”
Later on, I wrote this to Joe (the dear friend paralyzed with ALS with whom my old readers are so familiar): “I saw my entire room in 3-D all evening and part of the afternoon today. This, despite my switching to glasses that do not have prisms in them, which means I have learned how to converge my eyes quite successfully. Partly that is good, but partly it worries me because I do not want stereopsis — that is seeing 3D– to become old hat and something I don’t notice anymore. If it loses its magic, I will be disappointed. I want 3-D to stay special to me, to remain lovely and a thing of magnificence, so that I remain aware of it. I don’t want it to be humdrum and ordinary the way it is for most people. That for me would be very sad. Part of what is so beautiful about it is its very rarity in my life…
On the other hand, I do not want NOT to see in 3D most of the time just because I am afraid it will become ordinary…Or do I? Perhaps I am indeed willing to sacrifice a life of 3-D for those special times when a moment of 3-D comes upon me unaware and wakes me up with its splendor! I would hate to never experience that ever again, which could happen if 3-D were an everyday experience instead.
Oh, I do not know what to do! In fact, I cancelled my next vision therapy session because of this indecision. I didn’t know if I wanted to continue to learn to see 3D or to stop learning more than what I already know…and even to let some of it fall away into forgetfulness again. Dr D seemed to understand my dilemma as she agreed to the cancellation, appreciating how important it was to me that 3D remain beautiful…And it is spectacularly beautiful right now. I cannot convey it fully, as you know, except to say that space is not “negative” the way art critics speak of it, no, space loves the world into being, it caresses every object and person and cups and bears and holds them in its infinite arms, space is the roundness that makes things real, the thing – and it is a thing, – that gives all matter its matter of factness, its density and heft. It is magic, and it is magnificent beyond words…
If this has not convinced you of anything, I recommend an article by Oliver Sacks called “Stereo Sue” (June 19, 2006, New Yorker) about the phenomenon of stereopsis, its loss and the regaining of it in adulthood. In it he describes the experience and the wonder of it better than I have.