NOTE:
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If you Google on Vision Therapy or Vision Training (VT),
you don't come up empty. Likewise if you
do a search for Convergence Insufficiency.
That's a good thing, but begs the question as to why more optometrists -
or ophthalmologists - don't routinely check for issues beyond eye health and
things like near or far sightedness.
Likewise, adults who complain about dizziness and/or vertigo don't get
asked about their vision. To me, this is
a huge problem.
I started doing VT in May of 2013, over a year and a half
after I got sick. I'll discuss more
later about how I ended up in VT, but it's worth noting that not long after I
started, I talked with my therapist Ann about why I had my disorder. I never had blurry vision, which is a fairly
commonly reported problem for people suffering from vertigo. Ann said that she suspected I'd had a vision
problem all along that was never diagnosed.
Given her many years of experience as a therapist working with Dr.
Margolis, a Developmental Optometrist in the Chicago area, who has an excellent
reputation, this got me thinking and wondering.
I do VT for Convergence Insufficiency (CI). This means that my eyes don't work together
properly to send coordinated messages to my brain. The VT is retraining my brain. BUT, I'm convinced that my CI didn't start
when I got sick in 2011. Specific Google
searches for adults with CI don't come up with anything, which I think is
because behavioral or developmental vision problems like CI start with kids. The problem is that kids often don't talk
about how they see something. It's not
exactly playground conversation, so if nothing shows up in their school work,
no one knows. Unfortunately even when
something DOES show up, something like CI is not typically the first thing
that's checked.
Looking back, I think there were some signs I had a
problem. I hated large textbooks,
especially the ones with pictures as well as words. I remember reading lines of text in history
books, and having no idea what I'd just read. I think tracking long lines of
text was really hard for me. And math
was a struggle - trying to make sense of numbers all over the page. I eventually decided I was really bad at some
subjects, though in retrospect, I think I was actually doing really well. Reading small paperback books was easier for
me. I liked reading aloud, which makes
sense - reading out loud is slower, so it's easier to process, and it adds the
audio component. And reading music
worked fairly well, though even into adulthood, I was bad at sight
reading. I was never able to watch movies
in 3D, had motion sickness, and was somewhat prone to headaches.
So that was back in the 60's and 70's. I recently connected with my friend Michael
on FB. He's in his late 20's and did not
receive the care he needed when he was young.
When my older daughter Leena (who is 19) was in school, again, no one
tested for CI or Strabismus or Exophoria, etc.
Leena has since told me she saw double, but didn't know other kids
DIDN'T see this way. No one ever asked
her. Her writing was small and neat, and
she never appeared to struggle academically.
Finally in her senior year of high school, after I'd begun VT and she
came home complaining of horrible headaches, I decided it might be a good idea
to take her to Dr. Margolis. I took my
younger daughter Cara as well. I do
believe there's a genetic component to CI, and sure enough, both Leena and Cara
were diagnosed with CI. Only Leena's CI
was serious enough to require VT, which she did.
So now back to me.
During the first few weeks after I got sick, I saw a neurologist several
times. I remember telling him that I was
having trouble with my eyes, that I couldn't read. He basically blew me off. So I went home and said to myself "OK, I
am going to read," and proceeded to read a few sentences in a book. I looked up and my world was spinning. The spinning stopped, but clearly something
was very wrong. Over the course of that
first year, when I was tested to see if there was anything wrong with my ears -
nothing medically significant was found - no one asked me about my eyes. Some of the tests were horribly difficult for
me, and I remember thinking "is it really supposed to be this bad if my
ears are normal?!?" I remember
seeing someone post that the tests were "fascinating!" I was too busy feeling miserable to be
fascinated. After I had already begun
VT, I was examined by a neuro-ophthalmologist to confirm Dr. Margolis'
diagnosis. I was again told there was
nothing "medically significant" wrong with my vision. Surely just because a problem doesn't get
fixed with surgery or medication doesn't make it insignificant!
Now more about how I ended up doing VT. The first time I saw my Feldenkrais
therapist, Joyce, I told her that I had something wrong with my eyes. She said I might want to go to a
developmental optometrist, but that she didn't think I was ready to handle doing
two kinds of therapy. I'd never heard of
this kind of doctor. I'd had a check up
with my ophthalmologist early in my illness, but that exam only covers focusing
issues, and disease. I told him what
happened to me - at that point the only diagnosis I had was BPPV (treated with
Canalith Maneuvers) - and he said nothing.
I'd already been tested for Parkinson's - this is a pretty easy,
standard test. I'd also had, among other
things, an MRI, hearing test, etc.
Vision is key to balance, and yet no one ever talked about my eyes.
I wrote in "When my challenges really began"
about my hand problems, which I believe stem (as happens to too many musicians)
from what ISN'T taught to flutists, and I suspect many instrumentalists. I am
now learning to pay attention to my body.
Carpal Tunnel Syndrome was a trauma to my system. I believe it's quite possible that getting
sick was also trauma to my nervous system, and made a vision problem (CI) that
I already had to a lesser degree MUCH worse.
I also have problems with my Vestibulo Ocular Reflex (VOR) - (from
Wikipedia - This reflex functions
to stabilize
images on the retinas (in yoked vision) during head movement by
producing eye movements in the direction opposite to head movement, thus
preserving the image on the center of the visual field(s).) I think the combination of getting sick, and
waiting a long time till I even had my MAV diagnosis, not to mention my CI,
were bad for me regarding my vision problems.
I don't believe that all optometrists or ophthalmologists
should do as complete an exam regarding functional vision as developmental or
behavioral optometrists do. I DO
believe, however, that ALL eye doctors should do some basics that go beyond how
well patients focus, and whether or not their eyes are healthy. Both of those are very important, but
function is extremely important as well.
Examining some functional elements should not be a specialty, although I
think VT should be left to the specialists; the eye doctors who truly
understand the functional elements of vision.
I ALSO feel strongly that adults who complain of balance problems should
have vision tests that look for functional problems. Last but not least, because vision - not only
near and far sightedness but vision - is SO important on multiple levels for
learning, teachers need to be on the lookout for tell tale signs of vision
problems.
Having more understanding of how all the pieces came
together for me doesn't change my disorders.
It DOES make me more determined to have people realize how important it
is to get early proper diagnosis, whether you have a vestibular or vision
disorder, or a combination. Our bodies are not made up of all these
different compartments, one separate from the other; one system can easily
impact on another. Having a balance
problem which is diagnosed as a vestibular disorder doesn't mean that it's all
in your ears - vision is a complex sensory system that mustn't be overlooked.
Thank you! The problems with my vision and sensory issues have been the hardest part of my vestibular disorder to overcome. Last week my ENT told me (again) that the problems with my vestibular system would not affect my vision. I politely disagreed with him! Fortunately, at my request, he referred me to a Neuro Ophthalmologist and a Neurologist who specializes in vestibular disorders. It's taken 30 years of periodic,disabling vertigo and now being in a late stage, 6 months of chronic being off balance, sensory issues, vision disturbance..... to get these referrals. I really appreciate you sharing. It helps me to know that I am not alone in this and that my symptoms are real!
ReplyDeleteHi Theresa - I'm so glad this was helpful for you! It IS good to know there are other people trying to figure this stuff out, and you're not the only one.... as I've said to others, if you don't get full satisfaction from the 2 neuros, if I were you, I'd go to a behavioral or developmental optometrist - they have a VERY good understanding of balance issues, and in my experience are better re non-surgical/medication based treatments.... VT has been SO important for me! Let me know how it goes for you - I hope better - you've been struggling a long time!
DeleteI've noticed some blurred vision issues with my bilateral menieres disease. Have you heard of that before?
ReplyDeleteLeigh, I'm sorry, but I don't much a great deal about MD, and I said I've never had blurry vision.... that said, I DO know the Developmental Optometrists (DOs) do treat people with blurry vision.... I don't know where you live or anything, but if you have access to a DO - even just for a consult - it would probably be worth it for you.... disorders can manifest in so many ways, and vision often is part of the problem.... I hope this helps!
DeleteI was not aware of this issue. A very interesting read and a good topic to know about. I am definitely going to look into this subject more because my mother, I feel, might have the same eye condition. She has very similar symptoms and no doctor has every brought up her vision. Thank you for sharing this enlightening information.
ReplyDeleteJacquelyn Hart @ Clarity Vision - Clayton, NC
You're very welcome! I'm glad this was helpful :-)
ReplyDelete