September 9, 2021 - One decade... be present.

It’s been a decade since I got sick. I didn’t know then, that night, that my life was dramatically changed. I’ve done therapies, and they’ve...

September 4th 2015 Balance - it's about more than your inner ear

NOTE: Please cut and paste into Google Translate to listen if needed.

Whenever I write about vision, I hear from people grateful to find out about a missing piece of their puzzle, as it was for me.  Balance is a complex system, and when something is wrong, it can be hard to diagnose the source of the problem... that's why checking EVERYTHING - including vision - is so important. Vision is part of our sensory system - a really important part.  Vision impacts learning on multiple levels, and is a major piece of our system of balance. 

The standard eye chart that everyone who's ever had an eye exam has seen, was invented back in 1862 by an ophthalmologist named Snellen.  It was probably quite a break through at the time.  Now there is a chart called the LogMAR chart that some use - to me it looks pretty similar, albeit a bit fancier.  Both charts test for focal acuity - how well you can literally focus.  It's called 20/20 because the point is to see how well someone can focus at 20 feet. 

If you go to an optometrist or an ophthalmologist you will be tested for acuity and eye health - in other words, how well you focus, and if you have any eye diseases.  This is obviously important, but leaves out functional vision problems.  Optometrists and ophthalmologists, as I've said before, do not test for functional problems like Convergence Insufficiency (basically eye teaming), Strabismus (which causes double vision) or what is commonly known as a wandering eye (the eye isn't really wandering - the muscles aren't doing their job quite right). 

Currently, the only way to get a complete exam is to go to a specialist.  Most people have heard of Neural Ophthalmologists, but they really are surgery oriented. And of course, eye doctors do glasses, but what about Vision Therapy?  Surgery for Strabismus, from what I've heard, often ends up backfiring after a certain period of time, or not working in the first place, which is why I think Vision Therapy is a better option.  How many people are told about Developmental or Behavioral Optometrists? 

The formal name is Optometrist in Vision Development.  See this Wikipedia page about the international College of Vision Development -
which was established in 1971.  Here's a direct link to their site - http://www.covd.org/.  Doctors with training from this institution specialize in vision therapy and vision rehabilitation, and work to help people with functional vision problems.

Functional vision problems have a dramatic impact on peoples' lives because vision is so important - it's about processing and comprehending info - it's major brain work.  Imagine not being able to see the world in 3D;  seeing two sets of everything until your brain shuts down the messages from one eye because it's just too confusing, so you essentially end up with monocular vision.  Or not being able to comprehend what you read, or re-reading multiple times and skipping lines.  Imagine what it's like to try to comprehend info if you're concentrating on simply being able to read the actual word.  What would it be like if your world looked blurry? And keep in mind that these problems are NOT necessarily visible, easily seen.

And don't forget your vestibulo ocular reflex (VOR).  Note that this term actually includes "vestibular" for the inner ear, and "ocular" for vision.  What if your VOR gets affected (in my case, by a vestibular disorder)?  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)."  All of this really happens to people.  Imagine having problems like this - and imagine how it can affect your balance.  Think about how it affects how a person interacts with the world.

It can all be fixed if it's detected, but the proper testing needs to be done.  If doctors don't test for functional problems - if they're only concerned with focal acuity and disease - these problems go undetected.  Kids end up thinking they're stupid, or get misdiagnosed with things like ADHD, sometimes low level - or high functioning depending on how it's phrased - autism.  Developmental Optometrists do all the testing that Ophthalmologists and Optometrists do.  In addition, they do complete testing for tracking, proper convergence, 3D vision and peripheral vision.  Both of my daughters now get checked by Dr. Margolis (my Developmental Optometrist), and my husband recently went to him as well.  This meant that for the first time in his life, my husband had a truly complete vision exam!

As my friend Lori said recently, when people have knee surgery, the doctor thinks nothing of sending them for physical therapy.  But that's not the case with vision therapy.  There seems to be an attitude in the medical community that problems should be fixed with medication and/or surgery. But functional vision problems don't get fixed with either of these - vision therapy - training or re-training the brain is what works.  I don't know why people are born with these problems, but sometimes the brain needs help to get the messages right.  Vision therapy is time and effort intensive, though much less so for kids than adults.  VT for a five or ten year old is different than for someone like myself, in my 50's.  It's still effective for me, but it's a much slower process.


Children who exhibit problems need to be checked for everything, not just autism or ADHD.  Adults suffering from vertigo and/or dizziness - symptoms that can result from many conditions -  need to have their vestibular system checked,  but ALSO need to have a complete vision work-up.  If vision is overlooked, it's like checking a broken ankle, but ignoring a possible knee or hip problem.   You can't walk properly if one gets fixed, but another problem is ignored. 

NOTE: If a vision problem is detected, more extensive testing in a particular area may be done.

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