With both eyes open, a young subject's weaker eye receives vision therapy using a Visicare Lite Track Target device.
The subject's eye alignment and depth perception are being trained on the Bernell-Brewster stereoscope, a traditional vision therapy device. Photos used with permission of Pacific University, Colin Stapp, photographer
• turning or tilting head to use one eye, closing or covering an eye
• holding items or books very close to eyes
• frowning or scowling when reading or writing; frequent blinking, rubbing eyes
• losing place while reading
• mouthing words while reading silently, tracing words with finger
• omitting, reversing or repeating words or letters when reading aloud
• sloppy handwriting (varying, inconsistent size, compared to peers)
• poor hand-eye coordination (difficulty throwing, playing catch, tying shoes, writing on white board from hand-held notes)
• short attention span
• nervousness, irritability, restlessness, unusual fatigue after close work
• developmental or emotional immaturity
• high frustration levels
• difficulty getting along with peers
• headaches, nausea, dizziness
Behavioral optometry Sure, you can see. But how’s your vision?
By DENNIS BERRY for Active Lives
Three-D may be the "next big thing" in TV, as it's already revolutionizing movies (witness "Avatar") - presuming we all see in stereo. For some people, enjoying a 3-D movie is just a dream, and not just a dream but a headache. Literally.
Fortunately for many, 3-D vision can be restored through vision therapy from behavioral or developmental optometrists.
A local champion of vision therapy is Hannu Laukkanen, of Pacific University's College of Optometry in Forest Grove. Laukkanen's roots run deep in Knappa: He was the first U.S.-born member of his family after their move from Finland to Brownsmead in 1948. After 12 years of school in Knappa, Laukkanen earned his B.S. and did graduate work at the University of Oregon, later obtaining his O.D. (doctor of optometry) and M.Ed. (emphasis on Vision in Learning) at Pacific University's College of Optometry. He's now a full professor and chief of vision therapy services at PUCO.
"Vision therapy is an optometric treatment gaining scientific acceptance in the medical community," Laukkanen says, pointing to a recent placebo-controlled, randomized study published in "Archives of Ophthalmology," a high-profile medical journal. Sponsored by the National Institutes of Health, the study clearly demonstrated the value of vision therapy for "convergence insufficiency," faulty binocular vision that causes eye strain, headaches, blurred vision, double vision, sleepiness, difficulty concentrating, movement of print while reading and loss of comprehension after short periods of reading or close activity work.
"Hundreds of previous studies have shown the value of vision therapy, but few met the gold standard of being masked to the patient and placebo-controlled. This most recent multi-center study by ophthalmology and optometry researchers was published in the professional journal for ophthalmologists - one that had been skeptical of vision therapy. That's an important indicator of acceptance by the medical community of the scientific evidence supporting vision therapy. Optometrists have long known its value. We've seen positive results every day in our patients, for more than 75 years. Now, more general optometrists and medical practitioners recognize the benefits of what we do. That's so encouraging - and such good news for patients whose doctors who are influenced more by rigorous evidence than anecdotal tradition."
A little background here, about "sight" and "vision."
Sight is the ability to see - for our eyes to focus on objects. General optometrists treat sight problems (blurred images) using compensating lenses - contacts, spectacles or in the case of laser surgery by ophthalmic surgeons, by reshaping corneas to change how light refracts through the lens of the eye - so we can "see" better. Sure enough, that approach works well for most people. Students can read their books and what's written on the teacher's white board; athletes can see their goal posts, baskets and targets; drivers can see street signs and spot traffic hazards.
But sometimes, "seeing" is not enough. When our eyes don't play well together, "vision" suffers. "Vision" is the larger picture - a picture whose clarity depends on how our brains process the images from our eyes. When the images mesh, we see in three dimensions; our "vision" is complete. When one eye doesn't track properly, or when one or both eyes don't change focus quickly between near and far objects, the brain processes just the better image - or strives, futilely, to mesh dissimilar images. Headaches, nausea, dizziness, blurred vision and double vision can result, producing poor eye-hand coordination, learning difficulties and often, if untreated, psychological and behavioral problems.
When that happens, children can be mislabeled as learning disabled, slow learners or victims of attention deficit/hyperactivity disorder. In too many cases, medication is prescribed, treating the symptoms of the disorder and missing other important contributing factors. Frequently, the underlying cause may be a treatable, and curable, vision imbalance.
For many, that cure is vision therapy. It's not for everyone, of course. Vision therapy won't do a thing for glaucoma, detached retinas, macular degeneration or other diseases of the vision system. Similarly, ordinary optometric examination and prescribed corrective lenses are usually sufficient to improve the eyesight of patients whose binocular vision is in balance.
Optometrists trained in the specialty of behavioral or developmental optometry take another giant step: They also check how well their patients' eyes work as a team, how well the brain interprets information from the eyes and how vision affects that person's quality of life.
Walt Receconi O.D., of North Coast Vision Center in Astoria, trained under Laukkanen. Receconi routinely tests for vision acuity and prescribes corrective lenses, but as a behavioral optometrist, he also screens for defects that can be helped by vision therapy. Some examples:
• favoring one eye over the other
• mismatch between eye and hand dominance
• seeing similar characters backwards (b as d, p as q, E as 3 - and vice-versa)
• faulty depth perception
When patients show any of those symptoms, Receconi provides training lenses, conducts in-office exercises and teaches simple exercises for patients to do at home. He monitors progress to see if more in-depth, concentrated treatment is needed, referring them to the PUCO clinic in Forest Grove for additional treatment. "We're lucky," Receconi says. "PUCO is one of the two top places for vision therapy in the country, and it's less than two hours away."
Most of Receconi's vision therapy patients are school-aged, brought by parents who suspect their child needs help. "Which is terrific," he says. "Vision imbalances treated early are easier to treat because young vision systems 'learn' faster than adult vision systems. It's trickier for adults. They've learned to compensate for compromised vision, so more effort is needed to retrain their eyes to work together well - and for their brains to unlearn faulty image processing."
Receconi hastens to add, "But anyone with vision imbalance problems can be helped by vision therapy, at any age."
Hazel Dawkins, principal author of "The Suddenly Successful Student and Friends," heartily agrees. At the age of 7, she had surgery to straighten an in-turning eye. In a few months, that eye had turned out, and for the next 40 years, she was functionally blind in that eye. In her late 40s, Dr. Ellis Edelman, a behavioral optometrist in Pennsylvania, explained that the blindness in her "bad" eye stemmed from her brain shutting down the input from that eye because it didn't fuse with the input from her "good" eye. After a few months of vision therapy, Dawkins was able to hold her out-turning eye straight and her stereo vision greatly improved. Exhilarated, she concluded that others needed to hear the good news that vision imbalance problems can be corrected without surgery. "The Suddenly Successful Student," first published in 1986 by the Optometric Extension Program Foundation, was the result.
The fourth edition of Dawkins' book (a perennial best-seller for the OEP Foundation) adds even more information about the wide-ranging value of vision therapy, available not just in the United States, but in 40 countries worldwide. And not just for vision imbalances, but also to aid recovery from traumatic brain injuries, autism spectrum, attention deficit/hyperactive disorders and migraine headaches. Dawkins' book also recounts how vision therapy hones the skills of high school, college and Olympic athletes, and professional athletes from the New York Yankees, Chicago Black Hawks, San Francisco 49ers, Dallas Cowboys and Seattle Mariners (Edgar Martinez is a prime example) - professional golfers too.
Susan R. Barry, professor of neurobiology at Mount Holyoke College, also had successful vision therapy as an adult. Born cross-eyed, a series of childhood operations uncrossed her eyes but did nothing to restore stereo vision. So she learned to live in a monocular world until vision therapy at age 48. "Fixing My Gaze - A Scientist's Journey into Seeing in Three Dimensions" tells of Barry's remarkable recovery of full stereo vision. Her poignant and pithy op-ed in the LA Times is required reading for any adult considering vision therapy.
So now, Barry, Dawkins and thousands of others, young and old - their vision greatly improved by vision therapy - are lining up to see blue people do amazing things in 3-D. Can you imagine the thrill of seeing the world in stereo for the first time?
