Focus and visualization

I learned something interesting about myself in vision therapy this week.

I haven’t written about vision therapy here, so for those of you who don’t know, my left eye is intermittent exotropic. That means that sometimes, but not all the time, it drifts to the outside. And when this happens, my left eye turns off–I don’t see anything from it. This isn’t a problem with my eye, but with my brain. My brain is stopping using my eye, so it turns off and drifts, and this impacts my binocular vision, often without me realizing it. I don’t know that it’s turned off and I’m just seeing from my right eye. When my left eye is partially working, I have double vision.

I have been in therapy for it now for around 14 weeks, with another 20 weeks or so to go hopefully. One thing I learned a couple of months ago is that I don’t trust my vision as much as my other senses. Because I have had this problem since I was a kid, I have learned to compensate for it. Hearing and touch are my two primary means of compensating, and that’s evident in a few different ways. For example, I learned to play violin more by listening than by reading music, and I learned to touch-type rather than ever looking at the keyboard.

But this week taught me something new. We did an exercise where there were two pieces of paper, one on the wall and a smaller duplicate in my hands. The paper had coordinates around the edge using letters and numbers like the game Battleship. The therapist would call out a coordinate and I had to find the letter and say it. She’d call out a second coordinate and I had to look to the other piece of paper (wall or hand) and say it. I then had to remember all these letters as she went, and at the end say the word that was spelled.

There are a few different things addressed with this exercise. It’s making me focus near and far, back and forth. It’s requiring me to first find coordinates then to trace a line (horizontally and vertically) to find the letter. And it’s requiring me to put the word together. She encouraged me to visualize the letters and then visualize what they were spelling.

I really struggled with that last goal. Instead, I memorized the letters as I went because that’s how I was taught to spell. I memorized word spelling, and if there was a word I struggled with, I wrote it hundreds of times until I had it down. I am generally good at remembering spelling now for many words.

In this case, it made the exercise much harder because I naturally try to remember the letters and put them together, but I couldn’t differentiate between the letters and the coordinates. I memorized all of them. But because they were mixed together (two coordinates, then letter, then two coordinates, then letter, etc.), it made it more challenging to get the word. And as the words got longer, it became really hard. We stopped at six letters, by which point “flower” became “glewer” because I had substituted some coordinate letters for the word letters.

Visualization was hard in this context. What’s interesting to me about this is that I am able to visualize very well in other contexts. I read a lot, and when I read a good book, I became imaginatively immersed in it. I fully see the setting, the characters, and what’s happening as if I am there or as if I’m watching it on an IMAX screen. Also notable is that I read pretty fast, but without skimming (or skipping): I’m getting the words, but I’m diving into the scene. When I really get into the flow, I’m not even necessarily noting the individual words, but rather the scene that they’re constructing: I’m putting the sentences and paragraphs together.

This dovetails with another exercise I am doing: reading with a red/green bar screen on my Kindle and red/green glasses. I keep the green lens over my left eye, and as a result, the green bars are very hard to see through while the red are mostly transparent. This will help me develop binocular vision where both eyes are active at the same time, and my brain will learn to receive input from both eyes simultaneously and process it.

What ends up happening is that I’m focusing really hard on individual words and reading quite a bit more slowly, and the green bars continue to be pretty dark. It’s almost impossible for me to get into the scene. If I close my right eye, though, the green bars practically disappear, similar to how the red bars are all the time.

I began to wonder this morning if the problem is that I’m naturally too focused on the individual words. That is to say, maybe I’m focusing too much on those individual letters and words instead of widening my focus and seeing the whole page at the same time.

This is another thing I have been learning through vision therapy, and which my last assessment demonstrated I am improving on: widening my perspective. I have learned to compensate for my lazy eye by forcing myself to focus really hard on one point. When that happens, only one of my eyes is typically active, which is not ideal. I need to learn how to use both of my eyes, see both the point in space I’m looking at while also being aware of everything around, ahead of, and behind that point, and see the point clearly. I think this is easy for many people, but it’s quite challenging for me.

There is a psychological aspect to this therapy in addition to the physical. I am having to learn to trust my vision at least as much as I trust my other senses, which is surprisingly hard for me. My vision hasn’t been reliable almost my entire life. It’s like asking me to trust a person who hasn’t been reliable, and that’s hard. And this concept of widening my perspective so I can see the whole instead of a single point also seems to have some psychological aspects to it.

I was working hard this morning with the bar screen to not try and read the words for now, but just to keep both eyes active, keep them looking at the overall screen, and try to get both the red and green bars to be transparent. I didn’t get there, and it kind of made me nauseous. What’s happening is my left eye is turning on and off rapidly, and while I don’t perceive much change in my vision while that happens, it shifts focus and distance perception very slightly and very quickly. Think of it like putting on 3D glasses and having the 3D screen do a strobe effect of turning the 3D effects on and off, but probably a bit less dramatic because my brain is struggling to process it.

Which is really the crux of the matter: my brain is getting overwhelmed with the processing. Like any muscle, I can develop and improve this. It has been done before, and I will do it also. But like most exercise, it is hard and takes time.

I have already showed a lot of improvement. In many areas, I went from outside the desired norms to having normal vision and function, so that’s pretty cool. My drawing is a bit better. I noticed a few weeks ago when we were at a park that I’m better able to watch Simon and also appreciate everything around us–I’m seeing the foreground and background of the point at which I’m looking more than I was before.

But I’m also reflecting on what this says about me as a person beyond what’s going on with my vision. The way I absorb letters to construct words, and the way I put together words into a sentence, and the way I combine words and sentences into meaning… I feel like that hints at something about how I perceive and interact with the world. It likely says something about how I approach my work.

I don’t yet know exactly what it says. This light bulb just started to come on and I wanted to write it down so I could reflect more on it later. But I sense that there’s more to this, and I think understanding it will help me improve both my physical vision and my mental and imaginative vision.