We’re all a bit nerdy at TKS. And we’re all nerdy about slightly different things. One of my primary nerd-skills is binocular vision (BV). I find the way the eyes work together to send information to the brain, and the way the brain then interprets that information fascinating. Working with patients to fix their binocular vision problems is just the coolest thing to do, and it makes me happy.
One of the things I really love about BV is that I don’t fix people. I really don’t. I teach them the skills they need to take control of their eyes and then they fix themselves. The best bit is that they will always have the skills they’ve learned, so if they begin to notice the problem resurfacing at any point they can use their skills to get on top of things fast.
The other thing I love about helping children particularly to fix their binocular vision problems is the knock-on effect it has for other areas of their lives. Reluctant readers begin to enjoy books, messy writers become more legible and daydreamers and fidgets become more focussed (no pun intended). As I said in the previous post, I make no snake oil claims about binocular vision training, but it stands to reason that if someone can see clearly and comfortably, they will enjoy reading more, be able to write more neatly, and since they are finding these tasks easier they are likely to engage more fully in the classroom and thus appear to be concentrating more. No magic here…just clear vision.
It was the parent of a patient who first coined the phrase The BV Girl and it made me giggle because it sounded like a nerdy superhero name, and who doesn’t want to be a superhero right?
Binocular vision is at the core of everything an optometrist does.
Although sight accounts for just 20% of the five major senses (the others being hearing, touch, taste, and smell) about 80% of the way most of us experience the world is through vision.
In order to navigate this world we need to be able to identify objects, track them and perceive their depth (3D vision). In order to navigate school we need to be able to learn to read so that we can assimilate information easily and accurately.
Most people assume that all vision problems can be corrected with spectacles or contact lenses. But a surprisingly high number of children (with and without spectacles) have functional eye disorders. A functional eye disorder is where a little piece (or more than one piece) of the visual pathway doesn’t work or works inefficiently. To a child this may appear as blurred vision, difficulty tracking along a line of text, problems remembering what they’ve read, being a slow reader, difficulty catching or hitting a ball, headaches, or double vision. To an adult such as a teacher, the child might appear to be a slow worker; they might mix up words when they read; they might try to avoid close-up work like reading or writing altogether; they might become anxious or angry, stare out of the window, get up and wander round the class or distract other children.
These children are frustrating to many optometrists. In our consulting room they may appear to have great vision, reading the bottom line of the chart with ease, or conversely they may struggle to read more than half way yet when we examine them we can find nothing that requires them to wear spectacles. These children are also frustrating to their teachers, who are only too aware that they are underperforming without a seemingly good reason. And they are frustrating to their parents who are worried that their child has been labelled a ‘problem’. At the centre of this is a frustrated child, rapidly losing confidence and feeling a failure compared to their peers.
This is where a specialist binocular vision examination can be very useful. Binocular vision disorders are extremely common, but often intermittant, causing symptoms some of the time in some situations but not all of the time in all situations (at least in the early stages). Because of this these issues can be missed if they aren’t looked for specifically.
Binocular vision disorders may be helped with spectacles, contact lenses or vision therapy (kind of physio exercises for the eyes), or any combination of these. Please note that in spite of claims made in certain corners of the internet none of these solutions are a cure for dyslexia or ADHD and they are definitely not a magic bullet (though the results can seem like magic sometimes). The aim of any vision appliance or therapy is purely to enable child using their visual system in such a way that clear, comfortable, accurate vision is possible. Many children with dyslexia or ADHD may also display or develop an underlying binocular vision problem, the symptoms of which exacerbate the problems they are having with the dyslexia or ADHD! When the binocular vision problem is fixed the dyslexia or ADHD appear to improve, but in reality we’ve simply removed one problem, so they now have more energy and resources to devote the other problem.
A couple of short weeks ago I had never heard of the word, and now here I am…furloughed, along with all the team, apart from one clinican and a receptionist for emergency cover. But the word ’emergency’ has changed definition it seems. Conditions which would have been straight to Eye Casualty (do not pass go, do not collect £200) are now ‘wait and see’ or ‘monitor’. Hospitals are no longer deemed safe spaces it seems.
One good thing is that groups of like-minded practitioners are forming on FB and we’re working together to get through this, with mental health and businesses in tact. Sadly not all all practitioners are taking this collaborative approach but I’ve met some fabulous fellow optoms and ophthalmologists all keen to use the time to share and expand our knowledge.
Everyone at the practice is anxious. We’re hot on hygiene anyway but we’re disinfecting more, wiping doorhandles, computer keyboards and anything patients touch with alcohol wipes. People are becoming more frightened by the day. When I tried to buy hand gel at the pharmacist. she advised me to buy Polish Vodka and mix it with aloe gel! Only there’s no Polish Vodka, in fact there’s a national shortage of alcohol gel, hand soap, pasta, loo roll…and now Polish vodka!
I guess panic-buying makes people feel more in control.
I’m worried about my doctor and nurse friends and whaat will happen if hospitals are overwhelmed like they are in Italy.
There seems to be no other news in the entire world. I never thought I’d say this but…I really miss Brexit!
The virus which appears to have migrated from China to Italy is truly alarming. The TV footage from Wuhan, Milan and Lombardy is horrific and terrifying. Could this happen here? For years we’ve been expecting a pandemic yet no government seems at all prepared. Everyone has been caught off guard.
Dr Li Wenliang, the ophthalmologist who tried to raise the alarm about the coronavirus in the early days of the outbreak, died of the infection last week. He was a member of the eyecare profession, which makes it all a bit harder and closer to home.
As ever when I’m anxious and things feel uncertain I look for facts. I’m pretty sure I use facts like the superstitious among us use rabbit feet, horseshoes and garlic. Facts are my way of protecting myself. If I know the facts I feel (completely unjustifiably) safer. So here is my fact file so far:
The mystery virus has a name now. Viruses are named by the International Committee on Taxonomy of Viruses (ICTV). The name is based on their genetic structure which is meant to help in the development of diagnostic tests, vaccines and medicines. Yesterday the ICTV announced the name of the virus as ‘severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)’. The name was chosen because the virus is genetically related to the coronavirus responsible for the 2003 SARS outbreak.
What many people don’t realise is that a virus and the disease often have different names and are actually named by different organisations. Diseases are officially named by WHO in the International Classification of Diseases (ICD). This is because WHO’s role is human disease preparedness and response so diseases are named in order that discussions can take place about disease prevention, spread, transmissibility, severity and treatment . This disease has been named COVID-19.
I have no idea whether this will affect my clinical placement though this seems an entirely petty and selfish concern under current cirumstances.
Well I passed the second module (properly passed…satisfyingly high mark!) so I’m very happy. I should be chomping at the bit to start the clinical placement section but this virus brewing in the background, the news footage and daily NHS updates which are becoming more alarming by the day are slightly taking the edge off the celebrations. But it is what it is and we can only deal with things day by day as they unfold.