I spent the past few days focusing on fusion--primarily with a four diopter prism.
I am tending to the accommodation problem in the background, but mainly focusing on fusion.
That seems to have had very significant payback in a very short amount of time. It's incredible. I just noticed that when doing the Brock String--the double images were closer to one another than ever before. It was quite striking.
I was thinking about it last night, and sort of had a cognitive shift, and the thought occurred to me 'of course this is what I should be doing!'. Getting the lazy eye accustomed to work, and actively pointing at things. It is a high-level behavior, which possibly has downstream effects concerning the accommodation issues I've had. That's what my experience has been.
It seems vision therapy is a combination about tending to the micro as well as the macro. Micro: getting each eye to work on its own. Focusing on individual accommodation. Macro: focusing on the activity of fusion, which encompasses all subskills.
You have to develop the subskills to a passable standard. But at some point, you have to really work on fusion. And then the fusion macro skill will bouy the other subskills, and cause them to self-sharpen. I've spent the past two or three months uselessly sharpening the subskills to death, seeing marginal improvements, when I really should have been putting the emphasis on fusion. I'm going to do that for a month and see what that does. Not going to mess around with trying to decrease prism power. Only going to focus on fusion, and see where that takes me.