Reaping the rewards of focusing on fusion

Not much to say here.  I've seen quite a lot of improvement in the past month or so.  Way more improvement than what was seen from when I initially started using prisms with the fixation exercises way back in October (I think?).  Indeed, changing my focus to fusion was the right approach.

Focusing on fusion appears to be what is needed to ameliorate the accommodation out-of-sync issue.  Apparently practicing fusion with exercises causes my brain to want to practice fusion in real life for the most time, and so the real healing of the accommodation reflex occurs outside of exercise.  

Not sure how much time is left, but the changes that I'm seeing are real.  The changes with the double vision on the Brock String exercise is incredible.  They are so much closer to each other than they ever have been.  And the amount of prism that I can use and still comfortably practice fusion with the fixation cards is down to two--not like before, because I was forcing accommodation, but I'm genuinely on a two now.  

I'm also getting the impression that the Vivid Vision is starting to work on me.  I suppose I think that you need a certain amont of alignment for it to work.  Not sure whether that's true, but it jives with my knowledge for now.  I'm sanguine and looking forward to the changes that I anticipate in the coming weeks.

I have simplified my regimen a bit.  I removed the Columns workout and the acrylic accommodation sheet with concentric circles.  I think the fixation cards with the prisms are doing the heavy lifting these days. 

Focusing on fusion appears to be the right thing

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.

Focus on fusion

I think I started removing prism diopters too quickly.

I notice that when I'm at the right level of prism adjustment, the exercise with the fixation cards is a very different thing from what it is when I don't have enough.  I get really close to fusion.  And fusion/not fusion is a binary thing.  You're either fusing or not.  So there is a chasm of a difference there.

When there's not enough prism, I have to focus a lot on accommodation, which really defeats the point.  I suspect that I might have wasted a few months of vision therapy because I jumped the gun with the prism reduction.

I think I'm going to go back to the four diopter prism and really practice fusion, and I'm not going to move forward until I can still get fusion comfortably with a lower diopter prism.

A nice chat with Shane

Yesterday I talked on the phone with Shane, a member of the DIY Vision Therapy group.  I was interested in him because of a Facebook conversation we had earlier about the ketogenic diet.   I mentioned that the energizing effects of the ketogenic diet seems to have a positive effect on my vision.  He mentioned in that conversation that he knows of two others who claimed that their eyes had straightened themselves out while on the ketogenic diet.

So we talked for about an hour on the phone.  We started basically with where we live.  He's from Canada (I forget exactly where).  I didn't get his age--not really important.

His condition is interesting, and sort of unusual.  I was looking at his pictures as we were talking and commented that he looks normal, and that pushed me to ask 'do you have strabismus?' to which he answered yes.  Apparently his strabismus is on and off.  So sometimes his vision really looks normal--like a normal person, and sometimes, especially when he is tired, he gets rather significant exotopia--I couldn't wager a guess as to how many diopters, but it's significant.  He said that his eyes are aligned maybe 50% of the time.

And interestingly he has full stereoscopic vision when he is fusing, and he is able to resolve Magic Eye puzzles, which is the ultimate test for stereopsis.

Like many others, Shane developed strabismus.  I'm growing increasingly aware of those who were born with normal vision, and who had normal vision as children, but who got strabismus later.  Shane got strabismus, I think when he was in fifth grade.  I forget exactly the details, but apparently he got really, really sick, and got a fever of 104 degrees F.  After that, he started getting exotropia periodically.  He did mention that he thinks that perhaps vaccines which were given to him caused his strabismus--something to do with mercury and aluminum getting past the blood-brain barrier.  I sort of doubt it's the vaccines, and possibly to do with damage done by the illness.  There could possibly be a genetic component as well, since he mentioned he has a cousin with strabismus.

We did talk a bit about drugs and the ketogenic diet.  Shane has used Ritalin and Adderal to treat his ADHD.  He noted that he had no vision problems when he was on Adderal, which is speed.  But he had to stop taking it because it was destroying his teeth.  He also used Wellbutrin for some off-label use, and said that it also seemed to have positive effects on his vision, although he stopped since it seemed to have a lot of side-effects.

I noted that the ketogenic diet--when you're really in ketosis--appears to have some antidepressive effects.  That is, the feeling that I have when I'm in ketosis is familiar and similar to the feeling of being on an effective antidepressant.  [As an aside, I have had experience with depression (basically my entire life) and antidepresssants (for about three years).  I no longer have depression and haven't needed antidepressants at all for about two years.  Obviously there's more to be said there, but that's a long aside.  Main point, I have some experience with these drugs.].  Interestingly, I have heard of papers in which researchers have combined antidepressants with vision therapy with positive results.  It is my understanding that some of these antidepressants can improve neuroplasticity.  They definitely improve mood.  For me what's interesting is how similar the feeling is between being on a well functioning SSRI and being on the ketogenic flow.  It is a very specific feeling, and it feels great.  It's coupled with very high levels of feelings of well being, focus, cognitive energy, easier breathing, diminished appetite, and diminished sex drive.  And I notice that it appears to have a positive effect on vision therapy.  So I wonder what's going on with a ketogenic brain, and why the effects seem to be so similar, at least for me.

[edit: I did some research and found that there have been some findings on the antidepressive effects of a ketogenic diet]
https://www.ncbi.nlm.nih.gov/pubmed/15601609

Shane did mention that he knows of two others who mentioned that their eyes straightened out while in the ketogenic diet, but we didn't really get into any details of that.  They're people in some zero-carb Facebook group.  I just joined the group, so I'm going to investigate a bit more.  There are 10,000 members... so it should be interesting.

I guess what's notable about the past three paragraphs or so is the idea that there are things you can put inside your body which can possibly influence and improve your ability to fix your vision.  More work for me.  More stuff to look into.

Aside from that, he did ask me a number of questions regarding vision therapy, like 'is it effective', and surgery and LASIK, and whatnot.  I basically said that surgery sometimes works, but it's risky.  I told him that vision therapy definitely works, but there are a number of caveats.  And that was basically the extent of the conversation.  It was pretty good.  Pretty interesting and eye-opening.  Heh.  And with that awe-inspiring paragraph, I will now stop writing.

Slowing down

I think I got a little too excited a number of entries ago.

I'm not sure what's going on, but it seems almost like I'm going slightly backwards--but not quite.  Before I was talking about how I was quickly going down in prism, and that I was basically working with two diopters to zero prism, and I was using this focus/fixing technique to stretch the accommodation reflex to where it should be.  Well today I had to go back to the four diopter prism.  I probably wasn't ready to go down in prism just yet.

Anyway--strangely--I think things are still improving though.  Some things involving Vivid Vision.
But yeah, I'm going to sort of move according to my current abilities so that I can achieve the focus/fixing technique, which seems to work.  Important not to get ahead of myself.  That's the whole point of prisms.

What seems to be happening

There are a few things that I'm noticing that are happening.  I'm still seeing improvement, but also changes in unexpected ways.

One thing is that I'm correcting more for my hypertropia.  This makes sense because I'm not ever doing any exercises which accommodate for my hypertropia.  I suspect it's happening because my esotropia is improving so much, and that's decreasing my suppression, and so the result is that what's  standing out the most is the hypertropia, which jumps out into the foreground, and so it's on me to actively combat it.

Another thing that's unexpected is that I'm able to get up to the second to highest level in the fixation cards.  I'm not quite there yet, but I saw a level of improvement that was unexpected.  That begged the question 'just how much divergence does this require?'.  Of course, that requries finding out my IPD, which I just did, using this mirror method.  My IPD is 66 mm--50th percentile.  Dead average.  Then I measured the distance between the targets on the second to the top, which is about 55 cm.   The very top is something like 70 mm, so I don't anticipate ever being able to get the top targets.  Doing so would require going exo.  But it does at least makes sense that the second to the top is achievable--and actually surprisingly achievable.

That's what's really so surprising--how much ground I'm covering in such a short amount of time.  It's freaky.  It's like every time I get excited about how fast I'm moving, something else puts it into perspective, and I'm reminded that yes I'm covering a lot of distance, but there is a lot of distance to cover, and you're not done yet.

The degrees of freedom are opening up.  It's getting easier and easier to diverge and converge and focus on different things, but it should be very easy to get everywhere.  There shouldn't be some default area where my eyes want to situate themselves which makes it harder for them to go in some areas than others.  The resting place should be neutral, and my eyes should go from one place to another with facility.  I'm not there yet.  There is still some tuning of the accommodation reflex that is required.  That is apparently my key to a neutral binocular posture.  A more neutral posture will then enable antisuppression exercises to really be beneficial.  That will make the hypetropia even more obvious, which I will then tend to.  And it will go into a cycle, which tightens up until I have a totally neutral posture with no angular deviation.

Steady progress

Seems like I slowed down in the past week or so.  For a while there it seemed like progress was occurring extremely quickly.

To be clear, I still think I am making rather smooth progress.  It is just that the perceived improvement isn't always so smooth.  That is one of the benefits of doing so many different exercises.  Vision therapy exercises, almost by definition, provide you a meter with which to gauge progress.  Having a variety of different gauges is very beneficial for letting you know whether you are truly stuck, or just having a poopy day.

Actually all of my gauges are pointing to smooth incremental improvement.  The prisms and fixation cards.  Check.  I'm now vacillating between two diopter prism and no prism.  I'm still working with that technique that I talked about before with getting good accommodation on the right eye, and focusing on fixation with the left.

I am noticing improvement about every day.  It is a very incremental thing.  Every day it takes less time to get equal acccommodation across the eyes.  I've been experimenting with different 'fuse' 'focus' sets, from the bottom, to the bottom middle, to the top middle.  I doubt I'll ever be able to fuse the top set because I think that would require going exotropic.  I'm fairly certain that my eyes are straightening out, steadily.

I've been noticing this in particular with my modified Brock String.  Diverging out to the last string has always been--not necessarily a pain in the ass--but it always required effort.  Now it's pretty easy.  In fact, going from each bead to the other has become very--quite--easy.  Also moving the bead around my entire field of vision is seeing improvement.  The distance between the double beads is getting smaller and smaller.  Yeah, I keep saying that.  But it's true.

Finally--oh yeah, I can't talk about Vivid Vision.  I am working on it.  It is software for people with strabismus.  It, like other vision training, provides feedback.  I'm seeing improvement in that as well.  Alright.