Through the eyes of the beholders: Patients share their perspectives

Doctors of optometry recently got a view from the patient side of the examination chair.

At the 2016 Optometry's Meeting^®, that viewpoint was explored through three OD Talks presentations—inspired by the popular TED Talks–called "Through a Patient's Eyes." All of the presenters overcame challenges to their sight through the use of vision therapy, brain plasticity and echolocation–and their own gumption.

Seeing with sound

Daniel Kish is president of World Access for the Blind, a non-profit organization that facilitates "the self-directed achievement of people with all forms of blindness." Kish was born with retinoblastoma and had both eyes removed when he was an infant to save his life.

Although he is blind, Kish sees–by sound. The technique is called echolocation, also known as flash sonar. Birds, bats and dolphins use it to identify and locate what lies ahead of them.

As he entered the stage at Optometry's Meeting, Kish made a clicking sound with his mouth. He asked the audience if they heard the clicking and multiple echoes.

Echolocation is seeing with one's ears, rather than the eyes. The clicking sounds enable Kish to receive "sound flashes" as they bounce and reflect off of surfaces. They return as impressions, allowing the keen–eared listener to navigate the dark spaces. He likened the brain's ability to adapt and see differently to the loss of limb to a body: The body either requires assistance to function, or it finds another way to compensate.

"So our method essentially is to remove those proxy or surrogate methods of doing things so the brain's navigational systems and perceptual systems can return to their former glory or something like it," Kish said, noting how the brain adapts and remaining senses intensify.

Echolocation enables independence and freedom of movement—a quality and richness of life, despite blindness.

"The process here basically shows that a blind person, where the lights have gone off, can basically turn the lights back on in his or her own brain," Kish said. "We see with our brain, not our eyes."

Watch Daniel Kish presentation.

'The miracle of how the plastic brain works'

Clark Elliott, Ph.D., is a professor of artificial intelligence at DePaul University in Chicago and author of "The Ghost in My Brain: How a Concussion Stole My Life and How the New Science of Brain Plasticity Helped Me Get It Back."

Elliott suffered a traumatic brain injury in 1999 after his car was rear-ended at a stoplight. Afterward, doctors told him, that he would never get better.

"After three fruitless trips to the emergency room, I was soon struggling to get through just a single day," Elliott said. "My life was spiraling out of control from this concussion."

He couldn't will himself to initiate even the simplest actions. He needed help rising from a chair and even walking through a doorway. He felt overwhelmed, confused and unable to make decisions. He almost froze to death one cold Chicago winter when he stopped walking and was unable to move forward. Standing in the cold, he thought he would die there.

"My vision system had to take over for my damaged vestibular system," he said, "so that I could stay upright. My eyes had to take over for my ears. But this caused competition for scant visual-spatial resources, which were also, themselves, damaged."

In 2008, Elliott underwent optometric and cognitive restructuring treatment and realized "the miracle of how the plastic brain works." He told the audience, "You are not only the future of the treatment of brain injury, you are the future of neuroscience. We are primarily visual-spatial beings from the ground up. This is the basis of sensory interpretation and symbolic thought. You have all the power in the next decades to come."

Watch Clark Elliott, Ph.D. presentation.

Visual confusion

Susan Barry, Ph.D., professor emerita of biological science at Mount Holyoke College in South Hadley, Massachusetts, is the author of "Fixing My Gaze: A Scientist's Journey into Seeing In Three Dimensions."

Barry's future might have been doomed if it hadn't been for her mother's perseverance. In September 1962, she was just 8 years old. School had just started, and she was already stressed out. She was a slow reader and always worried about falling behind.

One day, an assistant principal at the school entered her classroom. A mistake had been made, and she should have been assigned to another classroom, based on her standardized test score, the principal said.

But mother knows best. She knew that her daughter's problems were about her sight, not her smarts.

"So she read to me and with me constantly," Barry said. "By the time I finished elementary school and moved on to junior high, I was placed back in a normal class."

Her struggles continued, though, despite three eye-muscle surgeries to correct her crossed eyes—something her parents had noticed when she was a baby.

She experienced visual confusion. When she read, words and photos in a book overlapped.

"I would suppress the input from one eye so I only had a single-eye view of the page and the words," Barry said. "But suppression takes time and energy." Fast forward 40 years to when a developmental/behavioral doctor of optometry in a nearby town introduced her to vision therapy and the Brock string.

"I worked very hard on my vision therapy, and over the next couple of months, space simply inflated and expanded and unfolded," she said, motioning with her arms.

"My experience has taught me that every child should have a thorough binocular vision exam before he or she starts school."

Watch Susan Barry, Ph.D. presentation.