Building Awareness – Part 3
The Good. The Bad. The Turn.
Candy has been in our Vision Therapy program for 8 months. A well establish professional now in her early 50’s, she had strabismus surgery to correct an esotropia (inward eye-turn) during her teenage years which ended in a misadventure, to say the least. Within a year of her surgery she began to suffer from diplopia compliments of an evolving exotropia (outward eye-turn), and by the five-year anniversary of her surgery, Candy recalls suppression had set in and her left eye was “so far out there that it became useless”.
At first encounter, Candy is a charming, light-hearted, engaging, highly intelligent woman. Clearly an extrovert, she enjoys a sarcastic jab followed by a good laugh as much as anyone I’ve ever met. No matter if we’re discussing politics, aging parents, religion, capitalism, new car purchases, bad drivers, or the current state of world affairs, she’s got an opinion which is usually equal parts satire and contempt. She is joy to be around, and even more of a joy to treat clinically every week. Although our office discourages our socializing with patients, a few of us accepted her invitation to lunch (with our doctor’s permission) a few weeks back, which only further demonstrated her warmth, kindness, and sincere appreciation for the people in her life. In case you can’t already tell, I like her a lot.
Like most of us, Candy also has a self-conscious side, which doesn’t take that much investigation to locate. She has an eye-turn; and by most standards, a pretty severe one. After getting to know her through Vision Therapy, Candy shared with me the depth and impact her visual system has had on her life. She owns a double degree from the University of Texas at Austin in political science and structural engineering and growing up had many aspirations; some of which included aircraft design, architecture, and reverse osmosis. She had very high hopes, and certainly the cognitive muscle to achieve anything she set her mind to. “I went into computer programming so I wouldn’t have to look anyone in the eye” she shared one day in the most glum of tones; almost as if she were suggesting she was forced by the Gestapo of social acceptance into a career she disliked simply on the grounds of cosmesis. She goes on to share that by the time she graduated from college her eye turn had become noticeable to everyone she encountered, and she did all she could to keep herself out of public view. She didn’t date, she didn’t attempt to create new friendships, and she settled for a career that kept her face buried in a computer screen several hours of the day; although clearly she would’ve chosen a much different direction had she followed her heart. According to Candy, “somewhere in her mid-30’s” she woke up one morning and decided to just be herself. She was not yet married, she had very few friends, and still had an incredible desire to show the world what she was capable of. Within months of her 40th birthday, she went on a singles cruise and met her future husband. They’ve been married for close to 12 years and although we’ve never met, clearly he is the yin to her yang. She is happy, well-loved, and has reached a peaceful level of acceptance with respect to her appearance; so much so that her eye-turn is occasionally the topic of some good-natured fodder between Candy, her husband, and their closest friends.
For those of you who are into the values and measurements, Candy started Vision Therapy about 8 months ago, as previously stated. She measured about three diopters of myopia in both eyes, with an astigmatism to match. Her eye turn in her left eye measured between 25-30 dipoters outward, with close to 8 diopters of vertical imbalance. At the time we met, she centrally suppressed her left eye but did have solid peripheral awareness and panoramic viewing; although, even under monocular conditions had very little control of its movement.
To suggest that Candy maintains a heightened level of self-awareness and self-analysis would truly be an understatement; although, I suspect accepting the things about herself which she cannot change has been a tremendous exercise in healing. Her bubbly personality and amazing sense of humor being testament to this process. At this stage, she is fairly light-hearted about things, but clearly certain emotional nerve endings are still a bit rough. Therefore, when I started asking questions in the VT room requesting information about “how the world looks to her”, she shared reluctantly. Early on, we worked on simple activities which helped her understand what it was like to move her left eye in all directions. As she progressed, different targets and exercises have helped her engage her left eye, even under binocular conditions, to a point where she can now hold her eyes in a “straight position” for 30-60 seconds at a time. The further she progresses, the more excited she becomes at the possibility of full-time binocularity. During one particular activity this week, I ran through my usual questions seeking her current level of visual awareness from the inside looking out. What she shared was equal parts raw, amazing, insightful, and profound.
Stay tuned for the Part 4 conclusion!