Motor vs. Perception – Part Two

I seek to provide Vision Therapy at the highest level; to offer my patients the best, most impactful, quality of life-changing, “I can’t believe how much this helped” care available. That’s how serious I take it. There are small moments in VT, usually during the most unexpected times, when I feel like I catch glimpses of that level of care.  Moments of “wow, did that really just happen?“. “Did I really just help that patient reach those results?” It’s a pretty awesome feeling!

Then again, I also have moments when I realize it would be best to follow the sage advice once offered by one of my most beloved optometrists when he affectionately suggested my goal for that particular day be to “suck less“.

Yeah, I have those days, too.

In Part One we discussed how Motor and Perception not only drive each other, but also how they benefit for each other, which are both important concepts to remember.  Also key to providing good therapy, at least in my mind, is figuring out how to address any given need with the activity you’re currently working on. So, here’s a few challenges to consider:

  • Can you think of how you might turn walking the Lowman Beam into an accommodative activity?
  • Can you find a way to work Visual Discrimination with the while working vergence ranges on the vectograms?
  • Is there a way to work Visual Sequential Memory while practicing saccades on a Hart Chart?
  • How could you turn monocular prism jumps into a visual-motor integration activity?

The good news for all of us, there’s really no wrong answer. As my dear friend Linda Sanet suggested to me long ago, the only wrong answer in Vision Therapy is placing a patient in dissociated prisms and sending them to play in traffic, which is pretty funny when you think about it.

As an aside,  I have stolen Linda’s line and recite it to other therapists often. Sorry, Linda 😉

My point is there are many possibilities and many ways to approach different areas, no matter where they’re rooted. In reality, the processes are so tied together we must always consider the idea that we’re working many aspects at once.

Check this out:

To understand the importance of the connection between motor and perception, it’s important to understand how the connection works. Let’s break it down into three easy to understand steps:

First, there is the input, which is commonly referred to as “taking the picture”.  The function of the eyeballs in this process is to take a clear and single picture for the brain to interpret. Major factors which contribute to an efficient process are the ability to coordinate eye movements both to the left and right, to point the eyes in the same place at the same time, to focus the eyes accurately, and to efficiently hold the eyes on a given target, such as page of words. Any challenges or inefficiencies in these areas can cause the target to appear blurry, or double, or words can “swim”.  Ask yourself how this person is going to perceive the world…

Second, there is the processing piece, which is where Vision Therapy becomes so powerful. In this stage, the brain is charged with interpreting the pictures the eyeballs have captured. If the pictures are clear and single, and accurate from second to second, generally there tends to be no challenge. But if someone struggles to keep the picture clear, or the coordination is tough making the picture occasionally go double, or cannot make efficient jumps from word to word, the picture becomes a bit tougher to interpret. Or perhaps even more challenging is when the picture captured by the eyeballs is inconsistent due to fatigue, changes in working distance, or perhaps a muscle weakness. Although the target (i.e a commonly known word) may be the same in consecutive sentences, the interpretation of the word becomes a new experience every time due to an inefficient input system, making the understanding of that same word different every time.

The last step in this process is the output system, which is generally where most symptoms manifest.  The person has to create a reaction, be it reading, writing, catching a ball, or driving a car.  Obviously, this is all impacted by the input and the processing.

As a parting thought for this post, think about how amazing a system we’re working with. Input, processing, and output occur within nanoseconds over and over and over again – millions of times per day.  It really is quite incredible.

Stay tuned!  For a finale, we’ll look at some of my favorite practical applications which work many areas simultaneously. Until then, ponder this:

Everything affects everything 🙂


Posted on February 2, 2016, in From My Perspective.... Bookmark the permalink. 2 Comments.

  1. So helpful! Is there a part three?


  2. Really enjoyed reading Part 1 & 2!! Looking forward to Part 3!!


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