Vision therapy progress: Maybe little efforts are a big deal after all

Stella's newly repaired glasses were a perfect complement to her owl costume.

So, my 26-month-old Stella has been patching for three months, and doing vision therapy for almost two months now. We do 20 minutes (30 or even more if we’re really, really lucky, 10 to 15 if we’re not) of vision therapy exercises at home five days a week, and we go into the office for a 45-minute session with Stella’s vision therapist once a week.

Stella has made obvious strides. Many fine motor tasks, like puzzles, are simply much, much easier for her, even when just using her ambylopic eye. She has more patience and confidence with such challenges–a wonderful side benefit to vision therapy and/or the product of more reliable vision. She’s taken to completely filling up a pipe cleaner with foam beads (they’re about a half inch wide with a tiny hole in the center). But when we first tried this exercise a little over a month ago, she couldn’t thread a single bead without tossing it in frustration. Catching a balloon is now pretty darn easy  for her, whereas not long ago she avoided it completely. One of our current efforts is catching feathers, which she really enjoys and is mastering despite the added challenge of the smaller, more erratic targets. Some of the progress may be due to the daily practice, and some to the natural advancements in skill that come with each additional month in age, but the smoothness and confidence of her motions tell me that her eyes have become better guides, too.

Those bits of improvement were clear. But then, during last week’s office session, her progress was illuminated. Our vision therapist brought out the quoits vectogram, used to encourage stereopsis, and discussed in Fixing My Gaze by Susan Barry. Stella donned polarized glasses, comically large and round, over her own specs. I did the same with my sunglasses, perhaps helping to secure her cooperation–especially after we smiled at ourselves in a hand mirror. (One of many subtle but clever tactics employed our vision therapist.) A good explanation of this exercise can be found on page 115 of Fixing My Gaze: “A vectogram consists of two clear polarized sheets, each containing a similar image… When the viewer is wearing polarized 3D glasses, each eye sees the image on only one of the sheets. To see just one image of the rope circle, he or she must fuse the right- and left-eye views.” The moment felt large. Would Stella see the rope circle in 3D?

I held my breath while our vision therapist presented the sheets to Stella, first right on top of each other, then slowly moving them apart and then back together, pausing to ask Stella was the “cookies” were doing. But Stella didn’t have to say anything, really. What she saw was obvious. Stella tried to grab the ring, clearly grasping at what she thought was a three-dimensional object in front of the cards. Then, in response to the therapist’s movement of the cards in the other direction, Stella reacted excitedly, and ran around to look behind the cards. She’d experienced the illusion of the ring shooting back behind the cards toward the therapist. Her brain fused the images from both eyes! Seeing the rings move back, noted the therapist, is actually somewhat difficult. So the fact that Stella was able to do this is quite encouraging! My heart swelled.

Seeing strong evidence of 3D vision was wonderful, but of course, Stella is still patching. We’re still chugging along on her course of vision therapy. The vision therapist reminded me that we want her ambylopic eye to achieve the best possible acuity, so 20/20, not just some level of improved acuity, before we ditch the patch and dive completely into binocular exercises that will increase eyes’ ability to work together consistently. Though much work lies ahead, I’m buoyed, and thrilled for Stella. She’s been an absolute trooper through it all, rising to every new challenge with unexpected levels of acceptance and determination. I’ll put aside, for now, the sky-high rate of glasses breakage and just say how proud I am of Stella. I really am. It’s not easy for a 26-month-old to focus for a solid 30 minutes, moving from one challenge to another, but with some cheerful insistence, she does it regularly. Her new catch phrase seems to be, “I can do it!” Or the more celebratory, “I did it!”

Not so long ago, upon sorting through every picture of Stella ever taken, I made the realization that Stella’s eyes have been intermittently misaligned for just about her whole life–much, much longer than I’d initially believed. Shortly after beginning vision therapy, I’d find myself on my hands and knees for ten minutes at a time, on the verge of tears and begging and pleading with Stella to please, please catch the balloon. As parents, especially of children with vision problems, we are constantly investing our time and energy in seemingly minuscule efforts to help our kids. Simply keeping Stella’s glasses on, and patching for the minimum prescribed period of time each day, is sometimes all I can handle (and barely). A feeling of futility can creep up. Exasperation. Maybe exhaustion. As I color toothpicks with markers, I wonder, is this even making a difference? Is all of this worthwhile? To both of those questions, at least for now, I’m answering with an exuberant “Yes!” More frustrating moments are no doubt ahead, but hopefully they’ll feel a bit less, well, pathetic.

Because everything we’re doing for them matters. It helps. Every little thing.

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7 responses to “Vision therapy progress: Maybe little efforts are a big deal after all

  1. Pingback: Hoo! Boo! And booyah, too! « The Life and Times of Stella·

  2. I LOVE LOVE LOVE your owl costume and may have to do a version of it next year =) Great job with the therapy!!! These activities are not only good for vision, but are awesome for academics. As a kindergarten teacher, I hope all kids have parents who will do these things with their children. My daughter also loves the mazes, hidden pictures, popping bubbles with a paint brush and hitting a suspended whiffle ball with a bat activities. Your post made me want to read Fixing my Gaze. It is on my to do list, just need to get it done now! =)

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  3. Pingback: Another look at full occlusion, and why we patch with tape instead. « little four eyes·

  4. Pingback: The eyes don’t have it. « The Life and Times of Stella·

  5. That is absolutely good news… I now how happy you are to see your child improving with her eye condition. It is such a pain for us parents to see our kids struggling from eye problem especially at a very early age. I pray that Stella will get well soon and get read of those eye glasses.

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