DrG

If yes, then it is unrelated to binocular eye cooperation problems, as using
one eye eliminates that.

If the blur is gone, try the other eye – is the blur related to one of the
eyes (probably not.)

If there is still dizziness with one eye covered, try closing BOTH eyes. If
there is still dizziness, then it is definitedly NOT related to the eyes,
and they are out of the picture when they are both closed.

Regarding Dr. Judy’s comment that she does not have binocular vision – may
not be entirely true.
if the muscle surgery (sounds like a transposition of Foster procedure for
total 6th nerve paralysis) was successful, and the eye is aligned in primary
position, even though there is lateral gaze limitation, there is no reason
not to have binocular vision where the eyes are aligned. Of course, if the
visual axes do no line up at all, then, no, there is no binocular vision.
These muscle procedures can restore or increase the field of single
binocular vision, or move it more towards the center, although the extent
will be limited.

David Robins, MD
Board certified Ophthalmologist
Pediatric and strabismus subspecialty
Member of AAPOS
(American Academy of Pediatric Ophthalmology and Strabismus)

On 12/14/04 8:49 PM, in article
20041214224955.11961.00001…@mb-m16.aol.com, "Dyhibb" <dyh…@aol.com>
wrote:

- Hide quoted text — Show quoted text -

> On September 1, 2002, my wife had an accident which resulted in a severe brain
> injury to the right side of the head. One of the results of the injury was the
> left eye turned towards her nose and would not move toward the center. She had
> two surgeries last year and the eye will now move to just left of center and
> all the way to the right.

> She has been complaining of getting very dizzy  mostly when she is standing or
> walking but sometimes when she is sitting.

> She was checked out by a neuro-opthomologist and he said the current
> prescription for her glasses was still fine and said that she may still be
> recovering from the surgery she had in October to put in a skull plate.

> Then she was checked out by an audiology specialist and he asked her to
> describe her dizziness and decided it was more of a blurred vision problem.

> We are waiting for an appointment for her to get some "vestibular testing" but
> after doing some research on the internet, I am wondering if I should skip the
> vestibular testing and get her an appointment with a "functional optometrist"
> or "neuro-optometrist" instead of going back to a neuro ophthalmologist.

> Also, I came across some web sites that sell software for vision therapy. Are
> these programs any good?

> Any comments appreciated.

> Thanks, David

> If there is still dizziness with one eye covered, try closing BOTH
eyes. If
> there is still dizziness, then it is definitedly NOT related to the
eyes,
> and they are out of the picture when they are both closed.

Dizziness is ALWAYS created by the eyes.

Now you see how these doctors are completely ignorant of the truth?

This test is very easy: if he feels dizziness with eyes closed, the
answer is that with eyes closed the strain is most.

The patient should learn some methods for resting his eyes and mind and
find a way to improve his condition.

Little improvements bring forth big improvements.

Eyeglasses must be avoided.

http://TheCentralFixation.com

The brain injury described (so vaguely) does suggest DAI (diffuse axonal
injury) did arise. DAI is a very useful marker for damage done via TBI.
There are some scans that can detect DAI, that may be worth persuing but it
will only confirm DAI, not much that can be done about it. Vision problems
are not uncommon post tbi though the exact reasons remain unclear. Dizziness
also occurs post tbi.

2.

Don’t skip the vestibular testing, should at least be checked out.

3.

The internet is replete with miracle cures, enter at your own risk. Caveat
emptor.

4.

Does your wife *always* experience double vision and dizziness. There may be
some merit in trying to determine what makes it worse, the frequency of the
symptoms and any correlations noted. Did the symptom appear before the
corrective surgery?

5.

Given the injury you should consider some dietary changes that may aid
recovery. Nothing spectacular, mostly common sense, but post TBI some
dietary changes can be beneficial for recovery. Don’t fall for the "miracle
herbs fallacy", in fact don’t even try the same without first consulting the
doctor. Some non-traditional forms of therapy can help but you need to be
very careful about this. MUCH wiser to go for an optimal diet that
facilitates brain recovery.

http://www.neuroskills.com/index.shtml?main=/edu/ceumtbi18.shtml

Check out in above link: Vision and TBI under directories pull down menu on
the left.

http://www.brainplace.com/bp/prescriptions/default.asp

This site has a variety of links related to keeping the brain healthy.

"Dyhibb" <dyh…@aol.com> wrote in message

news:20041215095916.21876.00001851@mb-m14.aol.com…

- Hide quoted text — Show quoted text -

> >rusht…@aol.com (Rushtown) wrote in
> >news:20041215013758.08274.00002079@mb-m05.aol.com:

> >>>and get her an appointment with a "functional optometrist"
> >>>or "neuro-optometrist" instead of going back to a neuro
> >>>ophthalmologist.

> >>>Also, I came across some web sites that sell software for vision
> >>>therapy. Are these programs any good?

> >>>Any comments appreciated.

> >>>Thanks, David

> >> Stick with MDs—but change if you are not satisfied.
> >> (This isn’t really an eye problem but a neurological problem)

> >Aw, gee thanks for the vote of confidence in optometry.  Now just what is
> >it that the neuro-ophthalmologist is going to be able to offer?

> >People go through rehab with phycial therapists all the time following
> >"neurological" injuries.  The neurologist doesn’t conduct the PT.  Same
> >relationship holds in this situation.

> >DrG

> Below is a paragraph from one of the web pages I found while looking
around the
> net. I found some of the statements very familiar except in our case there
is
> no litigation involved and my wife’s vision is blurry not  double vision
> (unless the double vision is so minor that it just makes her vision seem
> blurry).

> The following paragraph is from the web site:
> http://www.headinjurylaw.com/vision2.htm

> The software of the visual system consists of the neural wiring of the
optic
> nerve, the optic
> chiasm, the optic tracts and their offshoots, the lateral geniculate
nucleus
> (LGN) of the
> thalamus, the optic radiations from the LGN and the visual cortex located
at
> the back of
> the brain in the occipital lobe. The wiring is made up of thin, delicate
axons
> and the visual
> processing units in the LGN and visual cortex consist of tiny living cells
with
> fragile
> membranes. The axons are vulnerable to stretch/strain damage and the cells
are
> vulnerable to shaking or perturbation which can damage or kill them.
Closed
> head trauma
> causing "mild tbi" (with minimal or no loss of consciousness) frequently
> traumatizes the
> software of the visual system with disruption of binocular vision such as
> blurry or double
> vision. However, closed head brain trauma which damages the vision
software
> causes no
> detectable mechanical damage to eye structures and no cranial nerve damage
with
> easily
> detectible strabismus or hyperopia. The patient’s eyes look fine. He can
still
> read an eye
> chart. His brain shows no bleeding on CT or swelling/compression on MRI.
In
> such cases,
> and there are many thousands every year, the typical ophthalmologist
chalks up
> the
> patient’s complaints of double vision to "hysteria" or "malingering,"
> especially when they
> learn a claim has been filed. This not only wounds the feelings of the
patients
> (who know
> they are telling the truth, their vision really is double) but deprives
them of
> necessary
> treatment and may ruin their personal injury lawsuit or workers
compensation
> claim
> without good reason.

> Thanks, David

Thanks for your suggestions.

David

- Hide quoted text — Show quoted text -

>"Dyhibb" <dyh…@aol.com> wrote in message
>news:20041214224955.11961.00001619@mb-m16.aol.com…
>> On September 1, 2002, my wife had an accident which resulted in a severe
>> brain
>> injury to the right side of the head. One of the results of the injury was
>> the
>> left eye turned towards her nose and would not move toward the center. She
>> had
>> two surgeries last year and the eye will now move to just left of center
>> and
>> all the way to the right.

>> She has been complaining of getting very dizzy  mostly when she is
>> standing or
>> walking but sometimes when she is sitting.

>> She was checked out by a neuro-opthomologist and he said the current
>> prescription for her glasses was still fine and said that she may still be
>> recovering from the surgery she had in October to put in a skull plate.

>> Then she was checked out by an audiology specialist and he asked her to
>> describe her dizziness and decided it was more of a blurred vision
>> problem.

>> We are waiting for an appointment for her to get some "vestibular testing"
>> but
>> after doing some research on the internet, I am wondering if I should skip
>> the
>> vestibular testing and get her an appointment with a "functional
>> optometrist"
>> or "neuro-optometrist" instead of going back to a neuro ophthalmologist.

>Dizziness is almost always due to a vestibular problem, get that done first.

>Vision training by optometrists is directed primarily at improving binocular
>vision.  Your wife does not have binocular vision due to major damage to the
>6th cranial nerve which controls the lateral rectus of her left eye; the
>muscle is not working and will not be made to work with vision training.
>Sometimes the nerve recovers after injury, recovery may take months to
>years.   The neuro ophthalmologist who knows the details of your wife’s
>injury and surgeries can tell you whether any recovery is expected.

>> Also, I came across some web sites that sell software for vision therapy.
>> Are
>> these programs any good?

>Usually these programs are used in conjunction with a vision training person
>(either optometrist or occupational therapist) who knows the details of your
>wife’s injury and could tell you whether a program would work and recommend
>a specific one.   Again, most are directed at improving binocular fusion
>which your wife will likely not achieve due to the nerve damage.

>Dr Judy

>> Any comments appreciated.

>> Thanks, David

news:20041214224955.11961.00001619@mb-m16.aol.com…

- Hide quoted text — Show quoted text -

> On September 1, 2002, my wife had an accident which resulted in a severe
> brain
> injury to the right side of the head. One of the results of the injury was
> the
> left eye turned towards her nose and would not move toward the center. She
> had
> two surgeries last year and the eye will now move to just left of center
> and
> all the way to the right.

> She has been complaining of getting very dizzy  mostly when she is
> standing or
> walking but sometimes when she is sitting.

> She was checked out by a neuro-opthomologist and he said the current
> prescription for her glasses was still fine and said that she may still be
> recovering from the surgery she had in October to put in a skull plate.

> Then she was checked out by an audiology specialist and he asked her to
> describe her dizziness and decided it was more of a blurred vision
> problem.

> We are waiting for an appointment for her to get some "vestibular testing"
> but
> after doing some research on the internet, I am wondering if I should skip
> the
> vestibular testing and get her an appointment with a "functional
> optometrist"
> or "neuro-optometrist" instead of going back to a neuro ophthalmologist.

Dizziness is almost always due to a vestibular problem, get that done first.

Vision training by optometrists is directed primarily at improving binocular
vision.  Your wife does not have binocular vision due to major damage to the
6th cranial nerve which controls the lateral rectus of her left eye; the
muscle is not working and will not be made to work with vision training.
Sometimes the nerve recovers after injury, recovery may take months to
years.   The neuro ophthalmologist who knows the details of your wife’s
injury and surgeries can tell you whether any recovery is expected.

> Also, I came across some web sites that sell software for vision therapy.
> Are
> these programs any good?

Usually these programs are used in conjunction with a vision training person
(either optometrist or occupational therapist) who knows the details of your
wife’s injury and could tell you whether a program would work and recommend
a specific one.   Again, most are directed at improving binocular fusion
which your wife will likely not achieve due to the nerve damage.

Dr Judy

- Hide quoted text — Show quoted text -

> Any comments appreciated.

> Thanks, David

http://thecentralfixation.com

Thanks, I will check it out.

David

- Hide quoted text — Show quoted text -

>rusht…@aol.com (Rushtown) wrote in
>news:20041215013758.08274.00002079@mb-m05.aol.com:

>>>and get her an appointment with a "functional optometrist"
>>>or "neuro-optometrist" instead of going back to a neuro
>>>ophthalmologist.

>>>Also, I came across some web sites that sell software for vision
>>>therapy. Are these programs any good?

>>>Any comments appreciated.

>>>Thanks, David

>> Stick with MDs—but change if you are not satisfied.
>> (This isn’t really an eye problem but a neurological problem)

>Aw, gee thanks for the vote of confidence in optometry.  Now just what is
>it that the neuro-ophthalmologist is going to be able to offer?

>People go through rehab with phycial therapists all the time following
>"neurological" injuries.  The neurologist doesn’t conduct the PT.  Same
>relationship holds in this situation.

>DrG

Below is a paragraph from one of the web pages I found while looking around the
net. I found some of the statements very familiar except in our case there is
no litigation involved and my wife’s vision is blurry not  double vision
(unless the double vision is so minor that it just makes her vision seem
blurry).

The following paragraph is from the web site:
http://www.headinjurylaw.com/vision2.htm

The software of the visual system consists of the neural wiring of the optic
nerve, the optic
chiasm, the optic tracts and their offshoots, the lateral geniculate nucleus
(LGN) of the
thalamus, the optic radiations from the LGN and the visual cortex located at
the back of
the brain in the occipital lobe. The wiring is made up of thin, delicate axons
and the visual
processing units in the LGN and visual cortex consist of tiny living cells with
fragile
membranes. The axons are vulnerable to stretch/strain damage and the cells are
vulnerable to shaking or perturbation which can damage or kill them. Closed
head trauma
causing "mild tbi" (with minimal or no loss of consciousness) frequently
traumatizes the
software of the visual system with disruption of binocular vision such as
blurry or double
vision. However, closed head brain trauma which damages the vision software
causes no
detectable mechanical damage to eye structures and no cranial nerve damage with
easily
detectible strabismus or hyperopia. The patient’s eyes look fine. He can still
read an eye
chart. His brain shows no bleeding on CT or swelling/compression on MRI. In
such cases,
and there are many thousands every year, the typical ophthalmologist chalks up
the
patient’s complaints of double vision to "hysteria" or "malingering,"
especially when they
learn a claim has been filed. This not only wounds the feelings of the patients
(who know
they are telling the truth, their vision really is double) but deprives them of
necessary
treatment and may ruin their personal injury lawsuit or workers compensation
claim
without good reason.

Thanks, David