User Self Fitting (Setup)
Calibration
This section describes SETUP, this is more commonly referred to as headset to "patient calibration".
It is of prime importance that the headset is calibrated to the patient in order to get any benefit from the exercises
Your Heading
During the first step of each session this session is used to set or check the configuration of the headset with your eyes in their relaxed state.
Using the hand controllers the headset is adjusted to align the images to the eyes whilst your eyes are in a relaxed tranced state.
Sufferer's of Exotropia would move the images outward and vice versa for Esotropia.
Extra guidance for children is shown on this page
The Super Brock Exercise
The exercise here is to train eye convergence using the Brock Method.
In it's simple form. Focus on the most distant bead whilst trying to maintain convergence.
Hold that whilst counting for from zero to 5 (ie 5 seconds).
Shift your focus to the next closest bead and repeat.
While you are focused on beads along the length of the rope, an X should form where the rope perceived by each eye appears to cross at the converged bead.
When you are at the nearest bead you may push your self harder by sliding the green bead a step closer using the thumbstick.
When you have reached the limit of your convergence, repeat the above, but going from the closest bead to the furthest bead.
Repeat the above at least 5 times. Every time, trying to achieve the following:
- Speed of Convergence ie time taken to converge.
- Maintain a uniform X at each bead as you converge (tip: move your head slightly to the left or right)
- Ensure the eyes are balanced ie the vision of the left eye matches that of the right with blur and brightness.
Included in this exercise are the Quoits Add-On. The Brock String effectively becomes a Super Brock String and includes a mode containing Quoits. In the example shown below two rope rings are added to the Brock String.
The aim of this exercise, is to remain focused on the Green Bead.
Whilst gently pumping the left grip with your forefinger try to imagine the Quoit moving towards you and getting smaller the closer it is.
Conversely gently pumping the right-hand grip with your forefinger, try to imagine the Quoit moving away from you and getting bigger the more you grip that forefinger.
You are effectively telling the brain what it should be seeing.
Once trained, the Quoit will be observed to traverse to and fro' along the length of the Brock String bringing you another step closer to 3D perception.
For more information on this Equal-Eyes Exercise, click on the Link Below.
The Ball Exercise - Dynamic Tracking
This is an advanced and very powerful adaption of the Brock Exercise. As part of the Visual Therapy, the eyes are trained by tracking the ball as at travels in 3D space.
By reducing the brightness and focus of the good eye, the effort is balanced with the amblyopic eye. Over time and regular exercising, the brain will be trained through a process of building new neural pathways defining binocular (stereoscopic) vision. The exercise has a number of difficulty levels with the starter level being a simple green Ball.
The ball motion is controlled in both the Axis of Vision (backwards and forwards)
The Left-hand controller Thumbstick controls two aspects:
Ball Travel Distanced (Pulling the thumbstick towards you reduces it. Pushing it away, increases Distance)
Ball swing Amplitude.(Moving the thumbstick to the right increases circular swing and moving it to the left reduces the swing)
The right thumbstick controls the start point of the ball movement.
Pushing the Right-hand controller thumbstick away. Moves the start point further ahead of you. Pulling the Right Hand thumbstick towards you, brings the start point towards you. Be careful here as you can put the start point behind you!
Initially the motion should be confined to the axis of vision (backwards and forwards) with no Lateral (Up, down, left and right) motion until you managed to acquire a good target lock with both eyes.
From there, you may start adding Lateral Motion, Proximity to Eye and distance amplitude as your skill improves and becomes second nature.
As you advance, switching between object types will increase difficulty required to track the objects.
We recommend at least 10 minutes per session are spent on this exercise.
The Dark Room Binocular Suppression
This exercise is aimed at improving anti-suppression for amblyonic conditions.
You will be presented with image A in the Left Eye and Image B in the Right Eye. The text book image perceived for fully functional binocular would be Image D but rarely as perfect.
Image C is a typical example of what will be perceived for those with double vision or Amblyonic dysfuntion.
Typically the macular region (the highest definition part of the eye responsible for detailed vision) will occlude the weak eye and can create an image similar to Image C. (The example shown represents Right Eye Dominance)
In this exercise you are able to reduce good eye dominance as you boost the weak eye and provide you with the opportunity to focus building up the strength of your weak eye. This method differs from patching in that it is also forcing the merging section of the Cortex to work training the brain to process both images in tandem.
As you advance, you can push the image further away making the exercise harder to perform but essential as part of the course.
We recommend at least 20 minutes per session are spent on this exercise.
The Randot 3D Acuity Assessment
This vision test contains a small collection of stereo randot plates. Randot tests are defined as the definitive assessment of determining a persons 3D acquity.
Again, the assessment provides an option to weaken the image of the good eye to a degree where both eyes are providing the visual cortex of the brain a balanced left/right stereo image.
Prior to aquiring binocular 3D depth perception, it will be unlikely that you are able to perceive the embedded image hidden in the Randot pattern. This is quite normal if you do suffer with Amblyopia in its many forms.
Should you gain true binocular 3D depth perception, this test give you an illusion of a ghostly image either floating behind or ahead of the Randot Image. Although this would be hailed as a success for this program. You will still require continued exercising of the eyes to continue improvement.
We recommend you check yourself using this test weekly.
3D Games - Froggit
A child with strabismus can also have fun using this application as included is a variant of the Frogger game called Froggit.
During the games, a child can be supported by encouraging him or her to move the adjustment controls to the point where the child is able to confirm not seeing double vision with the brightness and/or blur being equal in both eyes.
The child can be helped by an adult adjusting and storing the geometric settings in the Setup Section of the App. Once done, the game can be started by the child using the stored settings and then left to the childs own devices having fun as they train.
Future releases of this application will implement more features making it more child accessible with less adult intervention.
3D Games - Grabbit
Another game has recently been added based on the Arcade Toy grabber with a joystick controlled articulated claw.
This game is a tough test of binocular acuity. The user required excellent peripheral vision and good judge of depth.
3D Games - Bubbles
This game tests 3D acuity but with a twist. All 2D Cues have been removed. So the player cannot attempt to judge depth by walking around the scene.
3D Games - Tetris3D
A remake of the Tetris game, but with a difference.
This is set in space with shooting stars whizzing by providing some peripheral stimulus. The game features nice music arranged by myself and the ability to change the skill level.
The easy level allows the use of both eyes.
The tricky level provides some subtle differences to each eye.
The hard level randomly assigns each piece to alternate eyes.
The Deadly Level is the toughest and randomly assigns each cube making up the pieces to each eye.
This is an exciting way of training and should be done after a session with the other more formal exercises.
The Tunnel
This concept of this activity was inspired by a long journey as a passenger heading up a long Tasmanian highway!
As a more relaxed exercise it stimulates both peripheral and central vision.
The exercise involves concentrating on keeping the road markings or the lights converged through the course of the journey.
The drive is accompanied by my remix of Spiral which I thought was quite apt for the tunnel.
Anti-Suppression
This activity presents you with a series of plate pairs.
The Left and Right plates both contain parts of an image that requires the eyes to converge to assemble a complete image.
Each plate pair increases in detail as you progress.
The exercise increases the strength of the weak eye over time. You will subconsciously require more detail from the weak eye for the final image to mentally make sense.
To use anti-suppression start with an easy plate. This will typically be the first plate that appears when you enter the scene. You may need to adjust the brightness or blurring to the point where a double image appears.
Using your eyes bring the images together to form a complete image. Hold that image for 10 seconds.
Move you gaze to another part of the image and repeat.
As you improve this will slowly become automatic with no dimming or blurring added.
Cycle through the plates using the A button. The plates get progressively harder repeating the proceudre.
Quoits
Quoits are circular ropes.
The function of this activity is depth acuity training with concentration tending towards a peripheral activity
The way this exercise is utilised is open to many techniques.
On a peripheral level you take in the image as a whole whilst not necessarily concentrating on the quoit but observing the entire image.
Whilst doing so, the mode of operation can be selected using the controllers and again subconsciously the quoits will, over time appear to be moving away or towards you. In 3D space the quoits are moving left to right opposing each others direction. However, they are set up in the scene so that each quoit (or quoit pair dependent on mode) are assigned to each eye eye.
Each eye has it's own view point, so as per all of the exercises in this application each eye has a subtly different image projected to it.
When in a state of total or near convergence. The brain is provided with detail to train the cortex in vision fusion.
The exercise can also be exercised whilst converging with accuracy. In this approach you would concentrate on the tennis ball in the quoit. The motion of the quoit will be observed in your peripheral with a view to enhancing binocular fusion.
The scene below is one of the various built in modes and shown with a weak eye darkened to balance the image within the headset.
There are various modes in quoits and some may or may not be of benefit to your particular conditions. It is always recommended to seek guidance from a VTOD if you have concerns as to what mode can provide the most benefit have been made by requests from patients. The shaking quoit is there to provide some peripheral awareness.
Saccades
Available in V1.09
Here you will find your self in a rather grand gallery.
On the large drawing desk a paperweight with arrow erratically moves across the surface of the writing table.
Your eyes are persuaded to following this rapid movement to which you must respond by pressing the trigger on the hand controller being pointed at by the arrow. Either Left or Right.
The speed at which your eyes track the paper weight and the subsequent rate at which you fire the control are assessed and your total time taken to complete the exercise. Thus lies the challenge set in this activity.
The Flight
Available in V1.09
Places you in the cockpit of a Cessna. You are part of a formation all flying into the sunset across an expanse of ocean.
On occasion a Mig29 will fly overhead and shroud you in jet wash.
Avoid crashing into your wingmen whilst trying to collect the coins in the sky.
This is a great challenge whilst exercising your peripheral vision.
Collect the points, Enjoy the music and take limited control of this Cessna weaving around you wingmen.
LONG TERM GOALS
The tests have been designed with adjustable offsets to compensate for mis-alignment of the eyes. However, as you become comfortable using the offsets, over the course of time (weeks or maybe months), an effort should be made to reduce these offsets to zero.
Even if the long term exercising has effectively re-wired the visual cortex to merge the images of both eyes, eliminating the double vision or vision occlusion in the weak eye, it is possible that after removal of the headset the vision may appear to revert to it's prior condition.
This does not mean that the training you have done has had no effect. On the contrary: what it means is that your brain and muscles controlling the eyes in their relaxed state are still off axis. In some cases, the use of optometrist supplied prism lenses can compensate, however this should not be relied upon. You as the patient should continue the exercises, upping the ante by reducing the offsets until the eyes muscles and the visual cortex are relaxed with the eyes as close as possible to at distance (infinity) converged state.
It may also be apparent that when you are away from the headset that you are able to converge the eyes with more ease. In that scenerio you will be able to use everyday vision to continue your exercising by making a concerted effort to concentrate your vision on objects in the real world. This concentration should be done on far field objects such as trees, bridges, road signs etc (preferably when you are not driving!) and then with a more concerted effort, on near vision items such as images in a book, pens, pencils or even your own fingers.
Exercising and dedication is paramount. If an hour a day, even if split into two sessions can help enhance success. Everybody is different, the technology is new and success may or may not be apparent. The judgement is made on my own visual improvement attained to-date.
I do encourage users to post their testimonies to myself and other groups as well as encourage feedback for improvements.
a note from the author
This is a personal thank you for visiting my page and I wish you every success in which ever direction you wish to explore in the view to fixing your vision and being rewarded with the aesthetics of beautifully converged eyes and all the self-confidence that is brought with it.
Mark Boyce