King Devick and concussion

I am so excited to get my King Devick test today.  This eye movement test is used as a screening tool to determine if someone can go back into the game after a hit. It is very important to know a persons baseline score before a possible concussion occurs.  Tonight, my son will be doing that test!

Recently, Dr. Debby told me that she was able to improve King Devick scores substantially  after prismatic correction. This is very exciting news since this is another way we can quantify how the prismatic orthotic glasses we prescribe effect the visual system! Post concussive visual symptoms are on the rise.  We know that if these symptoms persist longer than 3 months, a binocular vision evaluation is needed. Many of these patients can be significantly helped with prism. Children are particularly vulnerable  to concussion since their brains have more space in the skull to move around. If your child plays a contact sport, like mine, please have a baseline King Devick test performed!

Visual vertigo and fear of flying

I was speaking with a couple of patients today about the symptoms they have been experiencing that are due to vertical heterophoria. The sensation of increased dizziness in certain environments seems to be a recurring theme in a very large percentage of my patients.  Malls, supermarkets, big box stores are some of the places where this extreme "visual vertigo" happens.

A woman today told me a story of her first time she had severe dizziness. She was walking in an airport terminal. One of those large airports with very long corridors to walk down to get to the gate. It was so bad that she couldn't even get on her flight.  If we examine all these spaces we notice a few similarities.  High ceilings, long aisles,  a lot of visual stimuli on the sides.  All that side visual stimuli, combined with the misalignment of the eyes leads to the dizzy or lightheaded feeling. This in turn causes anxiety.  If one gets dizzy in a certain place, there would be associated anxiety with having to go into that environment.

The woman today started me thinking. I wonder how many people that refuse to fly in a plane due to anxiety attacks are actually people with VH.  Maybe the anxiety is starting when they are walking in the terminal and not on the plane. Hmmm. I think I will start asking more questions about airports.

Everyone is popping a pill

Dr. Debby and I were having an interesting discussion yesterday about how many people are taking some type of anti anxiety medication.  I have even seen lately a rise in the number of teens on these meds. Our American culture is always looking for a quick fix in a pill, whether it is the over use of anxiety meds or antibiotics. Most of the television ads today are for a medication.

A very common symptom we hear very often is anxiety. Our vertical heterophoria patients can experience anxiety in malls, big box stores, supermarkets, and cars to name a few places. If the world starts spinning around and you feel unstable and unsafe in these environments,  well of course you are going to have anxiety. Doesn't that make sense. So many of these patients are put on medication because their doctors do not know how to solve this anxiety. This can make the problem worse for people with vertical heterophoria because these medications can effect the eye muscles. When the visual system is functioning properly and the dizziness goes away, the anxiety is also relieved. No pills, just prism.

Doc, how does that prism work?

I have been talking a lot about prism and how we can use it to align the eyes.  It dawned on me that a lay person may not understand how this actually works! A prism will move an image.  It really boils down to that basic concept.  If you hold a prism in front of one eye the image from that eye will move in certain direction and amount that can be measured.

Let take this one step further.  If one eye's image is too high and one is too low, they land on different points on the retina. The human brain does not like this and try to compensate to correct this problem causing the symptoms of vertical heterophoria. Using very precise amounts of prism we can move those images onto corresponding points on the retina.  When this is accomplished the symptoms of vertical heterophoria dramatically improve.

How will the prism glasses look? The glasses look to the outside world like normal regular glasses in a normal regular frame, but they are actually a visual orthotic device.  The glasses become your medicine.  No drugs,  just glasses.

Sometimes a little prism is all you need.

When I see a patient who takes a lot of prism, I like to demonstrate to my staff how the patient sees without their prism. Putting prism in front of a person whose eyes are not misaligned gives them the same symptoms of the patient. I gave a clip to my optician with prism on it for her to look out of.  She puts it on and says "Wow! this is great!" I see so clear!!!!

She always complained of not seeing clear enough to me.  Of course she didn't because she had a ghost image. She described it as seeing "smeary" always trying to focus. Interestingly, she did not complain of headache or dizziness at all, but she did have VH. With the prism glasses her world is so much easier.  Aligning her eyes gave her the binocular vision and dept perception that she was missing.

Now if a patient uses that world "smeary" or just not sharp enough, I immediately pull out my instruments from Dr. Debby and screen for VH. Sometimes, a little prism is all you need.

Did you get your "bell rung"?

As I am getting ready to pick up my son from football practice, I thought this was a good time to talk about concussion.  Concussion is a hot topic today in the media.  Parents, coaches, and doctors are becoming more aware of concussion and the devastating consequences it can have.

Patient who experience even a mild brain injury can be left with many post concussive symptoms. These can include headache, neck-ache, dizziness, anxiety, and reading difficulties. If theses symptoms persist after 3 months, the visual system may be to blame. These patients need to be screened for Vertical Heterophoria and superior oblique palsy. Prism glasses can dramatically improve these symptoms and improve the person's life!

If you had your "Bell Rung" and still have post concussion symptoms, please reach out we can help.

Now back to my son, football was not my idea. He know one time he gets hit in the head football is over for him!

Looking at faces

One of the things I do in my spare time is volunteer for the American Cancer Society's Look Good Feel Better program.  This is a class where I teach woman who are undergoing cancer treatment to put on makeup and educate them about wigs.  As I was teaching my class today I was observing all the women with facial assymetry. It is amazing how most of us are not symmetric, but there are varying degrees.

Facial assymetry, we are all born with it, some more than others. If the face is extremely assymetric this can cause vertical heterophoria.  One eye is physically lifted up higher than the other.  This causes the images to be on non corresponding points on the retina. The retina is like the film on the back of the eye. To make this simple, our brains just do not like this.  The way the body reacts to try to correct this problem is what causes the symptoms of headache and dizziness! It really make sense. If you suffer from headache and dizziness take a look at your bone structure. You may have vertical heterophoria.

What is "Normal"

One of my favorite quotes from a patient, " I feel normal!"  I wondered what she meant. What is normal. Normal to me may be different than someone else. Sometimes a discomfort is our normal because we don't know any different. We just deal and think everyone may feel this.

 This young woman never felt steady on her feet. She described it as "swimmy". She had searched for an answer for many years but all her doctors told her that she was fine.  She just accepted that the swimmy feeling was her "normal". She thought she would just have to live like that.  As fate would have it, she came to me right after I trained with Dr. Debby.

She had a clear case of vertical heterophoria.  As soon as she got her prism glasses, she shouted out now I feel normal! The swimmy feeling was gone. Her whole family calls me the Vision Godess now!

Sometimes hearing "I understand is all one needs."

Yesterday, I saw a new patient that found me through the Vision Specialists of Michigan website.  There is a link to my office as a doctor trained in the Feinberg Method.  He had searched for 4 years for an answer to his dizziness. Doctor after doctor told him that nothing was wrong with him. I heard his complaints and started my exam.  He had a  distinct vertical misalignment with his eyes.  At that visit his dizziness almost completely disappeared.

The best part of that visit was the smile and laughter on that man's face. He was so happy when I told him that every symptom he was feeling I had heard before from patients.  Just validation that this wasn't a psychological problem made is day.  The whole staff was smiling and giggling.

Yesterday was a great day.

If you suffer from headache, dizziness or double vision please reach out.
Dr. Cheryl

I always have a headache.

Are you told that you have bad sinus problems with sinus headache but nothing shows up on a scan of your sinuses? Do this little test next time you feel that pressure around your eyes that you think is sinus headache. Rate this headache on a scale of one to ten, one being very mild to ten being the worst headache you have ever had. Then cover one eye and relax while looking at an object in the distance. Do this for 5 minutes. Rate your headache after the 5 minutes are up. If your pain has significantly decreased, then there is a good likelihood that a binocular vision problem is causing your headaches.

Please feel free to email me at drcbisraeloff@gmail.com if you suffer from headache, dizziness or double vision.