macular degeneration, macular, diagnosis steady eye strategy – My Macular Degeneration Journey/Journal

Not Your Eccentric Relative

Three and a half years ago, when I “lost” my second eye, I – an avid reader – had 30 pages left to read in a mystery novel. Not being able to see well enough to read that last, paltry 30 pages was frustrating and heartbreaking. Therefore, when a reader/member recently posted in another forum how she had lost the ability to read and was badly shaken, I got it.  Oh, yeah; I got it.

This reader/member, although shaken, reported she was going to try eccentric viewing. Hallelujah! First of all, I would like to thank her for validating our efforts here.  I am thinking she heard it here first and I am proud and honored to have passed on some valuable and helpful information. Second of all, I want to applaud her for continuing to fight.

There are ways to cope and adapt to vision loss and eccentric viewing is one of them.

Third thing I want to do here is talk again about eccentric viewing. If you are a latecomer to this blog/group or if you forget, let me start by defining eccentric viewing. In a nutshell, eccentric viewing is enlisting a part of your peripheral retina to do the jobs your macula used to do. One of these jobs is reading.

Now reading with eccentric viewing ain’t “pretty”. It involves practice and will never be as efficient as reading with your fovea. An analogy might be turning a screw with a butter knife or pounding a nail with a rock. The job gets done but it is slower and there are more failed attempts. However, some success is generally better than no success.

The first step is to find your preferred reading locus, affectionately referred to as your “sweet spot”. This is different for everyone and may require some searching and experimentation.  The one I have been using is below my fovea.  It works pretty well when I am able to work in close and be reclined – such as now when I am hanging out in bed typing on my iPad. It has not been working so well recently when I am, for example, trying to read the eye chart for the study.   That requires me to lean my head back and I have been getting a crick in my neck. Consequently I have been searching for a spot more in the horizontal plane. Play around and find a place that you like.

How do you play around to find it? Nancy Parkin- Bashizi in The Skill of Eccentric Viewing suggests drawing a clock with a star in the middle. Focusing on the star, see which number is the clearest. That may be your sweet spot for reading

Don’t be frustrated if you keep sliding off your sweet spot. Your brain has spent a life time putting your fovea on what you want to see. It is natural for it to keep trying to do that. Keep moving your focus back. Take it from me, things you are trying to see with eccentric viewing can be darn slippery!  I will get them fairly well in focus for a split second but then my eye just jumps away. I know I saw something but it did not “compute”.

This knowing what you are looking at gets better with practice as your brain learns to adapt. I saw an article about how your brain recruits parts of the visual cortex that normally handle peripheral vision tasks  to take over the reading tasks. If I can find it again I can write a page about that.

Another thing to do is practice keeping your eye still and moving the paper.  Many of the articles I skimmed suggested using an iPad or other brand of tablet so you can scroll the words past your eyes instead of moving your eyes across and down the page. Once you get that sweet spot on the page, you don’t want to lose it! [Lin/Linda: this technique actually has a name: ‘steady eye strategy.’ Here’s a good video demonstrating it.]

Does eccentric viewing work? Yeah. Sort of. I can read short, newspaper articles without magnification if I put my mind to it.  I am slow and make more mistakes than I would like but the job gets done. I can read.  And, in the end,  I guess that is all that matters

Written September 28th, 2019

Next: Rocking and Rolling

Highlight: Is there any way I can learn to better use what vision I have?

It’s Linda and today I have AMD.  Let me explain.  I want to share what I know about Eccentric Viewing which is a way to maximize the peripheral vision that you do have in order to read text and see faces and objects when robbed of one’s central vision.  I do not have AMD, that’s Sue. Because my Dad had it, I know that I have a 50/50 chance of developing it plus I have a few other risk factors. Having gone through the experience of Sue developing AMD & and doing research for the website, it is a much more real possibility that I will develop also AMD.

I’m simulating AMD by putting dots on my eyeglasses where my central vision would be

I decided to do a mostly unscientific experiment. I cut out dots from the top of a sticky note and pasted them on my eyeglasses.  I had to look in the mirror to find the right positions because my blind spots would not in the exact center of my glasses.  My spots are not perfectly round nor are they exactly in the middle because that would be how it is naturally.  The actual blind spot on the macula of the eye would be tiny but I had to represent it as it would appear in my visual field.  At first I thought that this would not be an accurate simulation because my glasses correct my vision but I know Sue and others wear corrective lenses to maximize the remaining vision (more about that below).  I’m sure this is not exactly accurate but I think it’s the best I can do.

Two observations right away: 1) I’ve developed a queasiness that I can’t explain but I’m guessing it is partly a physical reaction to the vision changes but also an emotional reaction to experiencing AMD.  As for the physical issues, I have serious astigmatism so my eye doctor adjusted my glasses and I’m guessing that some of the most extreme corrections are in the peripheral vision areas and that is not where I’m used to looking; 2) I found it hard to take a selfie because to do this, I had to look straight ahead.  I did much better navigating in the house probably because it is familiar.

On to Eccentric Viewing.  AMD robs us of our central vision but the peripheral vision is spared.  You may lose the ability to see text or a person’s face if you look directly at it or them but you should be able to look to the side or above or below the center and make out some of what’s in your peripheral vision.   You can learn ways to maximize the vision that remains.

Eccentric vision is one technique to do this.  It takes some practice but you can teach yourself.  The diagram below defines the Preferred Retinal Locus (PRL) which is the place where your peripheral vision is the best.  For example, as I simulate AMD wearing the dots, at first I moved my head around (not the best way) & I found that with my left eye (right eye closed) my vision is best on the right side of my visual field. With my right eye (left eye closed), my PRL is to the left of my visual field.  That doesn’t help me with both eyes open and looking straight ahead.  If I had AMD in both eyes, I might choose to read with the eye that has the best PRL. Has that been the case for any of you?

ecc_view_dia_txt
Click on the image for an article with more details.

Click here for instructions on how to teach yourself Eccentric Viewing.  As I followed the instructions, I found that it was hard to keep my head still as they instruct.  My first reaction was to move my head left, right, up and down not my eyes.  I’m sure that would change with practice.

Click here for another article about Eccentric Viewing.  It explains some of the science behind the technique.  It also says that the biological task of this way of viewing takes some time. They say it becomes second nature with 6 sessions with a certified low vision specialist and practice at home.

Here are some more articles:

Click here for an article that explains more about PRL (Preferred Retinal Locus).

Click here for an article on Steady Eye Technique (also called Steady Eye Strategy) which basically talks about maximizing the vision you have.

Click here for a great article that talks about both Eccentric Viewing and Steady Eye Technique as they are used together.

Click here for the definition of Eccentric Viewing through the details of a study done on reading with peripheral vision.

My thoughts after several hours of ‘having’ AMD:
  1. I never doubted that Sue was right in that dealing with low vision is tiring.  Everything that I tried to do took much longer.
  2. I was reminded that our ability to see things is not only a function of the eyes but a function of the brain.  When we change input to the eyes, the brain will try to adapt. I had an experience of this when I tried contact lenses where one eye had a prescription for near vision and the other eye for far vision. It didn’t work, my brain did NOT cooperate. They can do that with Lasik surgery but I wouldn’t recommend it unless you have tried it with contact lenses first.
  3. I can see that Eccentric Viewing/Steady Eye Strategy is very useful but I can also see that much practice is needed.
  4. I’m going to try to talk to my eye doctor about this but I suspect that making a prescription for eyeglasses AFTER central vision loss is different from when a person can use the whole visual field.  That might mean that wearing eyeglasses that you had before the vision loss is not a good idea.  If you’ve had this experience, please leave a comment or contact me directly.
  5. I can see how important things are like proper lighting and good enlargement of text.  I had to move a lamp closer to my computer and had to move it several times to avoid glare on the computer screen.
  6. I can take the dots off of my eyeglasses for which I am TRULY grateful.  My heart goes out to each and every one of you who cannot.

If you have learned or tried to learn any of these techniques, we’d love to hear about your experiences.  You can post a comment here or contact me directly at light2sight5153@gmail.com