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10/17/2015 1 See Happiness ® CookVisionTherapy.com David L. Cook, O.D., 770-419-0400 Strabismus, Illusion, and the Continuum of Consciousness Perception Perception is not something that happens to us, or in us. It is something we do. ---Alva Noe, Action in Perception Percepton is something we do. Think of a blind person tap-tapping his or her way around a cluttered space, perceiving that space by touch, not all at once, but through time, by skillful probing and movements . . . . The world makes itself available to the perceiver through physical movement and interaction. ---Alva Noe, Action in Perception

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Page 1: 10/17/2015 See Illusion · 10/17/2015 4 ILLUSION Sense/Retina Move Eye With Finger Monocular Stick and Straw Without Body Movement With Body Movement Hemianopsia Action/Movement Snapshot

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SeeHappiness®

CookVisionTherapy.comDavid L. Cook, O.D., 770-419-0400

Strabismus,

Illusion,and the

Continuum of

Consciousness

PerceptionPerception is not something that

happens to us, or in us. It is something

we do. ---Alva Noe, Action in Perception

Percepton is something we

do. Think of a blind person tap-tapping his or

her way around a cluttered space,

perceiving that space by touch, not all at

once, but through time, by skillful

probing and movements . . . . The world

makes itself available to the perceiver

through physical movement and

interaction.---Alva Noe, Action in Perception

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Vision

Change Blindness

Inattentional Blindness

Perception“We are told that vision depends on the

eye, which is connected to the brain….

[N]atural vision depends on the eyes in

the head on a body supported by the

ground, the brain being only the central

organ of a complete visual system.”

J. J. Gibson, The Ecological Approach to visual

perception, p. 1.

Perception The eye is considered to be an instrument of

the mind, or an organ of the brain. But the

truth is that each eye is positioned in a head

that is in turn positioned on a trunk that is

positioned on legs that maintain the posture

of the trunk, head , and eyes relative to the

surface of support. Vision is a whole

perceptual system, not a channel of sense

Gibson, p. 205.

“Direct perception is what one gets from seeing Niagara Falls,

say, as distinguished from seeing a picture

of it…. I mean it is not mediated by retinal

pictures, neural pictures, or mental pictures.

Direct perception is the activity [of]

information pickup [ from light striking the

seer from all directions] that involves the

exploratory activity of looking around, getting

around, and looking at things.”—Gibson, p. 147.

SAW Vision Perception is learned

agreement between:SENSE—Retina/Brain

ACTION/Movement—Eye/Body

WORLD/EnvironmentCook

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BMW Vision Perception is learned

agreement between:BODY—Including Eyes and Brain

MOVEMENT

WORLD/EnvironmentCook

ILLUSIONChange SENSE, ACTION, or

WORLD from their habitual

agreements, and perception

breaks down. We risk:

ILLUSION

ILLUSION IllUSIONCube

ILLUSIONCube Square

2 Trapezoids

ILLUSION

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ILLUSION Sense/Retina Move Eye With Finger

Monocular Stick and Straw

Without Body Movement

With Body Movement

Hemianopsia

Action/Movement Snapshot Vision: Fixation immobile,

exposure momentary.

Aperture Vision: Scanning a sequence of

“snapshots.” as if through a knothole in a

fence.

Ambient Vision: Head in chinrest.

Ambulatory Vision: Walking around.J.J Gibson, The Ecological Approach to Visual Perception,

1986.

Action/Movement 20/20 acuity is a measure of how little,

not how big, you can see. 20/20 means you

can see as little as everyone else at 20 feet.

Vision is more than 20/20 acuity. Vision has

as much to do with how you move your eyes

as it has to do with acuity. Without good eye

movements, you can’t see big, no matter

how little you can see.

Action/Movement

O F B P V E

T C H Y B A

K O E Z L R

W F M T X K

Z B N D L P

Action/Movement

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Action/Movement World/Environment

World/Environment World/Environment

ILLUSIONRecordings were made from forty acutely

prepared cats, anaesthetized with thiopental

sodium, and maintained in light sleep with

additional doses by observing the

electrocorticogram. Animals were paralyzed

with succinylcholine to stabilize the eyes.

Pupils were dilated with atropine.Hubel and Wiesel, 1962, p. 107

Vision is a mode of

exploration of the

environment drawing on

implicit understanding of

sensorimotor regularities.

---Alva Noe, Action in Perception

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World/Environment1) Coin Exploration

World/Environment1) Coin Exploration

Circle Ellipse Line

20 Inches

10 Inches

Figure 28: One Half Distance—Twice Retinal Image Size

Quarter

Quarter

World/Environment

Worlds/Environments

Real WorldsObjects in Space

Indoors, Outdoors

Paper WorldsWriting

Reading

Pictures

Inner WorldsVisualization

Verbalization

Worlds/Environments

New Worlds

Lens

Prisms

OcclusionFull Monocular

Sector

Pinhole

Spectacle Frame

ApparatusesSeptum

Mismatched InputLuster

Rivalry

Physiological Diplopia

1st, 2nd, 3rd Degree sensory fusion without motor fusion

Binocular Disparity mismatched withmonocular cues.

Vision

“The deriving of meaning and

the directing of action as a

product of processing of

information triggered by a

selected band of radiant energy.” Dr. Robert Kraskin

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Vision answers what and where

But Why?What does the seer really

want to know?

What’s in it for me!

Vision isn’t about just what is;

Vision is about what ought to be.

Vision is VALUEWe do not see what we have not

valued—to solve a mystery,

perhaps, or win survival,

recognition, acceptance, a smile.

Or, maybe even a kiss.

Definition: afford

1)To have the money to pay for:

I can afford the car.

2) To bear or tolerate without serious

consequence

I cannot afford your ridicule.

Definition: afford

3) To furnish or supply. To provide,

to give to, to make available.

A hot bath affords great pleasure.

The tree affords ample shade.

Tennis affords good exercise.

The roof top affords beautiful views.

Affordance“The affordances of the environment are

what it offers the animal, what it provides

or furnishes, either for good or for ill.”J.J. Gibson, p. 127

A cliff, for instance, is an affordance; it

provides or affords a view; it affords a

platform from which to hang-glide; or, it

affords a place to break your neck.

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Affordance“The verb to afford is found in the

dictionary, the noun affordance is not. I

have made it up. I mean by it something

that refers to both the environment and

the animal in a way that no existing term

does. It implies the complementarity of

the animal and the environment.”J.J. Gibson, p. 127

AffordanceThe environment affords animals…the

terrain, shelters, water, fire, objects, tools,

other animals, and human displays…. If

there is information in light for the perception

of surfaces is there information for the

perception of what they afford? If so, to

perceive them is to perceive what they

afford. This…implies that the values and

meanings of things…can be directly

perceived.

AffordanceObjects have properties or qualities: color, texture,

composition, size, shape, [etc.]…. The

psychologists assume that objects are composed

of their qualities. But I now suggest that what we

perceive when we look at an object are their

affordances, not their qualities. We can

discriminate the dimensions of difference if

required to do so… but what the object affords us

is what we normally pay attention to. The special

combination of qualities into which an object can

be analyzed is ordinarily not noticed. Gibson, p. 134

Affordances

Invariant

Circle Ellipse Line

Invariant

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Invariant Affordances and InvariantsThe affordance of an object is what the

infant begins by noticing. The meaning is

observed before the substance and surface,

the color and form, are seen as such. An

affordance is an invariant combination of

variables, and one might guess that it is

easier to perceive such an invariant unit

than it is to perceive all the variables

separately.

All men by nature desire to know. An

indication of this is the delight we take in our

senses; for even apart from their usefulness

they are loved for themselves; and above all

others the sense of sight. For not only with a

view to action, but even when we are not

going to do anything, we prefer sight to

almost everything else. The reason is that

this, most of all the senses, makes us know

and brings to light many differences between

things.

—Aristotle, The Metaphysics

We use visual exploration not

only to answer the questions

what something affords and

where it is compared to us,

but to evoke wonder. Vision

derives knowledge, directs

action, and delights

consciousness

Consciousness

Consciousness is not something that

happens inside us. It is something we

do or make. Better: it is something we

achieve. Consciousness is more like

dancing than it is like digestion.

Alva Noe

Out of Our Heads

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1) Stimulus-Response

Finger Touch

2) Prism—Conscious

Finger Touch

“But fundamentally an organism has

conscious mental states if and only if there is

something that it is like to be that organism.

We may call this the subjective character of

experience.”

–Thomas Nagel,

“What it is like to be a bat.”

Conscious SeeingVersus

Stimulus-Response Seeing

Stimulus-Response Seeing is like the daily

trip to the office; conscious seeing is like

viewing a splendid sunset.

Conscious Seeing feels like something,

appears like something.

Stimulus-Response Seeing does

something—automatically with little need for

consciousness.

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educate

etacude

Visual Consciousness falls on

a continuum with greater

consciousness allowing

flexibility of agreement and

lesser consciousness

facilitating faster performance.

Vision therapy exploits

movement and the continuum of

consciousness to expand facility

in exploration and guidance,

allowing enhanced performance

and flexibility in all worlds.

Splinter Skills:allow performance in one world.

When the findings improve and

the patient doesn’t, add worlds

and voluntary consciousness to

your therapy.

Increasing Consciousness

Questions about NOW.

Novelty New task

Variation During task

New World

Lens

Prisms

Apparatuses

Responsibility and Control:

Pursuits

Mazes

Vectograms

Suppression (MWBF)

Stereo

Time

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Strabismic

AdaptationsLanguage

What’s

closer:

the

footstool

or the

bowl of

fruit?

. . . when stereoscopic fusion

prevails, the patient is conversant in our

language and when stereoscopic

perception is absent he speaks a foreign

tongue which most of us simply do not

understand. For this selfsame reason we

misinterpret his statements by applying

them to our own mode of seeing instead

of to his. Brock, Optom Weekly, August 21, 1941, page 795

“he speaks a foreign tongue”

Where?

Where would your hands tell you it is?

Stereopsis

How many do you see?

How many would your hands tell you there are?

Diplopia

Therapy Conversation

Therapist: Which is closer to you, the Quoit or the

Dot?

Patient: The Quoit.

Therapist: If you walked down there, which would you

come to first: the quoit or the dot?

Patient: The Quoit.

Therapist: Where is the Dot?

Patient: On the wall.

Therapist: Where is the Quoit?

Patient: On the wall.

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Ambiocular

Vision

Making Sense of

Movement

This change [accepting stereopsis or

diplopia] is, however, not lightly made by

the squinter because he is apt to resent

the fact that he no longer can see things

as they really are and as he know them to

be.

Fredrick Brock: Conditioning the Squinter to Normal

Visual Habits. Optom. Weekly, August 21, 1941; p. 822.

“The adapted strabismic apparently

maintains separate sensoria for the right

and the left eye and relates the visual

impressions gained by the two eyes not

by retinal correspondence but by

estimation, a process of the frontal lobe,

i.e., a thinking process.”

Brock FW: Visual Training.

Optom. Weekly, Nov. 6, 1947, p. 1680.

The visual behavior is such as if each eye were

directly related to body-posture only. . . . If

body posture is experimentally eliminated as a

cue to the visual direction, all relationship

between the right and left visual impressions

seems to be lacking . . . .

Brock FW: Space Perception in its Normal and

Abnormal Aspects. Optom. Weekly, Sept. 5, 1946, p.1236.

I, therefore try to explain to my squint

patients how their mode of sight

differs from ours and what strange

visual falsifications they have to

expect before they may gain normal

binocular vision.

Brock, Optom Weekly, August 28, 1941, p. 821

“Visual Falsifications”

ILLUSIONS

Artifacts of immobility (remember dollar)

“Let’s stop and think.”

Luster

Physiological Diplopia

Pathological Diplopia

Common Visual Directions of Foveas

Stereopsis

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Luster

Lenses

Eyes

Normal Luster

White Screen Luster

Lenses

Ambiocular Perception: Split Field

Eyes

White Screen

“Normal Correspondence”

Cook Card(Common Foveal Visual Directions)

Perception:

Cook Card(Common Foveal Visual Directions)

Ambiocular Perception

Brock String

Single Physical String

Red Lens

Green Lens

Brock String

Normal Physiological Diplopia

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Brock String

Ambiocular Perception

Vectograms

Mind

Local

Normal Correspondence

Vectograms

Mind

LocalAmbiocular Vision

Adapted strabismics rely on movement, not

retinas, to construct a world. The spit field

response, the “Y”on the Brock String, the

confusions of visual direction—all depend on

movement. Only as the eyes approach

alignment does retinal correspondence

predominate. To understand and predict the

observations of adapted strabismics, ignore

retinas; concentrate on movement.

Stereopsis,

Strabismus,

and the

Shape of the Sky

Peripheral AwarenessGeneral

Avoids bifoveal avoidance of alignment

Aligns eyes

Circumvents ambiocular response

Combines perceptions of eyes

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Peripheral AwarenessStimulus Response

Dim Light

Blur

Movement

Peripheral AwarenessVoluntary

Vision

A

B

C

D

E F

G H

J KL

M

Peripheral Awareness

General Considerations in therapy— Constantly remind patients to open up their

vision.

Explain X, Y and Z periphery, the difference between seeing “easy” and “hard”.

Constantly ask about the space between objects. How much space is there between object one and

two?

How much space is there between you and it?

Peripheral AwarenessEyelash Vision versus Face Vision

Versions

Versions

Ocular Calisthenics

Look for limitations of gaze.

Endpoint Nystagmus

Discomfort (Like the stretch of your legs when

trying to touch your toes.

Vigorous stretching

To and fro, into the field of limitation

Move head in opposite direction

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Versions

Orbital Pursuits

Penlight held close to eye

Laterally to force stretching

Nasally to force control

Monocular

Binocular

Learning to control fixation with either eye in any position

Baseball Rotations

Four corners of wall or chalkboard

Move closer to increase stretching

Practice voluntary control of fixation

Stress seeing the other 3 corners for peripheral awareness

Add extended arm and fist to encourage z-axis peripheral awareness

Pursuit-Saccades

Stressing Peripheral Awareness

One Stick

One Stick different Head Positions

Chin: Up, Down, Right, Left.

Two Sticks

One stick still. Pointing to second stick moving.

Both sticks moving (pursuit/saccades)

Following one with eye, other with finger

Accommodation

Accommodation General

Don’t work a lot of accommodation if acuity is

okay.

Stress Silo (peripheral awareness) and voluntary

blur.

Push plus with non-accommodative ET

Do not push plus with accommodative ET

Use minimum plus to ortho

When able to do so, cut plus

NV Voluntary Blur

Monocular

Near without plus—blur and clear

Binocular

With transparent chart at near

With small opaque chart at near

With small chart on whole page at near

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Vergences

Cover Uncover Recover

Should be worked on every procedure where patient can straighten eyes.

Unlike smooth vergences, changes angle.

Cover eye so it fully deviates

Uncover eye; encourage peripheral awareness; encourage alignment.

Great for accommodative ET’s without glasses

Non-accom ET’s need feedback

Voluntary Alignment

Accommodative ETs

Over Bifocal

Without Glasses

Teach peripheral awareness

Work responsibility and control

Look at therapist’s eyelash to trope

Use peripheral awareness to align eyes

Add pursuits and saccades with non-accom targets

Near Far Jumps*

Doesn’t know how to diverge OR converge

Get convergence of both eyes at near

Throw the eyes far away, no central target; encourage peripheral awareness!

You want both eyes to converge and diverge symmetrically same rate—no lag of either eye.

With minimum plus for Accom ETs

With maximum plus for Non-accom ETs)

Physiological Diplopia

Inside the Centration Point

General

Esotrope is not adapted inside centration point—crossed diplopia

It is harder to diverge when something is between eyes

Work after mastering Near-Far jumps

Encourage peripheral awareness

Begin with less, add more.

Physiological Diplopia

Inside the Centration Point

Pickup StickWith near-far jumps and window

Maximum separation at given distance

R and C on separation

Work stick further away

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Physiological Diplopia

Inside Centration Point

*Superman SeeingNear Far Jumps—above card

Near Far Jumps—lift card

Near Far Jumps—through card

Short card to tall card.

Learning to break stimulus from response

Therapist Snapping fingers behind paper

Learning felt position of eyes

Physiological Diplopia

Inside the Centration Point

StringY not X

On window

Near far jumps

Make the strings cross somewhere else

Bug walk

Make bead double then converge until fusion

Discontinue if you are getting diplopia

Physiological Diplopia

Inside the Centration Point

Binasal CardWith Near-far jumps

Trying to narrow the gap

BinasalsTrying to narrow the gap

Bilateral finger Grabs

Chalkboard Circles

Red/Green MITRed Green

Lenses

Polaroid

Lens

Red/Green MITRed Green

Lenses

Polaroid

Lens

Split Field

Red/Green MITRed Green

Lenses

Polaroid

Lens

Luster

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Red-Green MIT

Get 2 or 3 inches from circle

“Is it half red and half green or mixed?”

“Does the red have anything to do with the

green?”

“Be aware of the outside of the circle—the whole

room—blend the red and green.”

Cover eye, show red; cover eye show green: “Is

it red or green or some other color.”

Red-Green MIT Use high plus if necessary.

Work R and C

“Look at the tip of my pen and split the red and green.”

“Be aware of the outside of the circle and the whole room and blend the red and green.”

Work Farther back

Check with unilateral cover test; be sure there is only a small flick.

Work Near-Far Jumps; Cover Uncover

Stereopsis

The Shape of the Sky

It begins with the touch of eyes

And soars above history

To get to the bottom of Mystery.

Ocean’s horizontal chill,

Ferris wheel, church spire,

Scudding cloud, soaring gull,

Sunset’s rapture, rainbow’s hue—

All burn, stab, swatch, press, dapple

The immensity of blue.

The shape of the sky: over the top,

Intangible, uncatchable, spatially exultant,

Too little perceived:

Oh heart-piercing depth of air,

Let me take you there!

—D. L. Cook

Stereo BasicsSee Big

Stereo BasicsSee Big—See Little

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Stereo BasicsEyelash Vision versus Face Vision

Stereo Basics

Seeing Little

Relative StereoWhich is closer:

Toe of shoe

Laces?

Knee?

???

Stereo Basics—Seeing Big

Absolute or Egocentric StereoHow far are the

pilings away

from your nose?

Stereo Basics

…[S]tereopsis is a qualitative visual experience

related to the perception of egocentric spatial

scale. Specifically, the primary phenomenal

characteristics of stereopsis ( the impression of

“real” separation in depth) is proposed to the

linked to the precision with which egocentrically

scaled depth (absolute depth) is derived.Dhanraj Vishwanath, “Toward a New Theory of Depth,” 2014

Stereo Basics

Seeing Space—Absolute Stereo

Seeing a room with stuff in it, not

just the stuff in a room. A sense of

negative space cushioning objects

from one another, each object seen

as having a position in the room.

Stereo Basics

Seeing Space—Absolute Stereo

“The characteristically vivid

impression of tangible solid form,

immersive negative space and

realness that obtains under certain

viewing conditions.” Vishwanath, 2014

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Stereo Basics

Seeing Space—Absolute Stereo“[I saw] palpable volume[s] of empty space… I

could see, not just infer, the volume of space

between limbs…the sink faucet reached out

toward me…the grape was rounder and more

solid than any grape I had ever seen…Objects

seemed more solid, vibrant, and real.”

Sue Barry, Fixing My Gaze, 2009, pp. 94-132 [Quoted in

Vishwanath, 2004]

Vectogram Local

Zone of Confusion Area of space where patient is adapted.

Patient’s perception is normal in periphery but adapted centrally.

The further away the vectogam, the more central. Quoit gets closer to plastic holder instead of following

patient.

Patient’s local of quoit no longer certain.

Vectogram Local

Local

Quoit Separation= Distance between Pupils

1/2 Way Out

Vectogram Local

Local

Quoit Separation= 2 X Interpupilary Distance

3/4 Way Out

Vectogram Local

Local

Quoit Separation = ½ Distance between Pupils

1/4 Way Out

Vectogram Local

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Vectogram Local

Goal— To get the vectogram out to its predicted

location.

To integrate this with movement.

If shaking the vectogram makes it come further

out, then the patient has not a) fully aligned his

eye and/or b) fully expanded his space.

Quoits with Dot at C-Point

At Centration Range

Moving C to 3

Shaking

Peripheral awareness

Loop with pointer

Compare to finger

Touch finger even with quoit

Peripheral AwarenessSee Gestalt

Quoits with Dot Back-away

Move as Far Away as

Local is Good

Continue 3 to C

With Near-Far Jumps

With Cover-Uncover-

Recover

Quoits with Dot on Wall

To Get Float

Shaken and Blurred

Language

Gradually Decrease

Blur

Work Responsibility

and Control

Quoits with Dot on Wall

Dowel SticksOne on dot

One touching other,

even with Quoit

Circling Quoit

Two Stick Touch

Feel them

Hear them

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Quoits with Dot on WallResponsibility and

Control “Look Hard at the fuzz on

the dot.”

“Make the rope go flat.”

“Be aware of the whole

room, of all the space

between your nose and

the wall.”

Make the Quoit pop out.

Vectograms

Movement Move forward and back with proper localization.

Stop moving back when the vectogram stops following patient and recedes toward wall.

At greatest distance with correct local work

Near are Jumps

Cover/uncover/recover

Vectograms

Movement

Add balance:

Head rotations

Leg Swings

Balance Board

Walking Rail

SpirangleGross Local

On wall or handheld

Shaken and Blurred

Compare Outside to Inside

Responsibility and Control

Gradually Decrease Blur

With Stick or Dowels

SpirangleFine Local

Stage I

On Ortho, Get Gross Float with Proper Local

Find alphabet

Stage II

On C, Get Gross Float with Proper Local

Find alphabet

Stage III

Which is closer Circle or Square?

VTS4--Stereo Shaking Ring

Sword inside or next to ring

Hands to side of ring

Awareness of Frame

Shaking Ring—Dog or Robot

Plane Slide with SILO

Fish Slide with SILO

Ring and Cat Large Rotated

Small Cat Rotated

Alligator or Frog—Rotated

Greatest Distance at which Target follows you.

Near-Far Jumps and Cover-Uncover

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VTS4--Stereo Shaking Ring

Sword or arm inside or next to ring

Hands to sides of ring

Awareness of Frame

Gestalt

Back up until ring no longer follows

VTS4--Stereo Shaking Target—

Dog and Ring Sword inside or next

to ring

Hands to side of ring

Awareness of Frame

Back away as far as ring follows.

Reduce Size of Ring

No shaking

VTS4--Stereo Shaking Target—

Robot and Ring Sword inside or next

to ring

Hands to side of ring

Awareness of Frame

Back away as far as ring follows.

Reduce size of ring

No Shaking

VTS4--Stereo Shaking Target—

Ring Sword inside or

next to target

Hands to sides of target

Awareness of Frame Gestalt compared to blue.

Compare distances of letters

Back away so long as blue follows.

VTS4--Stereo Shaking Target—Ring

Sword inside or next to target

Hands to side of target

Awareness of Frame Gestalt

Dolphin Closest

Sea Horse closer than clam, etc.

Back away so long as green background follows.

VTS4--Stereo

Frog Sword next to Frog

Awareness of Screen Frame Gestalt

Large to small

Rotated

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VTS4--Stereo Combining

Movement Therapist moves on Z

axis; patient moves to keep realign target with therapist.

Cover Uncover

Near Far Jumps

Walking Rail

Infinity Walk

Long Distances for exotropes

Tiny Targets 4 inches at 40 feet

3D Television

3D Television—Track 3 3D Television—Track 3

3D Television—Track 3 3D Television--Coaching

Be aware of Screen

Frame Gestalt

Stop Action and be

aware of position of

figures compared to

objects in room.

Repeat scene, this time

with action—see 3D

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3D Television--Mechanics3D Blue Ray Player and TV.

Wikipedia— “List of 3D Movies” Not

“filmed in 2D”

Madagascar 3

Journey to Center of Earth

Hugo

Imax Nature Films

Used on Amazon

Write prescription for 3D TV viewing.

3D Television—Track 12

3D Television—Track 12 Randot

First Perceiving Target

At Centration Range

Plus as necessary

Concentrating on Outside of Square and Outside of Screen

Vary Distance

Point to Smaller Target for Patient

Randot

Building Ranges

At Centration Range

Push BI

3 Minutes BI

1 Minute BO

2 Minutes BI

Gradually Increase Distance

Liquid Crystal on WallRandot

Start Close

Stress Peripheral Awareness See edge of target

Stress BI

Use Plus as Necessary

Work Farther Away

Exotropes: 4/30 Jump Ductions

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3D Without Vectos

3D Without Vectos

GeneralWorked after Good Local on Vectograms

Patient has learned to see big to float the

vectogram and little to flatten the vectogram.

Patient has the “feel” of 3D

Watch Eyes! Work with aligned eyes.

3D String

3D String Rotations

Rotate Bead on string in Circle

Keep Y meeting at bead

Be aware of space between bead and

nose

3D String

3D String—Bead and Pointer

Get Crossed Diplopia

Just fuse

Align stick and touch bead

3D String

3D String with Stick RotationsFuse Bead

Be aware of z-axis Stick rotations to side

Be aware of distance of bead and pointer

from face

Touch Rotation Stick with peripheral attention

3D String

3D String with 2-Pointer Alignment

Get Y at bead

Wide Pointer Separation—When aligned?

Narrow Pointer Separation—When aligned?

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Free Space 3D

Vertical Stick and StrawGet Crossed Diplopia

Just Fuse

Stick placement

2 sticks simultaneously

Free Space 3D

3D Saccades (Oblique Z-axis)Look red, wiggle blue

Look blue, wiggle red

Be aware of how far each stick is from nose

while seeing the space between sticks

Free Space 3D

3D Pegboard

Arrange patient so that eyes are only slightly

above pegboard

Hold peg above hole for one rotation

Insert Peg

Free Space 3D —Plexiglas and Penlight

Plexiglas

Free Space StereoYoked Prisms

1) View Room

2) Walk with high power yoked prisms

a) Perceived as up-hill with base down

b) Perceived as down-hill with base in

c) Encourage seeing big, see entire length of

room.

3) Remove prisms, View Room

Free Space 3DHand Mirror

Examine features

of face.

Be aware of frame

and see face

recede behind

glass.

Adjust distance of

mirror

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Free Space 3D

Wall Mirror

Aware of nose

Aware of frame

Aware of masking tape

Aware of Hands

Responsibility and control

Look at nose

See distance to frame

Free Space 3D

Look at my

eyeglass bridge.

See the space

between your

nose and my face.

Home 3D

Peripheral Motion Awareness

Walking In halls

Walking

In car

Awareness of Door Frame when walking

though doorway

Home 3D

Shape of the SkyBe aware of boarder of blue Sky formed by

Buildings

Clouds

Hills

Trees

Horizon

Compare views of one and two eyes

Be aware of space between objects rather than the objects themselves.