MACULAR DEGENERATION LEADING CAUSE OF VISION LOSS

Age-related macular degeneration (AMD) affects the macula, an area inside the back of the eye in the center of the retina. This is where the eye focuses for recognizing faces and reading. The retina records images we see and sends them via the optic nerve from the eye to the brain. AMD occurs when the central portion of the retina begins to deteriorate, affecting a person’s ability to read, drive, recognize faces or colors and see objects in fine detail. AMD is the leading cause of vision loss in older adults.

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VISION IS LEARNED - AND IT CAN BE RELEARNED

Vision involves over 70% of the neural pathways of the brain. Vision is more than eye sight. Vision is the only body system that continues to develop after birth. Vision involves the way the eyes and brain interact. It takes approximately three years for the eyes to learn how to work together. When they do not, it can result in the eyes turning in (esotropia) or out (exotropia), crossed eyes (strabismus) or lazy eye (amblyopia).

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WHAT IS BEHAVIORAL OPTOMETRY?

Behavioral optometry starts with the concept that vision is learned. When we’re born, we don’t know how to use our arms, legs and hands. We also don’t know how to use our eyes. We have to learn how to integrate them with the rest of our body. The brain must process what the eyes are seeing, and then it has to integrate that information with the other senses. From a behav- ioral standpoint, seeing requires a more holistic approach, getting all the senses to work together.

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AUTISM AND EYESIGHT

It may surprise you to learn eyesight and autism spectrum disorders have a connection.


One of the major symptoms of autism is a lack of eye contact. Few people with autism have trouble with their eyesight. The problem is with the person’s ambient visual system. The ambient system is concerned with things going on around us in the background. It generally filters everything out for us because noticing every little thing in the visual field would be overwhelming. However, people on the autism spectrum have trouble using the central and peripheral visual systems simultaneously, so subsequently they have trouble filtering things. Having autism can be compared to walking around with the tubes from paper towels in front of your face. You would move your head around constantly, trying to check out your environment and keep up with what’s going on. People on the autism spectrum tend to get hyperstimulated when there is too much peripheral movement happening all around them. Their ambient visual system is not telling them that people are, perhaps, moving in many different directions, both forward and backwards. Confused, needing to feel where they are in relationship to the things around them, people on the autism spectrum might start exhibiting stimming – self-stimulatory behavior that incorporates the repetition of physical movements, including flapping the arms. When the ambient visual system works as it is

supposed to, people on the autism spectrum don’t experience overstimulation.


Vision therapy using yoked prisms has been shown to help people on the autism spectrum tremendously, sometimes even removing autism tendencies. This therapy has a major impact on the ambient vision system. It is not a cure for autism; it is a calming of the sensory system. In one documented case, a 14-year-old boy who had never said more than one-word sentences started speaking full sentences within 15 minutes of putting on a pair of yoked prisms. The prism changes the distribution of light on the retina; one theory espouses the prism resets the timing between the ambient and focal vision systems. When they are out of sync, a prism can help the two systems blend better. Yoked prisms do what any therapy – physical, occupational, speech – is meant to do: create a new, more meaningful and useful environment for the patient. It changes input and thus changes output.


Vision therapy is an attempt to understand the world in which a per- son on the autism spectrum lives and moves, to understand what makes their sensory input different and to take steps to improve it. It is effective for both children and adults.

Once there is a better understanding of what is affecting the person with autism, vision therapy can expand his or her peripheral awareness and help him or her achieve the ability to judge space and distance so they don’t get as overwhelmed as quickly. For more information about yoked prisms and the autism spectrum, a recommended book is Mel Kaplan’s “Seeing Through New Eyes,” which details his work with patients on the autism spectrum.

DR. RICK GRAEBE

Dr. Graebe received both his B.S degree in Visual Science and Doctorate of Optometry from Indiana University. He is a Behavioral Optometrist and learning expert. He has been in private practice here in the Bluegrass area for the past 32 years.

more articles by dr rick graebe