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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SENSORY INTEGRATION IMPORTANT FOR BALANCE

What happened the last time you went on the Mad Tea Party ride at DisneyWorld? Did you enjoy yourself initially, but as the ride went on, did you start to feel sick and disoriented? When you closed your eyes, however, you probably felt much better. And you were immensely glad when the ride ended and you could get your bearings again.


Vision plays a significant role in balance.


There are basically three components to balance:


1. Vision, which includes much more than clear eyesight;

2. Vestibular system, which includes fluid filled canals of the inner ear; and

3. Somatosensory system, which includes both proprioception, or movement of the body, and tactile, or sense of touch.


These sensory components work together through a process called sensory integration.


Sensory integration is the way your vestibular and somatosensory systems communicate with and relate to your vision. The vestibular system is like a gyroscope that helps orient us spatially. Fluid in sacs in the inner ear moves around when you tip your head and it tells you

where your head is in relationship to your physical environment.


The somatosensory cortex is an area of the brain that processes input from various systems in the body that are sensitive to touch. It lets you feel your feet touching the floor or your back resting against a chair. The different sensory systems are constantly talking to each other as you move through space, sending information to the brain about where you are and how fast you are moving; and comparing their individual findings.


The reason you get dizzy on the tea-cup ride, or have motion sickness, is the three systems are telling your brain different things. The fluid in the vestibular system whirls in one direction at a high velocity, so when you stand up, that system tells you you’re spinning. But your eyes say you are standing still. The systems don’t match up. Then the brain decides there is a neurotoxic substance in your system that must be expelled, thus causing nausea. With motion sickness, your eyes tell you you’re sitting still, not moving. But the vestibular system is getting jostled around and telling the brain you are moving. When all three systems are working in sync, motion sickness and balance problems are

are reduced and often alleviated. That’s why in some instances, closing Closing your eyes can help you reestablish stability.


Over time, however, the relationship between the vestibular system and vision changes. Vision stays relatively stable but the vestibular system actually changes with age. The signal from the system hyperstimulates and it takes a while for the fluid in the inner ear to settle down. This is why you probably don’t enjoy roller coasters or spinning rides as much as you did when you were a youngster. Children love high-velocity spinning, but it’s too much for us as we get older.


Some Dr. Graebe’s office provides neuro-visual therapy programs that help with motion sickness problems. Their office also works closely with other specialists when needed.  Often it This is helpful when your balance issues call calls for the additional skills of an occupational therapist, who will work with the vestibular system; or a physical therapist, who will do more with midline awareness of the body; and a vision therapist, who might prescribe provides neuro-visual therapy or prisms to help you. The three specialists, working together, can determine which of the systems is most at fault and plan appropriate treatment.


For further information, or to schedule and appointment, you can reach Dr. Graebe’s office in Versailles at (859)- 879-3665.

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