To paraphrase an optometrist I consulted  "Panoramic viewing is the ability to perceive the images from each eye projected along the particular line of sight simultaneously without doplopia."  

It feels like to me as if this is what is going on:  1) Each eye turns out quite a bit (about 35 diopters) when it's not being used, 2) There's only a small area of overlap (in the middle) where both eyes are seeing the same thing, and 3) I suppress the area where there's overlap. (I don't know if this suppression happens in the eye I'm using, the eye I am not using, or both.)

What do people think?  What causes this?  How common is it?  How does it affect my chances of obtaining stereopsis?  Will strabismus surgery destroy it (decrease my field of view)?  Does it increase the frequency, degree or speed of "drift" after surgery?  

Anybody have any knowledge, ideas, thoughts, speculations about this?

Thanks!

-Frances

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Had trouble finding this again, as it is outside the Adult Strabismic Patient's Forum ... learning curves! (There are also several topics specific to strabismus inside the forum. Confusing, I know!)

Josh is another exo like yourself, but with less turnout. He has been blogging very informative and scientific aspects of strabismus for about a year.  http://squintyjosh.blogspot.com/ His post on

Your description of panorama made me wonder if there may be some abnormal retinal correspondence going on? I still don't fully understand it, and am unsure if I am experiencing it, but Josh blogged about it here http://squintyjosh.blogspot.com/2011/02/abnormal-retinal-correspond...

Josh's experiences will be similar to your to some degree, whereas the experiences of most of the folks on the forum is with eye turn-in.

Welcome to Sovoto and the adult strabbie community in particular!

Hi Lynda, I don't really know *what's* going on with the eye I'm not "using" at any particular moment.  Up until now it never occurred to me that other people with strabismus saw things any differently than I do so I never thought about it much.  

What it *feels* like is that what's going on has to do with my brain.  Because my eyes are pointed in different directions my brain is receiving two separate images. As far as I know, the brains of most people with this problem get intolerably confused by that and suppresses the image coming from the eye they're not "using."  

But my brain doesn't suppress the image that it's not "using."   At least not completely.  (I've just figured out that my brain does partially suppress that image.)  So while it's not as clear as the image my brain is "using" it's definitely there.  

So voila!  One brain, two images!

-Frances

Did you read Josh's article on abnormal retinal correspondence? Here's the panorama illustration http://squintyjosh.blogspot.com/2011/02/abnormal-retinal-correspond...

and what I think is relevant in your case: "In the case of exotropia, this can lead to a widened, panoramic visual field. Instead two eyes operating binocularly to make one image, the two eyes operate monocularly to make one panoramic image, neatly joined in the middle." ...

and ... "So that's the first problem of ARC. The foveas are not hooked up, and true fusion is not possible. The fovea of one eye doesn't overlap with the fovea of the other eye. It's the like story of the sun and the moon, of Apollo chasing Artemis. The sun approaches the moon, and the moon moves farther away. They're always separated by that 45 degrees of abnormal correspondence."

It doesn't sound like suppression to me, but I am not a vision therapist! ;-)


I have my own unique issue in that I lost the upper half of my vision in my dominant eye a year ago. I was an alternating esotrope (25-30°) before the BRAO and have yet to go back to my VT to determine what, if anything, I can do to gain true stereo.

I posted about BRAO here http://www.sovoto.com/group/adultstrabismicpatientsforum/forum/topi... and I'm trying to blog about my new glimpses of stereo here http://leavingflatland.wordpress.com/

We all come to the table with many variations on a strabismic theme! ;-)

That sounds really really awful!  

I don't know the references to various tests and exercises. I'm still *very* new to this. (I thought that I just lacked BV because my brain couldn't put the two images together while interpreting the differences between them in order to know distance/depth. And that that was the end of the story!)  

So I *do* understand that you've lost part of your range of view (the upper part) in one of your eyes.  (Sounds a lot like the result of partial retinal detachment.)

Has there been any change (for better or worse since you posted this? 

Also, I'd like to understand what people are saying here.  Do you have any suggestions about where I could go to learn the basic lexicon and concepts involved in the world of strabismus?  I feel like a child listening to grownups talking about something I know nothing about.  I know all the in-between words but I don't even have enough context to extrapolate the meanings of the new words.

Thanks!

I have checked out Josh's blog.  

The subject is way more complicated than I had imagined!

And I have an illness that has messed with some of my cognitive function.  One problem is that I now have is trouble connecting the conceptual dots, so to speak.  I will have to go over what he has outlined quite a few times in small bites, then larger bites, and maybe copy his diagrams and drawings in order to arrange it in my mind so that it makes sense--and stays there.

It can be a frustrating process, since this was the kind of thing that I was *really* good at before I got sick.  In those days I probably could have skimmed over it a couple of times and grasped all the major concepts right away.

The motivation to understand this information is pretty strong, so it will probably overcome the frustration.  But it could take a while before I can get back to you with any kind of intelligent response.  In the meantime, since I started this discussion I will always know where to find it!

Hopefully you will get this note and bear with me while I put the pieces together.

Hi Frances. When you figure it out, tell me what it all means, lol. It's pretty foggy and nebulous for me, too! If I find another source of info on the topic that's easier to understand, I'll send along a link. I wasn't quite getting ARC in Sue Barry's book, either.

I'm pretty sure I'm developing some ARC (abnormal retinal correspondence) now with only a half retina in the right eye. When I get some funding, I'm going to get another eye exam and ask about testing for ARC and whether I need vertical prism.

Hi Lynda,  So cool to get a response so quickly!  How did the visit with the retinal specialist go yesterday?  I hope s/he was able to tell you that your body will clear up the problem itself now and that your "built in visor" will go away.  Or at very least that they can do something to help.

I don't know how or why but I seem to have acquired a bit of knowledge about detached retinas--different problem, but concerning the same structure and resulting in similar effects.  

As to confusion.  Perhaps I could start by asking you for info on some of the terms you used.  If you're not up for providing any additional info that is cool.  You have plenty on your plate as it is!

McDonald chart (and  "the elusive V"):  No info found.

Tranaglyph.  I think this is a red/green image.  It looks like there are line drawings of shapes, people, numbers and letters with black, red, and green versions of each slightly offset from each other.  I would imagine that if you are fusing and stereoscopic that you see either the black ones or the combined ones positioned above the other?  I'm not sure what you mean by "missing upper right dot." I see circles there...

Brock string.  I've been meaning to try this.  (Gotta get me some beads!) I suspect that I will see one string no matter what I do.  Not even sure that VT will get me there...

Physiological diplopia:  I understand the meaning of each word but not the meaning of the two used in this context.

Bi-nasal occluded glasses:  I think maybeI can guess what these look like, but not their purpose.

"Use my new, built-in partial central occlusion to create diplopia and then work on divergence to bring the two distant objects together, but not with any consistency"  Again, I understand all the words but can't picture this.

********

Actually, that turned out to be fewer words/phrases than I thought I'd had trouble with.  Note:  I learn visually, so descriptions of the physical objects and actions are most helpful!.  But again:  If you're not up for this that is cool.  There's lots of other folks here and lots of other things I don't know so I know there's lots of opportunities here to learn all sorts of arcane things.  (I seem to have a fair number of them as it is.  Used to get them from my Mom who was interested in *everything.*  So now I've found at least once source (SOVOTO) of my own...

Hope your evaluation went well.  Hope your VT appointment (on a Saturday--Easter weekend)? does too.

Hello again, a quick reply this time:

My retina issue is not a detachment, but a blood clot and the loss is permanent. But the brain is amazing in adapting and creating a complete visual field for me!

It looks like you've picked up several things off my blog, and I'm pretty sure I've defined them in a blog post and maybe provided a link for even more info.

Check the list in the right hand column where these terms are under the heading Categories. Clicking on any term (eg "phyiological diplopia") will arrange everything I've written about that category in a list of posts. Start at the bottom of the list with the first post on the topic, and I'll bet I've explained it pretty thoroughly the first time I wrote about it ...


I get having a visual way of learning and absorbing info ... me too!

Yes,  I knew that it was not a retinal detachment--but it seems like the effect is similar: Part of the field of view appears to be obstructed...

I'm not having any luck with finding that "list on the right hand column."  (I'm really good at looking straight at things and not seeing them--and it has *nothing* to do with the strabismus...  Uh, or at least I don't I think it does.

Can you help me out here?  

(The page where I was seeing the terms I was wondering about was):

http://www.sovoto.com/group/adultstrabismicpatientsforum/forum/topi...

Also:  I think I might join that discussion rather than continuing here (even though I'm still trying to learn the format that makes it clear who is replying to what!)  

Thanks again!

Aha! You weren't at my blog, hence, no right hand column!

Here's the part of the Sovoto post you were wondering about, and I will explain each term:

"The tranaglyph reveals a missing upper right dot...'"

TRANAGLYPH image here http://www.bernell.com/product/3244/403 it is used with glasses that have one lens red and one lens green or blue. This red/green feedback helps strabbies to know if they are using right eye or left or both. With the tranaglyph, what is red or green will disappear if seen through the same color lens.

"Brock string lacks the upper right portion of the X at all points and bead fusion is more elusive than ever..."

BROCK STRING Here's a video demonstration http://www.youtube.com/watch?v=EGlCVTdNqfw

"Physiological diplopia reveals one and a half fingers ..."

PHYSIOLOGICAL DIPLOPIA Here are my blog posts about it (one has a painting of the half finger ;-)  http://leavingflatland.wordpress.com/category/developmental-optomet...

and there's a discussion on Sovoto about it, too http://www.sovoto.com/group/adultstrabismicpatientsforum/forum/topi...

"Yesterday, I adjusted my bi-nasal occluded glasses … "

BINASAL OCCLUSION is a tool to help folks like me with eye turn-in to learn to turn out. I have a photo of my glasses here http://leavingflatland.wordpress.com/2010/11/26/discovering-periphe... however, I have not used these glasses in the last year. Occlusion basically makes me unhappy at this point … let's just call that "denial" ;-)

Hi Lynda,  (Couldn't find the "reply" button to your last post.  Hope you find this)

Thank you for this list of links and descriptions!

TRANAGLYPH  Ah, I already know which eye I'm using.  (Though once in a while, under certain circumstances I need to make a quick check because I sometimes switch automatically and don't realize it.)

Brock String.  Already seen this (in a number of places--but the video is cool.  I am so far away from being able to make use of this!

PHYSIOLOGICAL DIPLOPIA Hmmm.  The only time I've experienced this was during an evaluation when they were doing things with prisms.  Very startling.  I wasn't bothered though, since the cause was external.  In fact I found it kind of amusing...

BINASAL OCCLUSION  I thought that might be what it was--but I'd imagined an opaque block.  With this occlusion your glasses simulate what my eyes do!  (I'm an exotrop with panoramic vision and as far as I can tell, my brain does this in order to prevent seeing anything double.

I wonder if a similar occlusion located on other side of my glasses would be something a V.T would use with me...  We'll see.  I'm still waiting for the end of the month when I will see the therapist for her initial evaluation of my eyes/vision.  And I'm still trying to figure out how to get to her on a regular basis.

Thank you again for the links/descriptions.  I don't know which--if any--will be used in my case.  But this information has added to my knowledge about strabismus.  And since people in my family believe in throwing information at problems instead of money this is especially useful.  -F

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