Beyond Glasses

by Lorrie Klosterman and illustrations by Annie Internicola, April 29, 2008 - www.chronogram.com

With a greater percentage of people wearing glasses or contact lenses more than ever before, we've come to accept that corrective lenses (or Lasik surgery) is all we can do to manage a vision problem. But it is possible to move beyond glasses without surgery. A few behavioral changes may help, like using better lighting or changing the computer's default font to something larger. But there is another way to address the imperfections in your vision. Integrative vision care, also called natural vision care, is a holistic approach to eye health and vision improvement that works not just on the mechanics of eyesight, but through a sea of variables that influence vision. An increasing number of eye doctors are learning this approach and deepening what it means to help people see better.

I recently visited Dr. Marc Grossman, a behavioral optometrist, acupuncturist, and natural vision educator, to learn about integrative vision care. Nothing else would likely have gotten me to an eye doctor for any number of years. Who wants their eyesight foibles reinforced? But rather than reprimand me for my neglect of vision check ups, he guided me through a fascinating hour similar to a patient's first visit at his New Paltz office. Within a minute of our session, the first of several unique aspects to this approach revealed itself.

"Already I'm looking at things that I see," he said as he scanned the way I stood and moved. "For one thing, you're tilting your head to the side." That observation may be related to vision, as people tend to tilt their heads to compensate for eyesight problems such as astigmatism. "That puts a bit more tension on the cleidomastoid muscle on one side," he said, referring to a strap like muscle on each side of the neck that runs from behind the ear to the chest. Grossman explained that the body in many ways accommodates to eyesight needs-and not just the physical body, but the emotional and psychological self as well.

The integrative vision approach

I was a bit embarrassed to admit to Grossman that I had only thought of eyeballs as objects that mechanically take in the scenery as best they can. That's partly right: Eyesight refers to how eyeballs collect light and form images. But their role is only one element in the bigger picture of vision. "Vision is our ability to take meaning from our environment," he explains in one of his books, Greater Vision: A Comprehensive Program for Physical, Emotional, and Spiritual Clarity (coauthored with Vinton McCabe). "It is pervasive in everything we see, touch, and do. It is a reflection of our biases, our hopes, and our judgments, all in one package." His training and practice in Chinese medicine enhances Grossman's perspective that everything is interrelated, and his books are brimming with examples from his patients of how good vision depends on much more than good eyesight.

Like other tasks running in the brain, interpreting what we see is inextricably linked to other sensory input, thoughts, biases, memories, emotions, nutritional and health status, and just about every other aspect of being human. What's more, a bounty of behavioral, psychological, and developmental studies have demonstrated how what a person reports to be seeing does not necessarily match what their eyes are capable of taking in.

Vision truly is a holistic activity. As such, visual problems are best treated through a holistic approach. "The integrative approach," Grossman explains, "evaluates the person's lifestyle, habits, diet, exercise routine, and stress management, along with the family history. It attempts to bring in the patient as an active partner in the program to improve or maintain eye health." A treatment plan may include acupuncture, chiropractic, athletics, psychotherapy, nutritional counseling, and other healing modalities, in combination with vision exercises.

Natural Vision improvement

If you've worn glasses since childhood, you've probably thought there's nothing you can do but wear glasses all your life. But most people aren't born with vision problems. Amazingly, only about 5 percent of Americans are born myopic (able to see well near, but not far), but the percentage gradually increases through childhood, to reach 40 percent by age 18. Adults, too, like those who use a computer for long hours at the workplace, complain of newly emerging vision problems. Some vision experts attribute those trends to the unrelenting hours of close-up work many of us do, without letting our eyes rest or gaze afar.

Ironically, glasses are also an accomplice. They often perpetuate, and even worsen, a vision problem. That's because, like any neglected muscle, eye muscles that don't have to work so hard (because the glasses are letting them off the hook) weaken over time. As a result, you become dependent on glasses, and on increasingly stronger ones. It's such a commonplace strategy that we don't suspect the "cure" is reinforcing the condition.

Improving your vision is truly possible. Vision therapy is a part of the integrative vision approach, in which the doctor prescribes a plan of activities to do at home and in weekly sessions with a trained vision therapist. Vision therapy has been proven to help people with such problems as lazy eye, crossed eyes, double vision, near- and far-sightedness, age-related vision decline, brain-injury vision changes, sports-related vision problems, and reading and learning disabilities. The strategy may use special tools such as therapeutic lenses, prisms, optical filters, or eye patches, along with exercises and games designed to improve visual skills and information processing.

Nancy Neff of Fishkill says she was sure she would grow up blind. "I got glasses when I was five," she says, "and they just got stronger and stronger my whole life. Everyone in my family had glasses, and students in school all had glasses like me, so I figured that's just the way it is." But she was inspired by one of Grossman's public talks and decided to try his approach to improving vision. It included using her glasses less, which wasn't easy. "You take your glasses off and you feel helpless," she says. "I run every day, and doing that without the glasses in the beginning was really challenging. I used to say hello to the mailboxes!" But it worked. "Slowly, you break that addiction, and go to weaker glasses for things that aren't that challenging. Now, I do almost everything without my glasses. I've turned it around. It's like I'm rewinding time."

Neff is a natural vision educator who now helps others, coaching them through vision therapy prescribed by an integrative vision care doctor. "One of the things I emphasize most strongly is that it's not really just exercises where you struggle and strain. It's about good, healthy vision habits," she explains. "It's like good posture-you want to do it all day long." Until recently, there hasn't been any attention paid to visual hygiene, she says. "Most problems come from strain and bad habits over the years. We do things like stare at a computer for six hours straight without looking up, and never blink. If you wear glasses, they train your eyes not to move because they force you to look straight ahead. That reduces peripheral vision awareness. Healthy eyes are sparkling because of tiny little movements all the time, scanning the environment."

Mark Girard, who is farsighted (sees distances better than close up), wanted to improve his vision. "As an artist and avid reader," says Girard, "I find that most of the things I look at are fairly close, and my eyes were accustomed to that." Through his integrative vision consultation, Girard learned that changing his visual habits could naturally improve his vision. "I found that if I looked off at distant objects every few minutes, say, by looking up and out the window at birds as I was drawing, I could really feel my eyes working," he recalls. "I also spent more time doing things without my glasses." Through that process, he markedly reduced the strength of the glasses he now uses.

Never say inevitable

During my appointment with Grossman, standard eyesight tests confirmed the over-40 age-related blur of things up close. Yes, he said, people generally experience some loss of lens flexibility with age. But instead of encouraging me to use the reading glasses I already have, he counseled that, "If you use reading glasses, they do the work for you. If you go back to trying to read without them, it's even blurrier." I've noticed that, which makes me shy away from using them.

Next, he handed me a pair of glasses and a page to read. The glasses made it even blurrier than it was without my glasses. "Those are 'opposite glasses,'" he explained. "You are farsighted. So I've given you nearsighted glasses. He then had me do some vision exercises while wearing them: focusing on my finger close up for about a minute, then on the distant wall, and then repeating this alternation of focus for several minutes. Then I took off the glasses and looked at the page. I could read it more easily (without any glasses) than before the exercises. Then he had me put on the reading glasses I had brought. They were much stronger. "If you get used to these opposite glasses [by doing similar exercises regularly], your eyes should get better," he explained. "It's a big part of the exercises I do with patients."

The eyeball team

Visual acuity is only a part of what gives us good vision. An integrative vision doctor will check other essential components of seeing. One is teaming: how well the two eyes work together to focus on something. Another is tracking: how well the eyes follow a moving object, or scan across something like lines of print while reading. Problems in those areas are often overlooked in a standard eye exam, but can have powerful repercussions in school or a workplace.

"Most laypeople are under the impression that if you see 20/20, then that's perfect," says Dr. Daniel Lack, an optometrist, vision therapist, and the director of vision services at the Northeast Center for Special Care in Lake Katrine. "But just as a camera has to change focus to see things at different distances, your eyes need to work together to focus on something," he says. "When they are seeing far away, the eyes are looking parallel. When they see close up, the eyes must turn in toward each other"-a skill called convergence.

"Children who have learning problems often have convergence insufficiency," says Lack. "Tracking is worse in children with learning disabilities, too. Most learning-disabled children have a vision problem that is at least contributing to it, if not causing it." Parents and teachers don't realize that the in-school eye exam only tests acuity, which may give a false assurance that there is no visual problem. "School nurses do a great job with the tools they are given, but they cannot check all these skills."

Without testing other eye skills, children and even adults may be diagnosed with a learning or behavioral disorder and treated pharmacologically. "One of my patients had a pediatrician who was going to prescribe Ritalin for ADD (attention deficit disorder)," says Lack. "But they came to me after hearing a talk, and we were able to use vision therapy instead of medication. Through visual learning activities, the patient learned to use their visual system efficiently." Lack adds that even children who are already doing well might do better if their vision were improved through tracking tests and therapy. People with brain injuries or stroke deficiencies also benefit from this approach.

Your eyes' keeper

Hopefully you see that eyeballs aren't just a bit of hardware we're entitled to. They are living, changing entities. What's more, good eyesight is just one aspect of a healthy visual system. How you treat not only eyes, but also the rest of you, impacts your vision. We've all heard that carrots are good for our eyes (and that's the extent of vision-care schooling for many of us!). Indeed, nutrition is one way to support visual health.

Carotenoids, which are abundant not only in carrots but leafy green vegetables, appear to protect against and even improve macular degeneration (a progressive loss of retina function). Studies have shown that vitamin C, abundant in healthy eyes, is lower in people who are developing cataracts, and this vitamin is a routine part of glaucoma treatment in Europe. So citrus fruits, red peppers, and tomatoes are good vision-support foods. Several other nutrients that help regulate fluid movement and pressure in the eye, such as omega-3 fatty acids, magnesium, and ginkgo biloba, can also moderate glaucoma.

As Grossman reminds us, these and several other nutrients with vision-healing potential should not be the only approach. Nothing replaces a nutritious diet overall, especially when it's combined with a positive, healthy lifestyle that also includes regular exercise and daily relaxation such as meditation or a walk in nature. As a holistic healer and not just an eye doctor, he adds, "The rapid pace of our lives often interferes with us taking the time to really take care of ourselves. Caring for ourselves helps to keep our bodies healthy, and maximizes the mind/body's inherent healing potential."

• This article was written by and published in the May 2008 edition of Chronogram.
• Luminary Publishing is the copyright holder of this article.