My own pilot study: Microwaves’ effectiveness in increasing compliance with vision training

The solution was there, sitting in the corner of the kitchen all along. My microwave timer has saved patching. The  obtrusive but helpful-in-a-pinch black box has also helped salvage the vision therapy we do at home. Cue an annoying series of loud, celebratory beeps!

It makes sense. The only reason women endure childbirth is because we know that it will end in a few (okay, maybe 32) hours. It’s a relatively short timetable. This is why, at the Cape Cod Bay Basketball Camp, I managed to swallow suffering and push myself to the limit of heat exhaustion and muscle failure during drills on sizzling hot blacktop that threatened to melt the soles of my black Nike hightops. It’s how I now carry my giant toddler home from the park down the street, when we’re running behind which is always, even when my arm is about to detach and my grimace nearly devours my face. The end is in sight.

Over recent weeks, Stella did her best to refuse to patch. Which meant I spent all day trying to eek out small periods of patching in order to accumulate two hours’ worth. But last week, the answer suddenly came to me. I took her hand and led her to the holy shrine of now-passe cooking technology that is the microwave, and said, “It’s patching time. So we’re going to set the timer for 90 minutes, and when the timer beeps, you can take it off yourself!” I said it the way you would say, oh, “We’re going to Disney World right now. When this timer goes off, you can eat ice cream while riding the tea cups with Mickey Mouse!” As if Tinkerbell had cast a magic spell, Stella quietly allowed me put the patch on the glasses and place them on her face without any fight or resistance or complaint whatsoever. It has been working ever since. Trust me this is just as miraculous as, say, seeing Jesus in a piece of toast.

So yesterday I tried applying this super brilliant countdown strategy to vision therapy. We are currently only doing very physical, “vestibular” activities (spinning, rolling, etc.), and they go fast (you know, when they go). I turned into Jack Bauer, set the timer for 15 minutes, and informed Stella that we had to do four eye games before the timer went off. I told her this with the urgency of a counter-terrorist expert called in to thwart an impending explosion. Only my voice was much, much higher, more enthusiastic. It helped! Though by about 10 minutes, we were significantly derailed by someone’s whining and avoidance tactics. So, I’ll split “eye games” up into two 10-minute sessions, spread apart, and see how it goes. Aaaaaand that sentence shows clearly how such mind-numbing minutia has officially taken over my life. Hey, we do what works, and you’ve got to celebrate the little triumphs (our children’s and our own), right? RIGHT? [Insert guzzle of wine directly from the bottle.]

Please excuse me while I go high-five Stella and snuggle with the microwave.

Two points of view. One big push forward.

Big girl

Big girl bed! New purple glasses! Happy Stella.

In the first chapter of John Gottman’s wonderful book, Raising an Emotionally Intelligent Child, my current daily life is illuminated: “Behavioral psychologists have observed that preschoolers typically demand that their caretakers deal with some kind of need or desire at an average rate of three times a minute.” Stella is officially two and a half, 38 inches tall and sleeping in a big girl bed. She has more demands and opinions and upset and glee now than even just six months ago. She’s in some sort of developmental transition period. At times I’m awed and at others, I’m borderline insane. This is a fun but challenging age requiring tons of patience. A tricky age indeed for vision therapy, which requires focus, patience and the tabling of those smaller demands in order to accomplish something she doesn’t fully understand. (I do think she gets it partially, though.)

Stella recently had two evaluations. One with her pediatric ophthalmologist and the other with her developmental optometrist, within about a week of each other. The conclusions by both were encouraging, overall, but quite different. Our intention was to use the results to gauge how vision therapy was going, especially since Stella’s been resisting more. We wanted to figure out whether we should take a break and come back to vision therapy in six or so months, or carry on.

The ophthalmologist determined that Stella’s amblyopic eye is 20/40 but bordering on 20/30. And that her other eye is 20/30 bordering on 20/20. They go with the lowest number, I suppose, in order to crush parents’ spirits–I mean, in order to be conservative and not overestimate visual abilities. (It does make sense.) She very cheerfully told us we could reduce patching from three to four hours to just two hours. I have not told her that we’ve been patching differently than she prescribed. Instead of patching three to four hours a day with an adhesive patch placed directly on Stella’s skin for complete occlusion, we’ve been patching two to three hours a day with Magic Tape over Stella’s glasses lens, and doing vision therapy, which they will hopefully remain ignorant of because I don’t want it to taint their assessment or treatment of me and Stella. It was reassuring to hear her, someone who said Stella may have to patch for a few years, say that patching was effective and that we could reduce it. At the end of the appointment, I asked her, “So, is there anything else we can do for Stella?” She hesitated for a split second and then said, ‘No. It doesn’t matter what they do while patched.’ And that was that.

Hold onto your hats. In our evaluation with the developmental optometrist, Stella showed 20/20 vision in both eyes. This is huge, and I haven’t really come to fully believe it yet–though I saw it with my own 20/20 eyes. It took Stella a tad longer to see the targets with her amblyopic eye, but not too much longer. She could see the chart’s 20/20 line far away and up close, with both eyes. Sometimes answering instantly, when the smiling doctor playfully sang “quickly quickly!” Why there is a discrepancy in performance between the two appointments, I’m not sure. The testing procedures and atmospheres were certainly different. Mainly, more time was taken at the optometrist, with more nuanced testing done.

Randot Stereo Test

Randot Stereo Test

While I was stunned when Stella identified the teeny tiny symbols (bird, cake, etc.) indicative of 20/20 acuity, I was just as thrilled when, during that same optometrist appointment, Stella was able to see three 3D circle images  in the top left section of the chart (the Randot Stereo Test at left). Last time, she didn’t get any of those and saw only one thing pop out at her–the 3D character in line A in the bottom portion of that left panel. Alas, she still only got one in that section. I suspect that her attention span complicates this, and the doctor did acknowledge that it’s possible Stella can see more than she is able to indicate. But perhaps not. As I’m known to say these days, after over-analyzing some Stella-related concern to the point of boring even myself, “Who the hell knows!?” I’m just grateful for the improvement.

The ophthalmologist’s 3D testing was much faster and simpler. Instead of a multi-layered chart with different lines measuring different degrees of stereoscopy, they used a single large image of a fly–the Stereo Fly test, which I learned about on Strabby (more on Sally and her blog in a minute). Stella seemed to try to pet the insect after some coaxing. They nodded approvingly. I wondered what Stella saw and thought and wished she could describe it to me.

I was crestfallen to hear, at the ophthalmologist’s office, that they saw no improvement in Stella’s vision. Yet they seemed incredibly happy with how she was doing. They noted that the acuity in Stella’s amblyopic eye is and has always been above average for her age. Her other eye’s acuity (with glasses, of course) is way above average. They said her vision was developing very nicely.

Both doctors concur that the eye crossing (esotropia), so far at least, has been eliminated by the glasses. Perhaps with help from vision therapy, as I believe the eyes did cross in exam with glasses earlier on in this journey. I haven’t seen Stella’s eyes cross in such a long time as they are aligned when she wears her glasses, which is all the time, excepting bedtime, bathtime and her weekly half hour of swimming (prescription goggles may be in her future) and occasional fits of toddler rage. Stella’s eyes did not cross in either of the recent exams, even after the typical attempts to break alignment. This is huge, often overlooked by myself and Cody, and worth celebrating with lots of wine. I have so many pictures from her babyhood in which I can now immediately detect the not-so-obvious difference in her eyes’ positioning. We also have photos and videos from her ER visit at 18 months of age, during which both eyes were severely crossed (seemingly out of nowhere, though again, we realize now that they’d been slightly misaligned, frequently but thankfully just “intermittently,” her whole life). We keep the ER images as a reminder of why we’re doing all of this. It’s very difficult for me and Cody to view them, because she looked so vulnerable and clearly couldn’t see anything except foggy blurs. But they’re powerful appreciation boosters, and quickly give me perspective when I’m stressing about Stella’s refusal to go to bed without getting up ten times to talk about Papa Bear’s porridge or flamingos or other topics meant to engage me and delay the train to Snoozetown by a good three hours. (And breathe!)

The bottom line is that her eyes–their refractive power and degree of slight astigmatism and as a result, their acuity–are different. It’s refreshingly simple. The two doctors agree on this. It’s the discrepancy between the two eyes that has led Stella down the path to amblyopia.

Both doctors, seeing Stella through their respective lenses, were very positive. Through the course of both appointments, I was amazed, disappointed, encouraged and informed on several levels. I walked away from these evaluations with some real reassurance, but also some points to ponder endlessly and inanely. Stella’s degree of stereopsis (3D vision) has improved wonderfully in just two months, but further improvement is needed. I wish I’d questioned the ophthalmologist more on their take on this. Do they think Stella has normal 3D vision because she tried to pet the fly (I think we called it a bee)? Are they settling by assuming, “at least she has some 3D vision,” or do they genuinely think she has age-appropriate stereoscopy? I wondered aloud to the developmental optometrist: When Stella has moments of experiencing 3D vision, does it freak her out and lead her to suppress her amblyopic eye? Our optometrist said that yes, this can happen. Which may explain why Stella frequently says, “Mommy I need a break!” But, the doctor explained, if I’m around, serving as Stella’s anchor and emotional safety net, it shouldn’t be an issue. For that reason and many others, I am so happy that I get to be with Stella during this time in her life. I get to be there to eat the pretend lunch she prepared and soothe her when her vision acts up (though I never really know for sure) and observe all the little things that indicate what she’s seeing and experiencing–which prove helpful to this process but might otherwise go unnoticed. I see how her peripheral vision is really good now. I see that puzzles are a breeze. I see her push her left lens closer to her eye. I hear her say things about her eyes that give me hope. I’m fortunate to have this time. Happy to take all (okay most) of it in.

Children's Eye Chart

These are the symbols Stella identifies.

These exams were more than just “let’s see how she’s doing” meetings. This latest evaluation, particularly with the developmental optometrist, was a crossroads. I was nervous. I feared Stella would feel my heart pounding as she sat on my lap in the big black exam throne. We came to this point of decision-making because it’s not only been increasingly tough to get cooperation from Stella for vision therapy at home, but also in the office at times. Some exercises are much more well received than others both at home and in the office. Some appointments are simply better than others and I still believe that she gets a lot out of all of them. At home, it can take over an hour to get 20 minutes of therapy done. (I find that time hard to fit in comfortably–but I suspect other, more normal and organizationally proficient moms might do a better job of this so I really don’t want to deter other families who have a child of two and a half who might greatly benefit from vision therapy.) We’ve been told to do the exercises earlier in the day, when Stella is less tired and there is more natural light, because we tended to shove them in at the end of the day. After a glass of wine, I’m a much more effective and relaxed vision therapist. But I am slowly getting better at overcoming my dread of possible screaming and infinite dawdling and learning to break therapy up into small chunks. A quick matching game (with the patch) before lunch. Sticking skewers intro straws while patched and eating dessert. That sort of thing. Did I mention that I’m not very organized? If The Container Store had a blacklist, I’d be on it. Though I do have a big green plastic box in which I dump all of our vision therapy games and tools, which is a true Martha Stewart moment by my standards.

In the end, due to her gains in 3D vision and acuity as witnessed in the optometrist’s office, and even the ophthalmologist’s thumbs up assessment of Stella’s visual status, we’ve decided to continue vision therapy for another few weeks, at least. With an emphasis on use of the yoked prism goggles, which merit an entire post (coming soon), and more physical exercises that engage the vestibular system and body as they relate to and inform vision, from what I gather, helping Stella’s brain devise a more accurate map of space and her place in it. Stella enjoys those activities more, anyway. Bouncing, rolling, running? She’s in! Donning red/green glasses and slowly scanning the kitchen floor for matches, MFBF style? She’s so done with that particular game. She used to get 15 matches in one shot, now I’m lucky to get five reluctant matches worth of cooperation and sometimes she refuses completely and we both end up in tears. So I have to roll with it and be more flexible than ever. Putting those cards on the wall over the couch and letting her bounce around while searching does help make it more novel and fun. But I’m not sure that exercise is worth it anymore. Stella’s vision therapist agrees and is going to move us along to some new MFBF exercises to build upon this work and mix things up. We really like her–she’s had letters thrown at her, cards torn out of her hands, and shrill, blood-curdling screams shatter her eardrums, yet she keeps a cool head at all times. Me? Not so much. I sweat during those appointments to the degree where I stash deodorant in the diaper bag.

So we are at the beginning of a big vision therapy push. Can I help Stella get to the next level? I sure hope so. We’re going to do our best. We’re seeing progress and it would kill me to break now especially with the promise of yoked prism goggles just starting to be a staple in her vision therapy buffet. If a break is needed after that, fine. But if so, we’ll be back at vision therapy as soon as Stella is ready. Do kids become more cooperative at three? Good lord I hope so because caring for a two and a half year old is like playing with fire. I’ll tell you what, though. I appreciate Stella’s strong will (the screaming? less so) and don’t blame her one bit for resisting patching and exercises, the purpose of which she doesn’t comprehend. Between that and patching, we ask a lot of her. She does amazingly well for her age, and knows her numbers, shapes, and letters better than many kids twice as old, which has helped make a lot of exercises possible. As they say where I’m from, she’s wicked smaht. Don’t even get me stahted!

It’s been twenty seconds since I’ve heard, “Mommy? MOMMY!?” So another Stella need will arise now and I must go. But first a shout-out to our comrade Strabby, who recently had a huge vision therapy breakthrough using a lot of the same therapeutic tools that Stella employs. It is so fascinating to hear her account of her first glimpses of “3D-ish” vision–I bet that’s what Stella was experiencing when she said, “I can see with both eyes!” Strabby gives me a better idea of what Stella might be seeing and going through, which helps keep me motivated. Thank you and congratulations, Strabby Sally. Keep it up. Lead the way to 3D-ville, baby! We’re right behind you!

Stella insists she can see with BOTH eyes

Yesterday was sunny and crisp. A Golden Delicious apple of a day. Okay, a frozen one. I’d recently read about how incredibly important and beneficial outdoor time is to kids’ eyesight, and was determined to whisk Stella off to the neighborhood park immediately after her nap. Stella woke up, and after wasting about 30 to 45 minutes doing absolutely nothing in particular, I removed the eye patch from her glasses and we headed out on foot.

Half a block into our walk, which was really more of a run, Stella seemed to have a revelation. I saw it before she said a word. She suddenly paused, looked around, smiled, and excitedly exclaimed, “I can see with BOTH eyes!” She went on to make this declaration at least twenty times. “Mommy! I can see with BOTH eyes! I can see the leaves. I can see the berries. I can see with BOTH eyes! Mommy! I see with BOTH EYES!” While she was having a great time, seeing with BOTH eyes, my mind raced to interpret this statement in relation to her amblyopia and strabismus and vision therapy. I tried not to let my hopes soar, and simply focused on the happiness of the moment. She was thrilled. I was spellbound and silent, mostly. I did say, “Yes, you CAN! You can see with BOTH eyes.”

What did Stella mean, exactly? It could be clear, simple, and run-of-the-mill. Even with her amblyopia, Stella does see with both eyes–with one more than the other, but still. I see with both eyes, as do most people, obviously. Was she simply making a smart, toddler-esque realization about the world and how it works? Or was a shift taking place in her vision? The whole point of our current vision therapy and patching efforts is to help her see with BOTH eyes, equally. Out of nowhere, she was expressing the essence of everything.

I mentioned the incident to Stella’s vision therapist today, and naturally, she found it very interesting. We both acknowledged that because Stella is two, it’s hard to know why she was saying that she can see with both eyes. But yes. Be still my beating heart! It could be that her eyes are working together better. Binocular fusion and increased stereoscopy (3D vision) could certainly create such an excited and interested reaction. On the other hand, it’s also possible that she’s seeing double–which isn’t necessarily bad. Sometimes kids in vision therapy see double here and there as their brains figure out the path to binocular fusion. But I don’t think that’s it, because she had no trouble grabbing small berries or pebbles, no difficulty running fearlessly up and down the small but steep slope that runs parallel to the sidewalk. She made eye contact with me frequently and purposefully.

When Stella’s eyes crossed severely on that day last April, the day that (thankfully) set us on the path to glasses and patching and vision therapy, she couldn’t see or do much of anything. Eye contact was impossible. She could walk, but not as steadily, and if told to walk to mommy, she’d miss me completely and sail by to my left,  aiming at one of the two inaccurate, fuzzy mommy images that she saw. Her arms flailed in front of her, grasping. She wasn’t scared. She seemed dazed and thoroughly amused, playing around in the blurry void. Nothing of this sort happened yesterday. There was a general feeling of clarity, in the way she spoke and behaved. Regardless of what Stella was actually seeing and experiencing, I view this small but striking incident as positive development. Even if her vision was not being transformed in that moment, it was still wonderful to hear and behold.

Due to a rough night of broken sleep, today’s vision therapy session was challenging. Stella was tired, and her fuse was short. But we did some solid work, and learned some new exercises. During the long-ish drive home, again I noticed something out of the ordinary. I looked back several times to see Stella positively beaming. Smiling such a sweet, powerful grin while gazing at something specific–one time it was the cherries hanging from the rear-view mirror. Stella smiles a lot, but this was different. Focused, for no obvious reason. We were listening to NPR, so I know music wasn’t the spark for her pronounced delight. I think it was her eyes again. Maybe she was seeing double and found it entertaining. Or perhaps she was seeing the world in full depth and dimension. How beautiful that would be.

 

 

 

UW pre-optometry students to the rescue!

Stella, nailing "The Treat Game" with her assistant, named Baby.

Stella, nailing "The Treat Game" with her assistant, named Baby.

Stella knows how to use “WHAT!?” for comedic effect. At PCC, the natural grocery store we hit up to three times a day, there are fun sculptures outside. In reference to one of them she exclaimed, “A dog on a bike–WHAAAT!?” Just a sliver of a pause inserted. She went ahead and tacked on the prolonged “WHAT!?” in a flat yet exaggerated way, the timing and tone appropriate for SNL or In Living Color. Clearly, she’s a comedic genius bound for stand-up stardom.

As I’ve hinted at before, here and at Little Four Eyes, accomplishing our allotted daily vision therapy is a challenge. A grind. More for me than for Stella. In the way that getting up at 5 AM is challenging for a wine-guzzling nightowl. (I swear that’s not me. Usually.) I’m not the most organizationally proficient mom you’ve ever met–unlike my cousin who organized, within an inch of its life, the kitchen drawer that holds her young daughter’s dishes and utensils. To me it was an awe-inspiring thing of unattainable beauty. Honestly, I’m just happy to have identified a drawer into which I can toss that stuff from across the room, since it’s usually left open. When it comes to what needs doing in daily life, I get it done, but piles, toe-stubbing, sweating, and flat-out sprinting are involved. My creativity helps compensate, though. It kind of makes up for the disarray. I write fabulous copy for a range of clients in order to pay for Stella’s vision therapy and other stuff, and enjoy it, and I easily conjure up ways of executing or adapting vision therapy so that it’s somewhat innovative and actually fun for my two-year-old, who is quite young to be doing vision therapy in the first place. I find this type of work–the creative part of vision therapy, but not necessarily the execution–incredibly motivating and satisfying. Which is only natural, but somehow my difficulty seems much more severe than it should be. Of course, it’s not some horrible Sisyphean nightmare either. I believe in vision therapy. Though I struggle with getting it done, our daily work is incredibly valuable and effective, and Stella is resilient, adaptive and more cooperative than she gets credit for. Oh, and she’s creative, too! Using random objects like bulb syringes and blocks and ribbon, she’ll construct a tall, thin structure with a rounded top and say, “Look, mommy! I made the Space Needle!” And you know what, it really, really looks like the Space Needle. Clearly, she’s a brilliant engineer/designer bound for international renown.

Genius aside, when it comes to vision therapy, it really, really helps that she’s willing to step up to the very hardest challenges for a taste of Theo chocolate, made one neighborhood over from where we live, just down the block from Cody’s workplace and PCC. We often stop in for tastings, pretending to be tourists, though I’m not sure we’ve ever fooled anyone, even with our well-honed Boston accents, since we are loud, include a toddler wearing purple glasses, and head directly to the Hazelnut Crunch every time. In the context of “The Treat Game,” explained in my recent post at Little Four Eyes, she’s now grabbing two cards at at time so as to find matches twice as fast. Those red/green glasses just aren’t posing enough of a challenge anymore. Not when Theo chocolate is on the line. That’s my girl. But I know we can’t rely on chocolate. That’s simply the trick I keep up my sleeve. We have been in need of assistance for a while now.

As opposed to my mental lopsidedness, my sister is organized AND a creative problem solver. When I told her I was thinking of hiring someone to come here a couple times a week and help with our at-home vision therapy, she immediately suggested that I find an optometry student. I was all, “Brilliant!” Because wouldn’t you know it? We live right next to a giant university–WHAAT?!

So I got in touch with an officer in the pre-optometry club at the University of Washington and she kindly put out the word. I’ve received five applications from wonderful young minds! I’ll not only tell them everything I know about vision therapy and provide true insider information on to get Stella’s cooperation, but I’ll also throw in a pot of coffee and some sort of hourly rate. The peace of mind I’ll get, and the likely improvement in Stella’s outcome, will be worth it’s weight in Theo chocolate. Wait. Maybe I should pay my vision therapy assistant in chocolate bars? What can’t that stuff do?

And that’s not all! I’ve got a lead on a fantastic babysitter and zeroed in on a preschool that may just be ideal for Stella, due to its notably bigger focus on physical activity and fitness than any other preschool I’ve learned about. They have gymnasts and professional ballet dancers work with the little ones an hour a day–WHAAAT?!

Feels like we’re on the brink of being on a roll. We might even, after almost two and a half years, get some much-needed support–WHAAAT?!

Honestly, it’s not just Stella’s eyes that need the help. It’s me.

Takin’ care of strabismus

Gah! I can’t tell you how long I’ve been dying to use the above title for a blog post about Stella’s vision. Eons. For those of you who don’t know, “strabismus” (defined as “abnormal alignment of one or both eyes”) sounds a lot like “business” with a funny extra syllable in front. So there you go. Was going to save that tidbit up for my next big update, but it just couldn’t wait. I’m sure it’s been done before, because come on, it’s incredible, but I did technically think that up on my own without seeing it elsewhere. I refuse to google the phrase, so as to preserve the mine-ness. I’ve been copywriting for over a decade now in various capacities, yet somehow a good or perfectly goofy headline still makes my heart flutter. Yes, I just wrote a long paragraph about the headline of this post. And I wonder why readers aren’t flocking here en masse.

Oh right, I had a minor point. See the “Eyes” link above? Yeah, so I added a new vision-centric page to this blog so that interested people can find all the write-ups about Stella’s exotic-sounding visual conditions: amblyopia, anisometropia, accommodative esotropia, hyperopia, adorablyopia. Okay I made that last one up. And there may be others that I’ve forgotten and some that I’ve misspelled. But you get the picture. There’s a lot going on in Stella’s super cute eyeballs and we’re working really hard and I’ll be damned if no one else benefits from our saga. It’s like Star Wars, wherein amblyopia is the Death Star. Come to think of it, Darth Vader would make a kick-ass vision therapist. Tough-minded, thinks outside the box, and controls people with his mind? You’re hired!

Coming soon: I have some really exciting news to share from Stella’s recent vision therapy adventures. Like, crazy stuff that you might read about in science journals and marvel at the amazingness and plasticity of the human brain and how the hell did doctors and scientists figure out how to do all this stuff in the first place? This is boring to most people, probably. I’m a blogging failure in the general sense, but clearly I don’t care. I don’t need to reach a lot of people, though if this really is anything like Star Wars, I will. I just need to reach a few people in similar shoes, to help them a little bit, just because I can. If Stella’s story can benefit other kids, well, that’s what it’s all about! Sweet, sweet meaning.

To me and parents of kids whose brains are playing favorites with their eyes, this crap is more fascinating than you can ever imagine (I hope). Anyway, in addition to patching and whatnot, we’ve been doing more “advanced” therapeutic exercises. At the last appointment, it felt like we were really onto something. No, it’s not like Stella’s eyes are cured of any issues, but words like “dramatic” were tossed around. The impact of therapy could be much wider than I’d realized. I promise to write it up soon, because it’s really amazing and fascinating and my hopes rocketed up a notch or two, and my head will explode if I don’t write it all out.

You read this far? Wow. Thank you! To prove it, please leave a comment saying only, “Luke, I am your vision therapist.”

Fabulinks

I quickly wanted to share the results of our fun photo shoot with Dave Estep of EstepWorks. He’s a friend, a former co-worker, and an incredibly talented creative photographer here in Seattle. Can’t recommend him enough. He’s so laid back and kind, and his happy brand of creative genius seems effortless in the best possible way. Honestly, I was so confident in his abilities that we really did minimal prep. We didn’t make ourselves look fancy, with the exception of Cody’s button-up shirt.  I made sure we didn’t clash and I put on a bit more make-up than usual (the usual being none), but I didn’t shower, barely combed my hair, and my jacket was covered in lint. But that’s us. I knew Dave would present us, as we really are, in a beautiful light. And he did. We’ll treasure these photographs for a long, long time. Thanks so much, Dave.

Check us out on EstepWorks’ blog.

In unrelated but also fabulous news, Stella’s vision therapy progress evaluation (this morning’s eye exam, after three months of patching and vision therapy) took place this morning. I wrote about it over at Little Four Eyes. I’m proud of Stella and her hard-earned progress, while also steeling myself for more hard work. We need to get that left eye up to 20/20. We can do it.

I’m off to make some more modern paper ornaments before bed. They’re taking over our home, and I like it. Happy holidays!

The eyes don’t have it.

I’ve always been proud of my perfect vision. I’ve bragged about it openly, and came to appreciate it even more after Stella’s visual challenges revealed the complexity and wonder of human eyesight. “I’m so lucky and blessed,” I thought, darting my hawk eyes around to appreciate my crystal clear view of life. Turns out it’s not that simple. News flash: My vision is decidedly imperfect. And if I hadn’t been so blinded by pride, perhaps, I would’ve realized it a lot sooner. But the realization didn’t come until Stella’s in-office vision therapy session today.

If you saw one of my recent posts at Little Four Eyes, you know about Stella’s experience with the quoits vectogram and how it showed that she can see in 3D! Well, today we did the same exercise, with a twist, and it showed that while Stella has a decent amount of stereoscopy, she has a hard time recovering 3D vision if the therapist “breaks” the illusion and then brings the sheets back into place for stereoscopic viewing. It takes Stella a long time to re-fuse the images after briefly losing fusion. It’s something we can work on, and greatly improve, according to our vision therapist. I feel confident that Stella will overcome this issue, and it helps that Stella was a rock star during vision therapy today. Her hand-eye coordination has come so very far. You should have seen her throwing beanbags into squares, tracking fluffy bumblebees, honing in on moving light-up targets, and stringing beads onto wobbly string! A thing of beauty, I tell you! Because of her improvement in this area, I’m now to shift our at-home vision therapy efforts toward making her eyes work across longer distances. Don’t ask me how I’ll capture her attention across the room. At times, I can barely achieve this with my face directly in hers. A way will be found, after much frustration and shouting in a chipper voice and bribing with chocolate chips. Or whatever.

At the end of today’s session, in an effort to help me understand the quoits vectogram, Stella’s vision therapist let me put on the polarized glasses and do the exercise myself. Drum roll, please… My performance was shockingly poor! And you know, I could tell before the therapist said a word. During the exercise, I sensed that it was taking my eyes (brain?) a long time to fuse the images. Simply put, it was difficult. “Maybe I have a vision problem,” I thought out loud, barely believing my plainly less-than-perfect eyes. According to the vision therapist, Stella actually performed better than me on the initial fusing of the rope circles! It took me longer! It seems I suppress input from one of my eyes when challenged to track closer objects and movement, but my eyes don’t cross the way Stella’s do. I’m guessing that’s because I don’t have Stella’s farsightedness, which puts extra stress on her eyes.

I was in shock! Sort of. But then I thought about a few incidents, and the testing results made sense. When I was in middle school, I tried refereeing a little kids’ soccer game. Fresh air, sunshine, control over younger humans–it seemed like the perfect way to earn money! But I forgot to add “barrage of insults” to the list of perks. The parents hated me, and heckled me like Red Sox fans at a Yankees game. It. Was. Brutal. They were a-holes, yes. But they weren’t wrong that I sucked. I absolutely could not follow the action close enough to make calls. Apparently, as the parents of one team made painfully clear, one kid was checking everyone else constantly. Oh I tried. But no matter how close I got or how hard I tried to lock my eyes on him, I just could not see what the parents were seeing. I couldn’t follow along, couldn’t catch the little movements. In a way, I felt blind. Clueless. Didn’t help that the parents turned me into their punching bag–that doesn’t tend to sharpen performance, you know? I still fume when I think about that, and if I could rewind my life and go back to that fall morning, I’d handle the scenario soooooo much differently. It would’ve involved a string of obscenities and several disturbing gestures. Perhaps assault with a deadly whistle. Nothing those kids didn’t see at home with their wildebeest parents, I’m sure.

Come to think of it, the same tracking issue plagued me during my sports career. Basketball was my passion, but I played pretty much on instinct and with general, big-picture court awareness. I swear that I never actually looked at anything in particular. I didn’t look at the basket when I shot, I didn’t look at the ball directly as I caught it. I didn’t look at my receiver when making a pass. Never actually even saw specific people in front of me while running a play as my high school team’s point guard. It worked out okay, but I was limited. I always wondered why I couldn’t get to the next level and become a really savvy, strategic player. I had the feeling that there was a deeper level of the game I couldn’t access, and it was frustrating. My husband doesn’t have that problem. He’s a fantastic, very tuned-in point guard who can watch individual players and movement and see the small details within the flow of the game. All I had was a very general sense of what was going on. Even though my eyesight has always been 20/20, somehow, it was foggy.

I now hope that, when all is said and done, and vision therapy and patching and early childhood are behind us, Stella will wind up with better vision than me. With her glasses, anyway. I couldn’t be happier (or prouder) about that possibility.

Excuse me while I go schedule an eye exam. For me. How refreshing.

 

 

 

A crime of passion. A lesson for us all.

It happened in the glow of our large flat monitor with the two dead pixels, which have long taunted us with their bold red hue. Stella freaked out, both passionately and oddly, flailing her arms around her head and wailing out of apparent discomfort. A powerful emotional display for a fit based on what seemed like extreme annoyance, rather than searing pain as an onlooker might have assumed.

She screamed, completely outraged, “I’M TOO BIG FOR THIS!!!” If she’d flowed into a monologue, I’d have heard rants about deep injustice and the heavy hand of parental control squashing her inalienable rights and unflinching conviction that she is no longer a baby. I’m sure of it.

Or was it more simple? Was she referring to the “Elmo Rides a Tricycle” video we were viewing together on YouTube? Was I insulting her intelligence with this media selection? It was eye patch time and Elmo had never failed to secure her cooperation. Were those days over? Or was he the inspiration for her rebellion? After all, the tricycle song is not about the act of riding so much as it is about freedom. Something I’d considered innocent now appeared insidious. Questions raced through my mind while those dead pixels continued their mocking stare.

But then, as quickly as the storm erupted, it passed. She went back to scrutinizing Elmo’s amusing antics, entranced once again by his simple joy. It was as if her tantrum switch had been flipped suddenly to “OFF.” I breathed a sigh of relief, and left the room to go prepare myself for our errand-filled morning. Crisis averted.

Or was it? When I came back, the meaning of her earlier, indignant outcry was shockingly clear. There on the floor, next to the stained office chair where she was perched, was a gory spectacle. Her beautiful French eyewear lay dead, brutally squashed and ripped into two damaged pieces. DOA. The hinge on the right cable had not only been stretched back far beyond its capacity, but also twisted violently. Horrifying. And she’d waited until just the right moment, after I’d departed, indicating premeditation. The office, once reserved for couch cushion bouncing and mindless online escapism, had become a crime scene.

But, dear jury, was Stella the perpetrator or only a victim herself? She had experienced a huge growth spurt in recent months–why did I not realize this would include her head? Oh I’m fooling no one! Dear God, I must confess! I knew Stella’s glasses had gotten tight. I knew! But I did nothing. I stood by while Stella’s head was squeezed mercilessly by those spectacles. Now we’re all paying an emotional and financial price. For shame, mother. FOR SHAME.

As we lay Stella’s ninth pair of glasses to rest, I’m compelled to help others learn from this tragedy. If you’re child says they are too big for something, they mean it quite literally! Size up for Christ’s sake!

I rest my case.

It’s all fun and eye games until someone attains 20/20 visual acuity in her left eye.

Toothpicks in a tea cup.

Toothpicks in a tea cup.

Eye strainer.

Eye strainer.

Candy spears.

Candy spears.

It’s amazing what you can do with a few markers and a tea cup. Oh, the simple addition of a tea cup seals the deal, my friends.

Overall, home-based vision therapy is getting easier as I find and engineer more and more exercises that she enjoys. Yes, enjoys! She still asks to play “eye games” at times, which means she gets excited about putting on her patch in order to play said games. I still do a dance of joy in response to this, tripping over myself to get it all set up before she loses interest. I feel like a genius at times. At others, a pathetic subservient fool. But of course, I’d do anything for this kid. Like that time many, many months ago when I used pinking shears to cut the edges of many individual carrot slices, because she was happily wolfing down the jagged-edged ones out of take-out Pad See Ew but not the smooth round ones I’d been making. (And no, she still didn’t eat them.) Thankfully, I’ve come a long way since then. I think/hope.

As you saw above, I markered up some toothpicks and a strainer, and guess what? She loves to send those little candy-colored bits of wood through the little matching holes in the dome. Our vision therapist gave us foam beads which also pair up nicely with the toothpicks, forcing Stella’s left eye to work hard in coordination with her hand and encouraging her brain to accurately map spatial relations and whatnot.

Stella continued to be actively disinterested in catching that damn balloon. So I drew a smiley face on it, and her willingness to look at it instantly shot up by at least 50%. Hope and Sharpies abound.

What a difference a smiley face makes.

What a difference a smiley face makes.

Cirque de Okay

My official assessment is that this week’s in-office vision therapy went well. It was interesting, and eye-opening. (Once again I’ve let you down and resorted to puns.) Eye-patched Stella threw a couple blocks in frustration and engaged in impressive evasive maneuvers, but we managed to reel her back in while avoiding a fight. We totally persevered. It felt like a small victory for all of parentkind.

Helpfully, as the session got underway, the vision therapist answered all the questions I’d been asking, having gathered input from the doctor in order to do so thoroughly. And from there, she wisely kept things moving right along from exercise to exercise. In that way, Stella’s in-office vision therapy equates to a miniature three-ring circus with acts designed to mesmerize only toddlers. Imagine a large beating drum in the background and super dramatic announcer voice: “AND NOW, the great spinning disk of wonder three inches off the ground!… gasps and applause… AND NOW, the neighborhood’s tallest block tower, assembled and destroyed before your very eyes!… more gasps and applause… and now, feathers falling from the heavens… entranced silence, some “oohs,” then applause… etc. etc.!”

Here at home, Stella’s vision therapy is also a circus–one in which the elephants, lions and monkeys have escaped and are trampling the ring master and audience. It’s almost impossible to keep the show going for more than three minutes, so we do home-based vision therapy in small stints or whenever she shows interest. Sometimes, she even asks to do eye patch games! Yep. My heart almost stopped the first time she requested vision therapy. In order to better seize these moments, I pre-cut and keep handy eye patches of Magic Tape that I can quickly slap on her glasses’ right lens. Previously, I’d to stop the presses, take off her glasses, put two pieces of tape on the right lens, then carefully and annoyingly cut off the tape edges around the lens resulting in tons of tiny pieces of tape stuck to my fingers and scissors which is utterly unhelpful when you are in a major hurry in trying to take advantage of a very small window of  toddler attention.

At this week’s appointment, opening acts included a matching game–simple but smart in that it forced Stella to hold an image in mind and then scan the floor for its equal. Then, there it was. The therapist brought out this large spinning disc with slim, straight back and white stripes. On this briskly rotating table, the size of a super duper extra large pizza, the vision therapist placed some small colored blocks. Stella’s job was to snag whichever color the therapist dictated. It took a moment to teach Stella to resist grabbing the disc and to only touch the blocks. “Okay, Stella! Get the red block! No, not the table, the red block! You can do it!” She got a couple, placing her hand on them and slowly dragging them off the disc before falling into what looked like a state of hypnosis. So I put her in my lap and gave her a little pep talk/verbal assistance.  I did not, of course, help her get the blocks off the disc. I did say, “Ooh… here comes the blue block… here it comes…. here it comes…” to help keep her engaged and tracking. She got through about three rounds of this exercise (six or so blocks per round)–HOORAY! It was clear, and interesting, to me and the therapist that this was extremely challenging and exhausting for Stella. She almost fell asleep as the therapist stashed the disc away, a marked change from her energy level immediately preceding. We’re talking a full-on daze and string of yawns. Those moving stripes forced her to work so hard to focus, and it took a lot out of her. Even with Stella’s frustration level climbing higher due to fatigue, we plodded steadily through more “eye games.” But she did all the exercises presented. Some more easily, accurately, and agreeably than others. But she hung in there.

The imposing disc of wonder wasn’t the only overt difficulty. In particular, Stella seems quite uncomfortable tracking things that fall from just a couple feet above (with her left eye, anyway). She doesn’t even want to look up for the “balloon game” anymore, wherein I simply toss her a balloon from my standing position so that it falls right toward her hands for catching. But with a small but fun bit of dancing around with scarves and feathers, the therapist got her to follow their descent with her eyes and catch, with me holding her arms to receive them. Chalk up another victory for Stella’s left eye! And hope and sanity.

The session–the stretch following the disc exercise, anyway–reminded me of my basketball-playing days. Early on I was taught to practice free throws after games or drills, when my arms and body were nearly depleted. Because that’s how you get good, that’s how you become consistent, that’s how you hit the winning free-throw at the end of a long battle of a game. “Stella’s left eye is going to be a champion and leading scorer,” I thought! But that’s not QUITE how it’s going to work with Stella’s vision therapy at this point. The therapist noted that she’d save the more tiring exercises for the end of sessions in the future, so as to lower Stella’s frustration level throughout. This makes total sense, doesn’t it? It’s important for Stella to feel motivated or at least willing to go on. If she starts to feel more defeated than successful, her resistance would surely skyrocket. No, thanks!

This week’s vision therapy appointment granted me a couple realizations. First off, good vision therapists and good mothers have a core attribute in common: a careful balance of assertiveness. You can’t use brute force and you also can’t let the kid off the hook. You have to be firm, consistent and persistent, while mindful of the temperament of the individual child. Secondly, the fact that certain exercises are so uncomfortable for Stella made me understand how hard sports or perhaps even reading would likely be for her without the help of vision therapy. I don’t know if we’ll achieve visual perfection, but I have faith that Stella and her eyes will be very much okay.

With feathers, spinning circles, constant encouragement and gentle but insistent correction, we are preparing Stella for the visual demands that lie ahead in the circus of life. “…AND NOW, the social interaction and focus-requiring structure of preschool!… hearty applause… AND NOW, organized athletics of some kind…borderline obnoxious cheers!… AND NOW, completion of a puzzle without angry tossing of the pieces!… And the crowd goes wild!