In-Depth

For most of us two-eyed creatures, stereovision is a given. It’s our brain’s ability to fuse images coming from our two eyes into one three-dimensional picture. It lets us see not only what’s around us, but how far it is — we call it depth perception.

But for some of us with strabismus, or “lazy eye,” the world looks very different. When one of your eyes drifts, even just slightly, your brain loses the ability to fuse images from your two eyes. You see double and can’t perceive depth. That’s how I see the world. It’s kind of like looking at a virtual reality screen loaded on a non-VR device:

Image Source

I still find ways to perceive depth through other means. For instance, I know what a tennis ball looks like. So if I see a tennis ball, I can know how far it is from me using its size, movement, lighting and visual clarity. If the tennis ball appears sharp while the background is blurry, it likely means the ball is very close to me.

Image Source

You too, didn’t have stereovision at some point in your life. None of us are born with it. Instead, we acquire it within the first few months/years of life. In fact, ophthalmologists say that only young children can gain stereovision. If by 6 years old you still see double, you always will.

But it turns out, that’s not true.

There are many cases of people who acquired stereovision later in life. The most famous of them is Dr. Susan Barry, nicknamed “StereoSue” because of this very accomplishment. StereoSue was able to gain stereovision at 48 years-old. Her secret? Vision therapy and determination. She wrote a book called Fixing My Gaze where she recounts her stereovision recovery journey.

Dr. Susan Barry, Image Source

I read Dr. Barry’s book at the end of 2017, and of course as soon as I turned the last page I thought: “Why not me?” If Dr. Barry was able to see in three dimensions, I could too! So I set an appointment with a specialist and started vision therapy.

The early tests showed great results. I was able to fuse images from my two eyes in no time using a VR solution called Vivid Vision.

But at the beginning of January, my vision started to deteriorate. I was seeing blurrier every day and my doctors didn’t seem to know why. At first, they thought my new contact lenses were too thick and creating glare, so we changed them.

Then I went to see other doctors who told me the problem came from the vision therapy work I was doing. They claimed that my brain was not used to what I was making it do, and so it was disturbing my vision. I went to see the ophthalmologists with the best reviews on Yelp, and they all told me to stop vision therapy. They told me to go back to my life, that everything would get back to normal. And if not, they said I might have damaged my vision for life due to vision therapy.

Vision therapy has bad reputation in the world of ophthalmology. Many doctors see it as a risk factor. Something that has the potential to deteriorate our vision rather than improve it.

So I listened and stopped vision therapy. My vision kept getting worse.

I was becoming desperate. There is nothing more frustrating than knowing something is wrong and being told to go home and wait. You also need a lot of strength to pursue recovery when most doctors tell you it’s impossible. I started doubting myself. I started thinking that it was a mistake. Perhaps doctors were right and vision therapy was a hoax. Perhaps I had damaged my vision and would never be able to get it back.

Until finally I went to see specialists at UCSF in early July. After 6 months of my vision getting worse every day, I was finally diagnosed. It turns out, all the doctors I had seen until then were wrong, and missed the elephant in the room.

“You have cataracts,” Dr. Julie Schallhorn said, “in both eyes.”

Cataract at 32. It’s rare, but it’s less rare in nearsighted people like me. I was born very nearsighted, which is what prevented me from developing stereovision in the first place. Still. It surprised a lot of the staff, and in no time I had a few medical students in the room. One of them looked at the results of my tests, and couldn’t help but let a “wow” come out of his mouth. To them, the results were obvious.

Yet for months, I had encountered doctors so focused on denigrating vision therapy that they had missed the diagnosis. I even went to see a cataract specialist, mind you, who spent the 15 minutes of our encounter telling me all the reasons why I should stop vision therapy. Needless to say he did not see the cataracts when he looked into my eyes with his painful lights for less than a minute.

What if I hadn’t told these doctors that I was doing vision therapy? Would they have spent more time looking into my case and found the cataracts? Maybe. And this realization is one of the reasons why Jacob Beemer, my amazing filmmaker of a partner, and I are making a documentary. We are capturing my entire journey in the hopes that more ophthalmologists become aware of their biases. We want to show the millions of people who see double right now, that there is a way out. Some of the pictures above are actually screenshots from the footage we already have.

I dream of a future where ophthalmologists promote rather than prevent vision therapy. Where we stop seeing life-long conditions as desperate causes that the patient needs to accept. There will always be cases we can’t solve. But it’s important for doctors to recognize their subjectivity when making a medical recommendation.

Take this example I read recently while doing my cataract research. It’s an article written by Dr. Charles B. Slonim, a cataract surgeon. For most of his career, Dr. Slonim had recommended his cataract patients to delay surgery as long as they could see “just fine” according to the eye chart. Until he got cataract himself. At that point, he realized the dichotomy between the quality of the vision he was feeling, and what the eye chart was telling him. He was also able to experience the relief cataract surgery gave him and how positive an impact it had on his life.

One month after surgery, I examined a 75-year-old woman who has been my patient for more than 20 years. She had developed “early” cataracts that I had been monitoring for more than a decade. […]
And this time, I took an entirely different approach when we had my standard cataract discussion that had been brought up at different times during the past decade.
On this occasion, I didn’t suggest cataract surgery; I insisted that she have cataract surgery. I suggested that she could benefit by seeing better to drive, but I insisted that she needed to see what I was seeing to enjoy her life better, beyond what she always had accepted as seeing “just fine.”

This experience transformed Dr. Slonim’s medical recommendations by adding empathy.

We should always use empathy to counter the effect of our subjectivity. Use it to push further, try a little harder, and see things from a different perspective. If my doctors had really listened to me and put aside their own preconceived ideas, perhaps I would have been diagnosed sooner, and I would have continued vision therapy.

What’s next for me, you may ask. I still have my cataracts, and they’re getting worse. In fact, they are so bad that you can now see them with your bare eyes — until now, you needed ophthalmic instruments. Take a look.

My left eye’s cataract is more advanced.

Fortunately, it’s temporary. Cataract can be fixed with a simple outpatient procedure. The doctor will remove my natural infected lens and replace it with an artificial one.

And that’s where it gets even more interesting. This procedure will go beyond fixing my cataracts: it will also fix my vision. After 32 years of extreme nearsightedness, I will see close to 20/20 for the first time. And that’s pretty exciting. I will also lose some of my close-up vision, and will need reading glasses, but that’s a story for another post. Besides, most of you will join the reading-glasses club by the age of 50, if you haven’t already. Once all of this is done, I’ll resume vision therapy and continue my journey towards stereovision recovery.

We will of course film everything so you don’t miss a beat. We hope to release our documentary at the beginning or 2019, depending on how things go. If you find this project interesting and would like to get involved, please don’t hesitate to reach out: indepth2019@gmail.com. This is just the beginning of a long journey.