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Authors: Clark Elliott

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Optometry Doctor; Fellow, Neuro-Optometric Rehabilitation Association; Fellow, College of Visual Development.

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It is typical that an initial appointment with an optometrist emphasizing neuro-optometric rehabilitation will take one and a half to three hours because of the extensive testing needed.

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That is, it was as though I were actually sitting ten feet closer to the performers, with the sound tending to wrap around me, instead of being in front of me.

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In the original, the colors blue, red, and yellow are used for shading, and there are many more items.

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And as we'll see later, it also reinforced a correct working balance between my central eyesight, which I was using to focus on the object, and my peripheral eyesight, which I was using to set the
context
that allowed me to filter out all the extraneous dots.

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For high-functioning people, this brain weakness is often disguised by the very real problem of spending long hours in school on group tasks that are moving too slowly—a mismatch where anyone would understandably grow restless.

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We now know, from contemporary research, that this chromatic response is not just in the cone cells in the center of the eye, but also extends out to the periphery of the retina as well, thus extending the effect of colored filters on brain processing.

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Donalee addresses this problem by starting out with the very simplest forms of rudimentary cognition, and working up only very slowly from there—recall the analogy of the broken leg.

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It later turned out that the
style
of my handwriting was as important to Zelinsky as were my answers: Did I slant up or down at the ends of lines? Under certain cognitive loads did I change the spacing between my words? What was the relationship between my writing on the left-hand side of the page and my writing on the right-hand side?

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Padula's
ambient visual process
can be described as having two parts: First, and fastest, one of the non-image-forming pathways specifically linked to posture mechanisms—
where am I?
Second, and slower, the part we've already referred to as the peripheral vision—
where is it?

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William V. Padula and Stephanie Argyris, “Post Trauma Vision Syndrome and Visual Midline Shift Syndrome,”
NeuroRehabilitation
6 (1996): 165–71.

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Deborah Zelinsky, “Neuro-optometric Diagnosis, Treatment and Rehabilitation Following Traumatic Brain Injuries: A Brief Overview,”
Physical Medicine and Rehabilitation Clinics of North America
, Elsevier, 18 (2007): 87–107.

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My notes are clear on this point, that I had to place
myself
on the left-hand side when running and also that I would lose the
right-hand side
of internal visual structures. But because the temporary hemispatial neglect I experienced from time to time was so pervasive when it occurred, I have no
direct
notes at all on being unable to
turn
right; it was not possible for me to take notes on something about which I had no comprehension. I knew only that I had to turn in circles.

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Doctor of Optometry, Fellow of the American Academy of Optometry, Doctor of Philosophy.

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Selwin Super, “The Clinical Testing of Fixation Disparity,” http://www.professorselwynsuper.com/pdf/educator/jbofdarticle.pdf.

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As a result of the concussion I got floaters (roughly, translucent occlusions in the viscous fluid behind the lens) in both of my eyes. One of my concussion-induced floaters is often situated in the central focus point of my right eye, making it hard to read with that eye.

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A syndrome in which mentally healthy people—usually with significant visual loss, and advanced in age—experience purely visual hallucinations, suggested by Grace Yoon, O.D.

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A special picture used by Richard Gregory to illustrate the top-down guiding of human cognition in vision.

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Zelinsky later commented that this calming was a direct result of the lessening of the activation of my fight-flight-or-fright (sympathetic) nervous system, effecting a better balance with my rest-digest (parasympathetic) nervous system.

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This preference for calm, and avoiding chaos—which affected whom I chose to spend my time with—ultimately led to quite profound changes in my life.

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This is a form of what contemporary brain-plasticity researcher Michael Merzenich, M.D., refers to as “use it or lose it,” the principle by which the plastic brain reconfigures itself. In this case, the bad pathways had become less dominant from disuse, such that even when switching back to having light enter from the front, I should still be able to find the new pathways that had been created.

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Now, years later, I find that my brain has rewired itself through habituation, and I am not nearly so dependent on my glasses.

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Over the years of working with Zelinsky I found this to be a common experience: that she often made complex predictions about what she was going to later find with her instruments. So many times I heard her say, “Now watch what happens when we . . .” and she was then proven exactly right in her prediction.

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