July 15, 2021 - EyeClarity Podcast
This is a presentation I gave to a group of occupational therapists on how to evaluate the visual system of spectrum disorder children. I discuss topics like lazy eye, strabismus, neurological imbalances, glasses prescriptions for children, and color therapy which are modalities that I use to help children reach their potential. Enjoy the show! If you want more, sign up for my newsletter at:Â www.drsamberne.com.
SUMMARY KEYWORDS
eyes, pupil, reflex, vision, therapy, prescription, kids, stigmatism, dullness, prisms, color, visual, relates, gestation, state, means, pupil size, arousal, farsighted, number
00:05
Hello everyone, its Dr. Sam, I’d like to welcome you to my EyeClarity podcast. This is a show that offers cutting edge information on how to improve your vision and overall wellness through holistic methods. I so appreciate you spending part of your day with me. If you have questions you can send them to Hello at Dr. Sam Berne calm. Now to the latest EyeClarity episode. First of all wears glasses and when what you might want to expand upon there is actually what is the prescription? And where that would be valuable to me would be you know, are they farsighted? Are they near sighted do they wear prisms? Are did they have astigmatism? Do they wear bifocals? And why that’s important is that over time? What I would like to teach you is the behavioral manifestations of what does it mean to be farsighted? What does it mean to be near sighted in terms of behavior, spatial understanding posture movements, emotional responses. So just as an example, if somebody is near sighted, they tend to be very defensive. And it can be physically defensive, it can be emotionally defensive. There’s usually a trauma related to nearsightedness. And you could also put on there you know, when they got the first prescription, was it at infancy was when they were a toddler because the earlier they get the prescription, the more the the eyes have taken on some pre verbal imprint. What I’ve seen is the higher the number, the earlier the vision problem has occurred. And this can even go back into gestation you know this, this opens up a whole other conversation, say somebody who’s highly farsighted or highly near sighted, I asked questions about well what happened in gestation, you know, so, and then it comes down to on the reflex level, the fear paralysis and the morrow, it just gives you information. And then you could get into things like strabismus and amblyopia could also be part of that as well. For example, I was working with a child the other day that amblyopia in the left eye and we discovered in gestation, that she had been laying on her left side. And, you know, there was ended up being a breech birth and I associates wanted to do surgery on the eye because there was a bit of a esotropia as well. And I said, No way, we’re not doing that. There was Tor to call us. So there’s, there’s things to understand about that prescription. On the other side of it farsighted. You know those, those folks tend to push the world away. So they want things a lot bigger than they really are and their tonicity their arousal is usually lower. So by being able to insert the prescription, then at one of our classes, we could go into how the prescription relates to a person behaviorally. And so on. The third condition, the stigmatism is a twist in the body. And this sometimes is related to neck issues, cervical compression, some spinal issues. And so, again, knowing that there’s a stigmatism and how that might affect postural Lee, that might affect some of the other reflex things that you’re doing. Based on the handout that you You gave me I’ve been studying that and seeing how myopia hyperopia and astigmatism would relate to those reflexes and where you might want to jump into it. And then prisms are kids wearing prisms, a lot of the eye doctors prescribe you know prism in one eye, which I don’t agree with and we usually take the prisms out and Then what we do is we might prescribe some kind of yoke prisms. bifocals are another issue. A lot of times these kids just can’t wear bifocals. So we have to figure figure that out. So, I guess you could plug into at what level you want to, but at least including the numbers
05:22
would be really great. So my recommendation is to do do it with it on and do it with it off. And this is where you’re going to get subjectively, you know, you can you can do the things right below there like watery red yawning, squinting, like you could add, you could add those behavioral observations with the glasses on with the glasses off. You may discover, like use intuitively know, many times I’ve heard this from you guys, that, you know, this prescription just doesn’t seem right for this child. And you would be able to determine based on some of the, you know, the tracking things you might be doing that, you would say, Yeah, that’s right, the glasses actually make it worse. And I mean, this is a whole big world, because the glasses prescription has a whole story of what it’s reflecting on so many levels. But we could keep it simple in that you could have Okay, a positive and then the number means it’s farsighted. A negative next to the number means it’s near sighted. And then a cylinder c y l means it’s a stigmatism and then the number next to the astigmatism is the meridian. That is the weakest in the visual field. So you know if we could start off really simple by just listing the prescription and maybe doing the testing with the glasses on and glasses off. And then if the classes we could I could teach you guys how to do it and then we could come up with something that a new therapist could just look at it and go, Oh farsighted. That means this nearsighted oh that means that if he’s nearsighted we have to work on these things. If he’s farsighted, we work on these things. If he’s got a stigmatism, we work on these things. Another thing that’s telling is where did they receive vision therapy? You know, was it from Dr. x in Wichita Falls? Was it Dr. Y from Albuquerque? Because what I have found is a lot of people that come to see me have already done vision therapy. And it tells me a lot about, you know, what kind of vision therapy, where was it? And maybe just a little bit more about Where did you get it. And sometimes you can get records that can be helpful. I mean, most vision therapy practices are not doing primitive reflexes. They’re not even doing the depth of what you’re doing in this screening. And yet, they have some foundation, but it’s going to be really, really different. And maybe the vision therapy they did didn’t help at all. You know, that’s that happens a lot. That’s my narrative. When people come to see me and the way you’re working the way I’m working, you’re going to create very deep level change in your therapy, and it’s different than the cookbook, eyeball, eye exercise therapy that most optometrists are doing in vision therapy. The doctor isn’t even in the room, you know, so eye surgery. Do you want to ask a little more about you know, when how many times what I that might be valuable was was the I turned in before the surgery? What was the diagnosis before the surgery and what does it look like after the surgery? That might be helpful to to have that and why is it strabismus surgery was an another kind of surgery.
09:33
You know, some some of these kids, they develop congenital cataracts. I’ve had a number of cases where kids develop cataracts. So that’s a different surgery where they have to get a contact lens as an example, so that things aren’t so blurry. I have a case right now from California. They did cataract surgery and they never put a contact lens on the eye. So he’s got amblyopia. anthropology didn’t want to do anything. We put a contact lens on them. And now he’s like, oh, I’ve got a right eye and school is better and everything is, is going well. So what kind of eye surgery is a lazy eye? Okay with that, again, you might want to, which is lazy? Which I? Is it the right, is it the left anything else about that, and not that you need to write this down. But when kids come from another doctor’s office, a lot of times where they’re coming from is that they’ve been told to patch eight hours a day, which sets up this and the Moro reflex to amp up. And because it doesn’t work, and it creates more of those reflex patterns, like really up in nervous system. So any therapist that’s has where their child has a history of lazy AI, and they’ve done a lot of patching? I would definitely check fear paralysis and Morrow, because it could be much higher than it was based on having to be confined in an eyepatch over time. With watery eyes. Again, you can determine is this more allergy based? Or is it more functionally based? Some kids that have functional vision problems, they do have watery eyes, other kids, it’s an allergy, you know, in the infants, they were putting in the antibiotic drops right after birth. And I was seeing a lot of infants who had watery eyes after that because they were allergic to the antibiotic, or the eye drop that they put it put in which I don’t agree or recommend that. So a little more deeply in the watery eyes in the red eyes. How long? Is it both eyes? Is it one eye? When does the red eye one or the red eyes? The worst? Is it when they wake up in the morning? That’s gonna tell you that there’s probably chronic adrenal fatigue. And if it’s towards the end of the day, then it may be more functional. So just a little more specifics on you know, when the red eyes is a both eyes, is it one I’m more than the other? yawning is fine squinting, eye itching, rubbing. You know, those are great closing one eye head tilt. complains of eyestrain, headaches, double vision. Now with the double vision, what I like to do is I actually, during the exam, I like to ask the child directly. Do you ever see too? And the reason why I do that is because a lot of times kids don’t know what to means, or they’re embarrassed to admit that. And most of the time, they’ll say, Yeah, I do see too, and the parents are really surprised by that admission. So that can be really insightful around that, you know that, that sharing, and then complains in bright light. That’s a huge one. Because that’s saying that the the nervous system is really in a deep sympathetic state. Fight flight freeze. And then you’re going into those reflexes, again, like the fear paralysis in the in the morrow, just just as a start. But that’s an indicator, it’s a couple other things about the bright light. And you you did this below with the pupil response. A dilated pupil really reflects that there is a constriction in the peripheral vision.
13:58
So the visual field is usually reduced. It can also be in some cases, if this is a school aged child, where they have what we call the non malingering syndrome, which means that they basically their visual field has collapsed into a tunnel. And they have a lot of blurry vision. But there’s no prescription that will make it better, except the learning lenses. So if you get a child, and you don’t know what to do with the child, and they’ve got, you know, the the bright light issue, and you know, they’ve been under a lot of stress. Giving them the learning lenses can actually open up the visual field within a couple days. And you’ll probably say something like, wow, this feels good. I like this. Oh, I’m seeing things a little more clearly. And when you go to a conventional optometrist or ophthalmologist, they’ll walk away and say, Well, he doesn’t need a prescription. It’s nothing And this sometimes happens around the first grading period where we see this, this real collapse of the visual system. And there isn’t really a reason. Except we know it’s probably some kind of PTSD, more or reflects fear, paralysis reflex, just really overriding the visual system. So any questions or comments about anything? I’ve said?
15:29
No. Unless, yeah, those This is fabulous. And anything that we missed, any red flags that we missed, or that you feel like are really important, we tried to pull out the most important ones.
15:44
Okay. No, I don’t think you missed anything. I think you’ve you’ve got it. The reading and writing observations. I would agree with those. I think those are really, really good. And you know, you’re you’re accenting left and right. You know, I’ll just put this out there. I don’t know if it’s in the sequence. But I’m seeing a fair number of kids right now who have torticollis.
16:13
We are getting more to. Okay, we’ve had an influx of babies with torticollis. Yeah.
16:19
Well, I think it’s worth noting that the regular allopathic care, first of all, probably doesn’t even acknowledge it. And what has worked really well for me, and I know Susan’s, we’ve talked about this is the cranial work. And that that’s really, and then when you get the Beamer, they can actually lay on the Beamer at a low intensity, and then they’ll they’ll get into a relaxation state with the Beamer. And then when you do cranial, it’s like having six hands instead of two. So it’s really nice to, to have both of those. I think they’re they’re definitely some issues with the birth nonindustrial Industrial birth complex and things going on there. But so you’re seeing that too. I’m seeing it more in school aged kids actually. So they’re still having that tick, to the right or the left in terms of their neck. And it’s, it’s clearly torticollis. But you know, it’s been around for a while. So let’s go on the eye parents eyelid drooping. That’s great to note, the dullness, the pupil size.
17:42
There we are questions in this area, too. If you would do what you did at the top, we don’t know what that means when there’s our lid drooping. So if there is an eyelid droop, what does that mean?
17:59
It means that there could be some neurological interference. And so a deeper history would need to be taken, you know, the medical term is called toastiness pt o si s. And in the toeses is it like and you have it here unilateral or bilateral? If it’s just one eye, it could be more functional. But also you have to rule out any, you know, tumors or traumas, toxicities, stress, you’ve got to take a little deeper history. And you’re gonna probably have to make a referral to a neuro ophthalmologist or a neurologist. Because now you’re getting into the situation where there’s something in the brain or something in the visual pathway. That’s not in not allowing that eyelid to work properly. And it’s a it’s cranial nerve three. So there’s something going on in the cranial nerve. Now, you could also do some cranial sacral therapy, and see if you could, you know, help help it that way. But it is a red flag that there could be some neurological impediment, and that’s where it becomes a medical intervention. At least you have to rule out neurological disease and so cultivating a neurologist or a pediatric ophthalmologist or neuro ophthalmologist, these folks are going to be very allopathic. So, you know, there may be scans, there may be MRI, things like that. So it’s it’s a very serious condition that needs to be addressed quickly.
20:19
Okay. Same question with the dullness. What should eyes look like? And what would you notice if you saw
20:28
dole eyes, and we do the pupil response, to see if there’s any digestion or integration of the light, and the pupil would tell me that. But don’t eyes mean, means to me that there is a complete disconnect of the eyes with the brain and the body. And we actually see degrees of this and almost all the kids you refer to me. Because at some level, what has happened is, the eyes have been left behind as a relates to the brain and the body. This requires visual stimulation. And as you’ve observed in the evaluations I do with kids, I’m looking for probes and prompts to see what would it take to get them connected, and it usually is pretty instantaneous. And then when they connected, you see the all these magical things happen. And really, what it is, is just we’ve gone online, with the eyes with the rest of the person. And so now, all these things that weren’t happening are happening. So what the dullness says to me is, okay, what can I try to see if we can get get the eyes connected? And you know, you’ve seen me do all these different things, whether it’s Mr. tubular, whether it’s prisms, whatever it is color therapy, and it’s intuitive, you know, we don’t know exactly what is going to work for each child. But that’s why there’s all these different, you look at every case that comes in and you go, Wow, how did this, this really changed. So the dullness is the opportunity to say, we could make some really deep changes here by stimulating the visual system. Let’s explore it. Let’s, let’s try some things. And then if it’s not really working, then probably the reflexes are so strong, the primitive reflexes that you’ve got to somehow work in directly, or the other one that works well for me is the vestibular stimulation, and then bringing in the vision. But some of the table work you do with the reflexes, and then bringing in the vision after that could be beneficial. So it’s a it’s a diagnostic tool on where you somewhere you need to enter the eyes. The dullness is telling you that and then the pupil size is going to tell you well in the autonomic nervous system reflex. Are they at all responsive to light because if they have any responsiveness, the pupil is going to constrict. A lot of kids just have a dilated pupil constantly that even if you shine the light to penlight towards their eyes, the people doesn’t constrict. So those two go together really well. And then you can on the other you could just make some notes, the effect the arousal, eye contact, you know, social engagement with with the eyes, that’s another one that I like to explore because that tells me the state of the nervous system. And you know, if there’s no social contact, or eye contact, that tells me we know what they’ve been through.
24:23
Okay, so for the pupil size itself, if you had to describe what a normal pupil size would look like for a kid or person in relationship to the color around the eye, how would you describe what a normal pupil should look like?
24:43
So a normal pupil should look like that the percentage of the the the color part of the eye to the pupil size. The color part would be about 70% Then in size and the pupil would be about 30% in size. Okay, and that would vary based on the, when you shine the light, it would go from 30% to maybe 20%. So it’s going to get smaller. So then the iris would take up about 80%, when the pupils constricted, and what we could do is, we could do a little workshop, where we could work with each other. And the way you learn about the pupil size, is by watching a lot of different pupils. So what we could do is, you know, each person like we could, we could, I could measure each person, and then everybody could watch and see, okay, well, this is a normal pupil size, this is what happens when the light strikes the pupil, it’s it gets smaller, and then in dim light, now the people is going to grow a little bit. And it’s just something you learn by seeing a lot of different people responses. Okay, but it’s something great, yeah, but it’s something you need to, you need to see. But I’m just giving you broad brushes, 70, to 30, and then 80, to 20. When, you know when it’s in brighter light, what that would mean is that they, they tend to dwell primarily in the parasympathetic state. So they may be in a lower arousal, their vestibular system would be under acting, they would be in a state of hypo tone, low arousal, needing a lot to stimulate them to come out to move forward. So it’s very para sympathetically driven at that point, you don’t see as many of those sometimes it could mean that their sympathetic state is so worn down, that they’re now just all they’ve got is parasympathetic, they would see poor eye contact, maybe avert averted vision, where they’re looking away a lot. If you engage them with a tracking object, that they would not be able to sustain the, the fixation for more than like two or three seconds. And they would just, it’s a little bit like an autistic behavior where you just withdraw and in more dies. And you’re basically in your own your own world. So you’re not really responding externally. And when you look at the eyes, there’s just, there’s just no effect. Again, maybe, you know, that’s something that as I’m evaluating some of the kids, maybe that’s one of the things that I can note, you know, where’s the lightness darkness in this particular person, because again, it’s like the pupil response that comes from experience, but you know, if somebody is engaged or not engaged, and I would say that most of the kids that you refer to me, they are on the doll side of their vision. And for whatever reason why you’re referring them to me, there’s probably some dullness. The only time that you would do that is if it’s unequal pupils. Okay. And the pupils are responding differently. That would be a sign of a referral. But as long as it’s bilateral equal, then on that dilation, no, you wouldn’t have to refer.
29:29
I think just the things that you know how to do to teach self regulation come into play at that point, that’s a that’s a self regulation case. Why don’t know if they need to go in the list, I’ll just share a couple of things. And you can see if you want to put them there somewhere else. I think a one would be eye contact and length of eye contact. Another would be the health of the neck. You know, the mobility of the neck, the mobility of the neck as it relates to the eyes? those, those are things that I tend to look at. I don’t know whether they would fit there, or you know, you need to worry about that. But those, those are some things, I would say, Okay, here’s some other things. Again, I don’t know whether we’d go there. When I, sometimes, if I’m going to test the Moro reflex by dropping the head a little bit, I do look at the pupil response. And if I’m testing the reflexes, I am looking at the eyes, and the fixation and the pupil response. Because it tells me how tight in the visual system may be influenced by the lack of reflex integration. I can’t tell you the number of kids Well, I’ll drop their head a little bit. And I see this pupil dilation. And it’s like, Wow, that’s really telling me a lot about their sympathetic system. So I do look at the pupils when I’m doing a tracking test. Or I’m watching the pupils if they’re doing a cognitive exercise. So I think it’s just something to know to bring in an observation of the pupil response while they’re doing something.
31:37
Okay. Even teaching the therapists to do that during treatment to during treatment. Yeah, exactly. Right. Yeah, for sure. You know, watching their body. So you know, one of the things in my in my training was
31:54
one one of my teachers was great at this is saying, you have to watch the eyes, while you’re doing a three dimensional while you’re doing a parquetry you’re doing a Marsden ball you’re doing, you know, those kinds of things. And it really was insightful. For me, even when I do some testing, and I asked him to read something, I’m really looking at their eyes while they’re reading. So, you know, I know you’ve got a lot of things you’re looking at the body and, and I kind of bring the eye thing into it. So I would just say once in a while, can they maybe note what’s happening in the eyes while you’re giving them a treatment? task. Number one, the color therapy. And the colors that would bring out more of a parasympathetic balance would be the blue, green, the blue or the purple overlays over their eyes. Number two would be the the sound of the palming with the humming. And that particular sound palming combination, will get them to breathe more deeply slow them down, open up the stress in the eyes. Number three would be putting on the learning lenses, especially if there’s headaches. Because sometimes part of the headaches could be their stress point is right at the distance where they’re reading. And when they put on the learning lenses, the stress point moves closer to their face, which is what we want. So that could open up their peripheral vision. And, you know, relax their eyes, outside the scope of the vision part would be imploring some essential oils, possibly that that’s tricky because some of them may not be able to do that, as I’ve used, as you’ve seen in many of my sessions. The color therapy is a language that kids seem to understand. And they relate to it even if their verbal skills are low. Or, you know, they might have some secondary cognitive stuff. It just seems like they really get that energy, energy medicine, vibrational healing. You know, I was working with a kid yesterday, who is pretty low functioning, and we did color therapy, and then I just had to do some drawing. And all of a sudden, he said, Oh, I see a dolphin and he actually drew this dolphin. And his mom, I mean, we were just like blown away and there was an OT in our clinic also. So the color therapy seemed to open up something for him. And I mean, I don’t know where that all came from. But that’s that nonlinear state of like, Something really shifted in him. So that’s just yeah, it’s just an example of, you know, potentially what we can do with these kids. By coming out of the, the narrow confines of what the allopathic approach has been, and I know your way out of the box as well. But there’s so there’s such vastness out there, if you do that frequency medicine frequency, vibrational stuff, just, you know, introducing it and seeing how their, their system responds to it, because it’s pretty non invasive, and it penetrates their defense strategy, their defenses, and they don’t recoil as much, or at all and then something gets reconnected. So that’s why I think the color work, and we’re gonna, we’re gonna go more deeply into the color. I know you had requested that. But this is just just a superficial thing that in your toolbox with all the things you’re already doing, which are great, adding these few little things, if it’s not working, or you want to try something else, they’ve worked for me so I would, you know, share them with you.
36:22
Thank you for listening. I hope you learned something from the EyeClarity podcast show today. If you enjoyed the episode, make sure to subscribe on iTunes or Spotify and leave a review. see you here next time.
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