Prepared for MAER 4/26/2012

Spatial perception is understanding the space we need to move through or manipulate objects within

Vision is the deriving of meaning and direction of action as triggered by light

Vision is the primary human spatial processing sense

So what if?• You can’t see? • OR Can’t see like you used to?

Your visual attention may be the key!

Sight• Sight loss (eyeball and eyeball wiring hardware)

is rarely total

Vision Vision loss is never total that I know of

We can have vision without eyesight • As many in attendance can attest to we see

through our eyes (eyesight) with our brain (vision) Mobility work depends on spatial processing (vision)

in the brain not the eyes Thinking in pictures (Visual thinking)

Development• Most are born seeing, but don’t understand

what we see (vision)• Vision is learned

Learned by bumping into reality with our sensory systems (with mouthing, touch, hearing proprioception and movement)

Learned by figuring out the patterns of reality well enough to even anticipate

It is the last sensory system to fully mature Complex environmental interactions or movement

experiences are needed Movement is essential to spatial perception

And visual development Therefore Vestibular and Cerebellar function is

important as well When working well vision leads and guides,

when not it interferes (John Streff OD)

When mature it can substitute for the sensory systems that helped it’s development Vision has been said to be hands extended

• Amblyopia (lazy eye), strabismus (wandering eye), and learning related vision problems are a lack of full visual development not usually a loss of anything Lack of development Truly successful cures require addressing

improper development• Most nearsightedness, astigmatism and

farsightedness can also be viewed in a developmental light.

Congenital (Never had) and acquired (had and lost)

Loss of eyesight is not the loss of vision

But, vision without eyesight is not the same

“Not the same” is the key issue

Change is never easy for anyone at almost any time

What has changed with the loss of eyesight (hardware) is how you now will use vision with limited or different eyesight as a part of the visual process (software)

The role of automaticity or habituation

Even with full visual capacity you cannot attend to everything all the time!

Also true for hearing, smelling and feeling (shoes?)

Selective attention is an important component of successful spatial processing

Changes to visual attention and how we use eyesight in visual spatial processing is what changes and needs to be addressed

A visual cure is making vision function like it used to

Many losses of eyesight have no cure, but vision is still present

It is not bad or unusual to look/hope for cures

It is not always realistic to expect cures for many loss of sight conditions at least in the immediate future

Hope to improve visual function with rehabilitation is more realistic and attainable

Getting used to changing the way you use vision is the key • Silverware drawer example• Practice over time• Effort/habituation/ease of use

Decreasing effort is the way to reduce eye strain (asthenopia)

Trying to use old software with changed (new) hardware is stressful and tiring

Learning to use what is left (pieces of eyesight, visual memory and spatial vision) with the least amount of effort is very important

Part of any visual rehabilitation

Two approaches:• 1) Limiting visual loss due to misuse or

nonuse is important Ex. peripheral vision

• Circling the wagons Self limitation

• Lots of research on visual field (attention) restoration!

• 2) Learning to re-write software There is no substitute for hardware loss in any

sensory system There is a lot of brain plasticity research out

there that tells us making new software to run different hardware is possible at any age

Doesn’t it make sense to use all of our sensory systems to rebuild dormant software or build new software just like our vision developed to start with

Look Hard Look Soft procedure• Ease eyestrain

Visual imagery/memory practice• What you remember things to look like• Visual closure-filling in the missing pieces• Visual anticipation

If you think you can or you think you can’t you are probably right! Henry Ford “The Secret”

Hope and faith are important Learning is having the correct

experience at the correct time Expert guidance increases the odds new

software can be developed Acceptance of loss and getting support

• Psychology of loss• Support groups• Local Rehabilitation Team

Loss of eyesight can cause one to feel unlucky, frustrated, anxious and/or depressed

There are no cures out there for many eyesight conditions

But there may be many rehabilitation treatments that are possible

For those with eyesight or visual loss:• You can do something!• It is your choice• It is your software and attention and only

you can change it• You are in charge of how you choose to use

your eyes and your visual process

For the rehabilitation team:• You are responsible for keeping abreast of

new science, new development in your field• You need to learn how others learn in order

to use your knowledge about your field of expertise in a positive way

• You are responsible to use everything you know to help your patients improve the quality of life with eyesight or visual loss

Rehabilitation is a process not a destination

Thank you for your attention today

Questions?