|Monocular Fixation in a Binocular Field
Jennifer S. Simonson, OD, FCOVD
2017 Colorado Vision Summit
Understand the levels of sensory fusion
Monocular Fixation in a Binocular Field
Use activities in optometric vision therapy to develop each sensory level:
Equal vision skills in each eye (accommodation, fixation, pursuit, saccade, perception)
Improve monocular fixation when both eyes are open.
Awareness of simultaneous perception.
Learn techniques to decrease suppression.
Use activities that create luster.
Use one eye at a time
Goal: Equal vision skills in each eye
Monocular Fixation in a Binocular Field (MFBF)
One eye sees detail and the other eye sees the background in the same space.
Goal: accurate perception of details with one eye and the perception of the background with the other eye.
Most Monocular Activities can be modified to MFBF –
1. Change the occluder to a filter
2. Change the target so it cannot be seen with one eye
Complete: “pirate” patch, “Band-Aid” patch, occluder, hand
Fully occluded? Then MONOCULAR
Occlusion Types - MFBF
Translucent: light, but no detail.
One eye can see background only? Then MFBF
Most important Concept:
RED plus GREEN = BLACK
RED plus WHITE = RED
GREEN plus WHITE = GREEN
MFBF #1: WHITE background, RED detail, RED patch or Red/Green Glasses
WORKSHOP: Red Ink Activities
White board/Red marker
Copier with pink setting
Red letter tracking
Wayne directional sequencer
Red coloring book
White fish with red letters
Red/Red Rock tiles
White Sherman Cards
Red/Green Toy box train play set
Sanet Vision Integrator (SVI)
Joanna Carter I'd check www.bernell.com or Red Green Toy Box. On Amazon there's a Pinkalicious Pinkadoodles book that almost-entirely cancels. But we make our own, and others have shared theirs with us. The color combo that cancels is: R194, G24, B52. So you can make word finds, Hart Charts, etc. with that color. Hope that helps.
Red print test screen.
Modification: Green detail on White background
White board/Green marker
Red/Green toy box activities
Vision Tap and Opto Apps
MFBF #2: BLACK background, RED detail, RED patch or Red/Green Glasses
WORKSHOP ACITIVITY: Black Felt Activities
Goal: accurate perception of details with one eye and the perception of the background with the other eye. Also, the perception of luster, Anti-suppression, and Detail recognition
WORKSHOP ACITIVITY: Tap-n-See Now Little Bear Sees
Background = Black, Images = Red, Select size and speed
Both eyes see the iPad, but only the left eye can follow the red bear.
Modification: Green Detail on Black Background
MFBF #3: RED background, BLACK detail, GREEN patch or Red/Green Glasses
1. Black Print (eye under red lens sees detail)
Modification: White Print (eye under green lens sees detail)
Modification: Red Filter (eye under red lens sees detail)
MFBF #4: GREEN background, RED/GREEN glasses
Eye under green lens sees detail
MOST IMPORTANT CONCEPT:
A red filter only allows RED light through and blocks all other colors
A green filter only allows GREEN light through and blocks all others
A blue filter only allows BLUE light through and blocks all others
MFBF #5: RED background, RED LIGHT, RED/GREEN glasses
The red light is blocked by the green filter. Use the red lens on the fixating eye.
Modification: Red Filter + White paper +White Light
Mazes with red filter
Red Light Red Ring
MFBF #6: RED LIGHT, GREEN LIGHT, BLUE LIGHT
Alternate Red/Green or Red/Blue lenses with activities to fixate with each eye.
Biocular Activities that use Red/Green (or Red/Blue or Red/Cyan) glasses – are basically MFBF with alternation.
For MFBF: select just one color combination of a binocular or anti-suppression activity. For example, only the perceptive cards that are red with black ink.
Goal: to improve the ability of both eyes to alternately shift focus in an un-fused situation, which will facilitate anti-suppression and prepare the patient for simultaneous perception.
Red Green filters placed side-by-side on reading material, crossword puzzle, hidden pictures.
Polarized or Red/Green bar readers with the appropriate glasses
Perceptive or Carl’s Cards- entire deck
Anaglyphic projection= projected hart chart with overlays onto wall.
Dichoptic Training and Suppression Control
Fortenbacker, OD, FCOVD “Advanced Amblyopia Treatment for Better Results” – 2015 COVD Annual Meeting, April.
The History of the Treatment of Amblyopia, S.E. Loudon, H.J. Simonsz, Strabismus, 13:93, 2005.
Amblyopia Treatment Study 3 (ATS18) Study of Binocular Computer Activities for Treatment of Amblyopia – http://pedig.jaeb.org/Studies.aspx?RecID=235
Bateman, R., Danner, R., Dowis, R., et al. (1985). Manual of Esotropia Therapy. Colorado Vision Consultants: Colorado.
Cooper, J. S., Burns, C., Cotter, S. A., Daum, K., Griffin, J. R., & Scheiman, M. M. (1998, March). Accommodative and Vergence Dysfunction. Retrieved from http://www.aoa.org/documents/CPG-18.pdf
Headline, T. C., Wahlmeler, I., & Bedes, V. (2005). The Vision Therapist's Toolkit. San Jose: California.
Maino, D., (2011). 3D in the Classroom: See Well, Learn Well. Optometry and Vision Development, Vol. 42, Num. 4: Ohio.
Press, L. J. (2008). Principles and Practice of Vision Therapy. Optometric Extension Program: California.
Press Lites: http://www.oepf.org/sites/default/files/OVP1-2_article_Press_web.pdf