A girl with kaleidoscope eyes, Part II

Dear Professor Bielschowsky was the first modern physician to associate head tilt with fusional amplitude compensation. I’m an expert on head tilting, because I have to make up for a deviation in visual input, which causes diplopia. Massive, annoying diplopia for poor little me.  

As I mentioned in my post of June 14, ‘A girl with kaleidoscope eyes’, I was due for my follow-up appointment at the Medical Arts and Research Center Neuro Ophthalmology department in San Antonio on July 10. Fortunately the blood tests and MRI proved to be ‘unremarkable’. Big relief!

I am equally happy to report that this idiopathic trochlear nerve palsy, also called 4th nerve palsy or superior oblique palsy, can be correct through prism ‘inserts’ in my eyeglasses. To test their effectiveness a MARC technician attached some gel self-stick prisms to the inside of my progressive vision glasses.







As one can see in the pictures, the prisms appear like miniature glass jalousie shutters. Amazingly though, they actually DO fuse my visual input into one comfortable image! After you get over the annoying urge to rip off your glasses to clean them, because the lenses seem opaque or smudged, their benefits are overwhelmingly wonderful to experience. For the last two years or so, my fusional control has been deteriorating so much, that it  became a serious problem. When you arrive in an airport and the overhead signs directing you to the baggage claim turn into sparkly, shapeshifting and bouncy non-sensical objects, it is frustrating and infuriating. My dizzying kaleidoscope eyes just wouldn’t stop swirling. But these prisms have stopped the kaleidoscopes!


I can’t emphasize enough, how important it is to follow your instincts, when you try to find a solution to a medical problem. Don’t let yourself be dismissed with a shrug! As a rule: funky vision and near daily headaches are not usually cured through application of artificial tear lubricants.

Terminology:
Trochlear or 4th cranial nerve: one of 12 nerve pairs in the head

Superior oblique muscle (or obliquus oculi superior): one of six muscles moving the eyeball in humans, a seventh muscle operates the upper eyelid

Palsy: paralysis, incapacity

Trochlear nerve palsy: paralysis of the nerve going to the superior oblique muscle

Fusional amplitude: when the eyes transmit a ‘picture’ to different spots in the brain, which can not be reconciled into one, single image

Fusional control: the ability of young people to overcome the fusional amplitude and fuse the image despite a dysfunction. They can compensate, make up, for the fusional amplitude or deviation without consciously trying

Diplopia: double vision

Idiopathic: unknown causes (of a desease or dysfunction)

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