Vision tips

 In case this may help, the following are the best SCA6 vision suggestions I have discovered to date:

• Find an OT who can & will “think outside the square” for potential solutions.  (Age alone won’t necessarily indicate OT effectiveness);

• Practice eye focus using a Red Laser-Beam Cat Toy as therapy (designed to increase eye-muscle control);

• Get optometrist to add Prisms (for reading glass prescriptions only) & avoid Bifocals;

• Depend on a Walker not just for balance & mobility, but also for visual assistance;

• Avoid unfamiliar situations & where there are a lot of people with constant movement & noise (supermarkets, malls, traffic, etc);

• Keep Gaze ahead & limit head movement as much as possible.

 

I recently had eye surgery at Mass General in Boston to correct double vision caused by my ataxia. The doctor tightened certain muscles in my eyes to make them move in tandem resolving my double  vision. Dr. Gomez found the doctor for me through a referral by a. doctor at Harvard.  Surgery is a success so far.  Barry

 

Doctor who performed eye procedure:

Dr. Dean Cestari

Mass. General Hospital

247 Charles Street, 9th Floor

Boston, Mass

telephone 617 573 3412

 

Common movements include tracking moving objects (smooth pursuits), jumping back and forth between targets (saccades) and coming in/out together (convergence). Certain features of eye movements (such as the eyes over or undershooting when looking at a target) are used to diagnose neurological conditions. 

 

One of the reasons that I have not tapped into more thoroughly pursuing eye movement training with CA is to stay within my scope of practice. I recommend individuals seek out a neuro-ophthalmologist and follow their expert advice. Another fantastic resource is going to a vision clinic. I have a friend with SCA6 who has found improvements in her balance and stability with her eye exercises prescribed there. Working with a therapist they can customize an exercise routine specific to that individual. 

 

The harm in me providing exercises is that it may deter people from seeing an expert. Not only that but certain exercises (such as the pencil push-up) are controversial in their efficacy. I wouldn't want to cause anyone eye strain and/or headaches. 

 

There are a few things I have recommended however: 

 

One is a research study on eye-rehearsal and foot fall accuracy.... Research shows when an individual with CA stops to first map out their foot-fall placement, their gait can improve by increasing their foot fall accuracy. This is using our saccadic eye movements- jumping back and forth between targets. For this reason, if someone is doing something such as crossing the stage- I encourage them to stop and visually map out their steps first. Linking the research study to this below: 

"Rehearsal by eye movement improves visuomotor performance in cerebellar patients"

https://www.researchgate.net/publication/11191832_Rehearsal_by_eye_movement_improves_visuomotor_performance_in_cerebellar_patients

 

Another movement that is essential for balance is the coordination of the eyes to the head with gaze stabilization. This is done through the Vestibulo-Occular Reflex. Research is strong that by practicing the VOR, balance can improve. Here is one study that showed an individual with  Hereditary cerebellar atrophy. She did VOR exercises and  had a 78.6% reduction in weekly self-reported falls at one week • 89.3% reduction in self-reported falls at discharge (average of week 4-7). I'm happy to elaborate on VOR exercises if interested. 

 

 "Gaze Stabilization Exercises to Decrease Fall Rate in Person with Hereditary Cerebellar Atrophy: A Case Study"

https://cdn.ymaws.com/www.mnapta.org/resource/resmgr/education-conference/2020_poster_presentations/interim_healthcare-_gaze_sta.pdf

 

Hope that information helps!

:) <3 Elizabeth