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  • Binocular vision troubles - Anyone else experience/overcome this?

So in my other thread I have been talking about how Windows 10 is triggering my migraines, and no combination of video card or monitor solves the issue. Even an eInk monitor with no back light, no refresh rate, and no color triggers my symptoms.

I have been taking notes of my symptoms and the muscle pain I am feeling feels like the pain I get when I have an improper prescription contact lens or glasses, and it feels like the muscles in my head are trying to "move" my eye to compensate, resulting in those muscles tightening up which then impinges nerves and causes migraine (according to my nuerologist). Someone in the other thread suggested trying an eyepatch to cover one eye I happen to have one from my vision training, so I put it on, and have been using my setup, and so far (it's only been 30 min or so) I haven't had symptoms. I usually get symptoms almost immediately.

So another hypothesis is that this is binocular focusing related. Somehow the way the Windows 10 desktop compositor is rendering the image, regardless of video card or monitor, is causing my eyes to struggle to maintain a binocular balance between the two eyes, and my brain is trying to compensate for that by activating muscles in my head and "move" my eye to compensate, resulting in those muscles tightening up which then impinges nerves and causes migraine

I'm going to continue wearing an eyepatch when using that system for a couple hours, and if it holds up, that would seem to at least indicate a root cause to the problem: I have no idea how that would be fixed, but at least it is a plausible hypothesis to start from.

Has anyone else had some sort of binocular balance insufficiency identified/fixed? I did some reading on it and it seems like it is something fairly easily fixed among young people by patching one eye but the older you get the harder it is to fix

Great discovery.

@martin has talked about binocular vision extensively and the progress he has made with vision therapy and prismatic eye glasses. He even has a great blog post where he talks about the "eyepatch" test for heterophoria. I think you have discovered the same as Martin writes 🙂.

I know you have visited many specialists, but maybe you should find another Optometrist. I have found they vary markedly in their capabilities (more so than say, MDs). Offering vision therapy and prismatic lenses is definitely a good sign. If you have been to one already, try another.

Martin may be able to connect you to his specialist (in the Czech Republic, IIRC). I came across this OD who offers vision therapy remotely in the USA, but have no personal experience. I also came across this OD in NY, USA, who specializes in prism lenses. I may suggest at least giving them a call.

The Neurolenses which are often described here may be a good fit (they are heinously expensive), they are a prism, but in a progressive lens. A regular prism to correct the eye misalignment may also work (and will be cheaper) ~ but getting the right measurements for prism is very dependent on the skills of the provider.

One at-home test and exercise you may be able to do is using the brock string. The brock string is nice: it is useful as both an exercise and a diagnostic tool. Martin describes it nicely in his post. My eyes cross before the bead, indicating a binocular vision dysfunction called esophoria.

I do think many folks on here have some degree of binocular vision dysfunction, but have been to Optometrists who are not equipped to diagnose nor treat these issues. I have been to ODs practicing 20+ years with excellent reviews who did not test my eyes for binocular dysfunction and told me to take more breaks! You just need to find a good provider -- @martin may be able to describe some of the tests a good Optometrist should be doing.

    Sometimes the binocular thing is also the wrong glasses prescription. The new glasses I have, I can't wear them at the computer. One eye is in focus, the other eye is quite blurred. I basically can only use them outdoors where at infinity focusing distance both eyes will be in focus. With my old glasses which I still use at the computer, the blurry eye is in focus and the other eye is slightly blurred.

    So the lesson here is that if you wear glasses, but spend a lot of time looking or working with something at distance X, tell the prescriber that you need it to be in focus 3 feet away or whatever distance is important that you spend the most time with.

    ryans

    I happen to have a brock string from my vision therapy experience. I am also going to go back to that doctor in a week and tell them about my new experience.

    I am looking for OD's around my area who may offer more exact prism diagnosis. Price isn;t really a concern, if $1000 can save me my career it's well worth it.

      ensete

      Great. If you wanted to give it a try, Neurolens has a list of providers on their website. In your case, travel may be well worth the expense and effort. The "nice" thing about Neurolens is a device/algorithm measures the exact prism you need with high precision -- so it is not dependent on the skills of the OD. The only downside seems the price, which luckily is not an issue for you.

      (I haven't used Neurolens as I have a good setup, but will be looking to get a pair soon, as this setup will not remain forever).

      Keep us posted 🙂

      I have heard this theory on this board for the last few years, and is very intriguing!

      The upshot, if this is the issue, is I'm willing to bet 99% of this site's users will be able to, if not fix binocular issues, make it much more tolerable, by pursuing vision therapy, or in some cases minor surgical procedures.

      Now to the caveat; I was born with binocular vision issues (alternating esotropia/strabismus), my eyes are as straight as they will ever be, however my brain never fully grasped binocular vision. I don't see double vision, but I definitely don't have as good depth perception as most people, also add to that astigmatism and an above -10 prescription in both eyes, and it's a winning combination 🤣

      I have tried patching for computer use, and honestly haven't found much difference, at least after extended periods of time (I essentially see through one eye at a time anyway). The thing with patching is it's supposed to be a closely monitored activity by a professional as changes can occur in the binocular system if you patch a single eye for extended amounts of time.

      My finger points to the industry; why would an update to software require 100% binocular vision? We're not fighter pilots. Is there some sort of pseudo-3D happening in modern tech? Perhaps the imperceptibility of dithering algorithms was only tested on individuals with an intact binocular vision system. Although strabismus is said to only affect 2-3% of the population, heterophoria is a much higher number.

      So if it can be proven that we all have a binocular vision issue to some degree, we are being discriminated, in an era where technology is ubiquitous and supposedly available to people with accessibility issues.

      As others have mentioned though, first and foremost everybody should get a thorough eye exam, including cross-cover tests and others such as the brock string.

        diop
        So if it can be proven that we all have a binocular vision issue to some degree, we are being discriminated, in an era where technology is ubiquitous and supposedly available to people with accessibility issues.

        They don't care. Microsoft doesn't care, Google doesn't care, Dell doesn't care, HP doesn't care, etc etc. No one cares. Corporations only pretend to care about doing the right thing when it will impact their bottom line. Helping .002% of their users won't make them any money, so they don't care.

        When we reach out to them we get pointless boilerplate responses. When you try and contact engineers at the company, it's almost impossible. When we go into excruciating detail about our problems and the real pain and suffering it is causing, they ask us if we rebooted our PC, and then they say have nothing for us.

        The limit of a corporations compassion ends at them telling the world how woke they are on their Twitter feed. These are people who will shout how much they love and support the LGBT community at the same time they are doing business with countries where LGBT people are literally thrown off rooftops to their deaths. But hey, they made a rainbow logo, so they "care".

        No, this issue is on us, and us alone, to diagnose and solve. We should expect 0 help from any technology organization. They do not care.

        rant mode off

          I tried 3 months of visual training but I didn't see any improvement, unfortunately. Instead with a 0.25 internal base prism, the pain in the eyes / burning sensation was totally gone but the magic lasted only 3 days.

          let me know if any of you try the neurolens. I am very interested but unfortunately, they are not available in Europe. If they work on someone on the forum I would consider a trip to the US to buy them.

            ensete When we reach out to them we get pointless boilerplate responses. When you try and contact engineers at the company, it's almost impossible. When we go into excruciating detail about our problems and the real pain and suffering it is causing, they ask us if we rebooted our PC, and then they say have nothing for us.

            I PM'd an Intel Graphics dev via Reddit, and got a "that's interesting, I'll forward this onto the team" response. I wonder how possible it is to organise roundtable/video conference with members of staff in these areas. I suspect incredibly difficult not to mention prohibitively expensive. I'm sure money could get you through the door.

            However this doesn't stop at PC's obviously. If I try to use any modern Smart TV apps/Smartphones and games consoles, the same symptoms occur. So whatever these changes are have occurred at an industry-wide level in the last 5-10 years.

            I'm so glad this little corner of the web exists, though. There still may be no fixes, however we're all going through the same thing.

              Lauda89 was totally gone but the magic lasted only 3 days

              Patients sometimes "eat" the prism, meaning they require more and more prism increase to get the same effect. 3 days seems unusually short, though. Have you shared this with the eye doctor? Perhaps you need to do exercises with the prism glasses? Perhaps the prism prescribed was not enough?

              Take note that Neurolens are also prism glasses, if you really did "eat" the prism in 3 days, the same may happen with the Neurolens.

              Consider trying another eye doctor and make sure they know the prism helped but not for long. They vary markedly in their expertise of treating binocular vision dysfunction(s).

                diop Intel Graphics dev via Reddit,

                I've reached out to engineers from various companies, too. The problem is we have not identified a cause of these issue(s). The cause(s) are unlikely to be the same for everyone on this forum, too.

                If we could point to specific evidence of the problem (dithering, LCD inversion, something else) they will be more likely to help us out. If we are going to get any kind of help, we need to help these engineers identify the problem. Since they cannot "reproduce" the problem themselves, it is pretty much impossible for them to even verify a potential fix.

                • diop replied to this.

                  Lauda89

                  0.25 is also near to nothing especially if you have horizontal prisms, so if you see improvements here, I guess maybe it would make sense to test this further.

                    ryans If we could point to specific evidence of the problem (dithering, LCD inversion, something else) they will be more likely to help us out. If we are going to get any kind of help, we need to help these engineers identify the problem. Since they cannot "reproduce" the problem themselves, it is pretty much impossible for them to even verify a potential fix.

                    This is why we need ways to control dithering on new tech now. We can't confirm that it is dithering unless we use a system without it for comparison. It's a catch 22.

                    ryans

                    I know about these "eating" problems but 0.25 is not enough to fix an eye misalignment so maybe I should try a more strong prism. It seems that nobody wants to prescribe me a real prism to fix the exophoria (i live in Italy) so I tried the visual training but honestly, I didn't see any improvement in my symptoms!

                    xelaos

                    She calls that prism something like "Postural prism" and it's not used to fix the exophoria (horizontal) but to keep the head straight and help the neck muscles.
                    I've tried two different doctors but they don't want to give me a "real prism" for the exophoria because they said that prisms are used for cross-eyed people and not to fix heterophorias?!

                    I can try to go to an orthoptist and see what he said!

                      Lauda89

                      I mean, "postural prism" with 0.25 sounds a little bit unscientific to me. Head straight in which axis? If you have exophoria maybe you move your head more to the left or the right or you raise your head a little. If you have vertical misalignments you tilt your head to one side.

                      However, all head adjustments are also clearly more influenced by more prisms. I don't know if more prisms fix your problem, but prescribing 0.25 prisms horizontal seems a bit like a placebo. Don't get me wrong, maybe you have a stronger exo, but your eyes are nearly capable of compensating and +0.25 had reduced the tipping point to a point where you didn't feel pain for a few days.

                      If you wanna go the DIY route and test something you can order something like this https://www.3m.com/3M/en_US/p/d/v000094832/ with 1pd and turn the base in the same direction (internal) as in your 0.25 prescription, but maybe try another orthoptist first and tell him/her that 0.25 helped.

                        For what it's worth, I've been using Neurolenses for the past few months & haven't noticed any significant improvements in terms of flicker sensitivity. They're nice for general eye strain, but don't seem to help at all with flicker.

                          xelaos

                          I agree with everything you said. Of course the placebo effect is possible because when he made me try the prism I noticed an improvement so I bought the lens and I was certainly optimistic and it definitely helped to let it work, for few days.

                          I tried 2 occultists and 2 optometrists no orthoptists. So I book an appointment with an orthoptist and let's see what he says. I keep you updated 🙂

                          What is your situation? Some heterophoria too? You seem really expert on this topic!

                          bkdo

                          finally, a user who has tried these lenses. So have you been diagnosed with eye misalignment? Can you use more devices than before? If you are PWM sensitive then lenses surely can't help. In my case, I'm not PWM sensitive because the devices I find most comfortable are OLEDs that flicker at 240hz often! So they might be perfect for my problem. I will have to organize a trip to the US I guess…

                            bkdo

                            Can you share what kind of Neurolens you got (they have several types of lenses)? Are you happy you purchased them? Did the Neuorlens give you measurements and a "diagnosis" (such as exophoria or esophoria) -- the machine does provide this output to the provider.

                            • bkdo replied to this.

                              Lauda89

                              Yeah, it seems that I do have some kind of eye misalignment, though it's definitely a milder case. The main thing that I've noticed is an improvement in eye fatigue at the end of the day. For example, before Neurolens, I'd get to the end of the day and any high-contrast text would appear doubled like this:

                              After Neurolens, it seems like I don't have this issue nearly as often. Also, I did get my glasses w/ my new corrective prescription, so that could be a factor in the improvement as well. Unfortunately, absolutely zero change in regards to flicker or eye strain from it. I'm still sensitive to any sort of flickering.

                              ryans

                              I'm not totally sure of what kind of lens I got, I think it's just the standard one. My prescription for the Neurolens is:

                              OD +0.75

                              OS +0.25

                              H Prism 3.00 Bl

                              (I wear them all the time)

                              This is the only info I got from the provider, & I wasn't diagnosed specifically with exophoria or esophoria. They didn't work for me in terms of helping with flicker, but I'd still recommend trying them since they have a 6 week return policy.

                                bkdo

                                Are you in USA? Are you happy you made the purchase?

                                I see your prism is Base In (BI) lens, which means you likely have exophoria. I wonder if additional Vision Therapy (which is more effective at treating exophoria, rather than esophoria) might help you.

                                What devices are you using?

                                • bkdo replied to this.
                                  dev