Thursday, February 4, 2016

Left neglected: an experiment in piracy





We happened onto this idea last night.

It's called monocular eye patching. I got curious about its use in supporting recovery of hemispatial neglect in stroke survivors while Mr. PNU and I were cuddling in bed last night and I experimented with his visual field by placing a hand over each eye interchangeably.

When they were small, both my oldest son, E—, and my youngest daughter, L—, went through periods of eye patching as treatment for amblyopia, or lazy eye. The idea behind the method is that in covering the more active eye, the brain is forced to improve use and function of the affected eye.

The post-stroke hemispatial visual field is equal to the vision experienced when a person covers his or her left eye. While the vision capabilities in both eyes remains 20/20, the damaged portion of the occipital lobe fails to register or pay attention to the left eye's peripheral range. For Mr. PNU, it is as though he were always walking around with a hand over his left eye. He doesn't see me when he rides next to me in the passenger seat of the car. He doesn't see the students who sit on the left side of the classroom. He doesn't see walls, rocks, ledges, or gaping holes on his left side. Thus, the left neglect he experiences leaves him vulnerable to environmental dangers and all the more dependent on others to help him negotiate the world.

There isn't nearly enough research on the use of eye patching in stroke recovery. But there is some, and enough of it positive that this afternoon I purchased a five-dollar eye patch and we've been making jokes about buying blousy shirts and a pet parrot ever since. He's walked up and down our hallway twice, and spent the last hour reading Daniel Dennet's The Intentional Stance without issue. It's likely too early to tell if the patching can trick the brain into rewiring neural pathways to compensate for the lost occipital visual registry and wake up my husband's left visual field, but I swear he's turning left corners with greater ease.

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