What are our eyes for?

Illusions and Paradoxes Seeing is Believing?    - external link

Jessica's visual experience. - life with Jessica.

Jessica's Visual Fields - picture.

About the Optic Chiasm

Jessica's eyesight as the result of the Tumour.

Bilateral hemianopia.

Cataracts

Corneal transplantation

After care.

Jessica's expected eye surgery.

  Visual Perception - See also ---The Joy of Visual Perception: A Web Book
 

Very briefly, it may seem a silly question to ask what are our eyes for? However being able to see images or detect light is only part of what we do with our eyes. Seeing is one thing, knowing that we see and what we see is another.

The biggest issue Jessica, and others like her, has is that her eyes do not see images very well anymore, however she is aware of the meaning of the world around her.

Unless our brain knows what to do with the visual input then we may as well be blind! Our eyes are linked straight to our brains so that their sensory input goes directly into our brain where it is processed. Unless our  brains are trained from an early age to correctly interpret the world our eyes  reflect then none of us will know the meaning of the world around us.  Seeing and knowing what we see and its meaning are part of a complex system called Visual perception or Cognitive perception.

Though we have 5 senses it is our sense of sight which seems to do the most to assist us interpret our world - or so we think while we can see. When someone losses any one of their 5 senses those left become more acute to compensate for the loss.

 When people lose their sight their other 4 senses take up some of the slack, so to speak, to make up for their lack of vision. This explains why Jessica has extremely good mind maps of the City of Sydney and other places. Vision impaired people make the best use of touch, taste, smell and sound to compensate for their loss of vision or partial loss thereof.

Think about it! If someone was told as a child that the colour green is called blue then what colour are the trees?

Life with Jessica Visual experience.

I have a wonderful, marvellous wife who lives a full life under extremely difficult circumstances.

Jessica lost her sight as the result of the Pituitary adenoma - a Prolactinoma to be exact.

The tumour, situated on the posterior lobe of the Pituitary gland, grew so that it pressed upon the Optic chiasm and eventually brought about the loss of her sight. Jessica still has some sight in her left eye, t hough now experiences the condition known as Bilateral Hemianopia. This means that  her small percentage of sight  is missing its outer visual field due to damage to the Nasal nerve.

Below you will read part of an article from Wikipedia about the Optic chiasm, it will assist you if you make your way to the site to read the definition there.

When Jessica and I first met her loss of vision wasn't immediately obvious. She did not even use her sight stick so as not to draw attention to herself, however I had not known her for very long before I realised that she needed to use the sight stick to prevent herself bumping right up against people and to indicate that there was a problem with her vision.

Over the eight years we have been together her sight has become progressively worse until now she sees with difficulty when she is out and requires the use of a cane with a roller ball to navigate her way around the City and outer suburbs. Due to her frequent seizures it is more often that not necessary for her to be guide by myself or one of the day cares who come to relieve me.

Nevertheless, Jessica makes the maximum use of her remaining vision, she can often find things on the supermarket shelf quicker than I since she knows how to use her bit of vision to scan the shelves progressively until she finds whatever we are looking for.

In the time we have been together we have put a few computers together, Jessica still works from the command prompt and does the maintenance on our computer. She also enjoys her digital camera and takes excellent photos just by pointing and shooting.

She will then work on the photos in our imaging programs, Micrografx and  Image Pro 10, to bring them up to scratch and to make Panoramas and stitches which reveal entire vistas such as the coastline in Kiama near to the Blowhole caravan park. You will see some of her pictures once we load the galleries.

It is amazing what people can do to compensate for the loss of one of their senses, sometimes I might believe that my wonderful wife is not visually impaired especially when I see her wielding the electric drill to repair or create something. She cuts my hair and uses the sewing machine and she loves to wash which is not so good since I am t he one who has to do the ironing.

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About the Chiasm

  <- Click to enlarge.

Knowledge of the topographical arrangement of visual fibres as they travel in the chiasm is of utmost importance to understand the effects of compressive lesions in this portion of the optic pathway.
See Wikipedia the free encyclopaedia for a definition.

The optic nerves from both eyes meet and cross at the optic chiasm, at the base of the frontal lobe of the brain. At this point the information from both eyes is combined and split according to the field of view. The corresponding halves of the field of view (right and left) are sent to the left and right halves of the brain, respectively (the brain is cross-wired), to be processed. That is, though we might expect the right brain to be responsible for the image from the left eye, and the left brain for the image from the right eye, in fact, the right brain deals with the left half of the field of view, and similarly for the left brain. (Note that the right eye actually perceives part of the left field of view, and vice versa).

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Jessica's  eyesight as the result of the Tumour.

Showing the reduction in my visual fields.

 

 

 

 

Bilateral hemianopia.

Bitemporal hemianopia is a specific type of visual disturbance in which sight in the outer half of the visual field of each eye is lost. As a result, the patient retains central vision but loses sight at the edges of his or her vision. This is not always obvious to him or her, even when the damage is quite severe on objective testing, because one tends to focus attention more on objects in the centre of the visual field.

Bitemporal hemianopia is usually caused by a lesion of the pituitary gland, most commonly a benign tumour pressing on the optic chiasm. Because it is the inner (medial) part of the retina which receives light from the outer visual field, this is what is lost when the inner part of the optic nerve is damaged by such a lesion.

Hemianopia signifies a loss of half of the visual field, and bitemporal denotes the two lateral, or temporal, sides of the head. By contrast, homonymous hemianopia signifies that the same half of each visual field is lost, i.e. all vision on the left, or on the right, of the midline. Such a pattern of visual loss is caused by damage to the more distal part of the optic radiation, most commonly by a stroke.

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Jessica's Visual Fields - picture.

Hemianopia is a result of the brain's impaired ability to to recieve or make sense of information transmitted to it from bothIt isn't a fault with the eyes, but a fault with the brain,

How does it affect daily living?

Hemianopia can cause loss of confidence with doing simple daily tasks. For example:  The person may feel unsafe crossing the road or going shopping, Loss of half the visual field will affect many daily tasks including reading, travel and daily living skills.
 

This photo with thanks from Special Kids in the UK

In Jessica's case she has her near blindness in her favour, also the experience of having had the condition for some time. In the case of those who acquired the condition recently it will take time for them to reinterpret the world they see and to train themselves to fill in the missing parts of their visual field input.

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The diagram below shows how loss of vision varies depending upon at which level in the visual l system is damaged, see below for ledgend.

See 3 of this diagram. Follow the link to the web for a clearer picture.

·      1 = central scotoma secondary to optic neuritis (does not respect the vertical meridian)
2 = Total blindness of the right eye from a complete lesion of the optic nerve
3 = Bitemporal hemianopia from a complete lesion of the optic chiasm
4 = Right nasal hemianopia from a peri chiasmal lesion
5 = Right homonymous hemianopia from a complete left optic tract lesion
6 = Right homonymous superior quadrantopia caused by partial involvement of the optic radiation in the left temporal lobe (Meyer's loop)
7 = Right homonymous inferior quadrantopia caused by partial involvement of the optic radiation in the left parietal lobe
8 = Right homonymous hemianopia from a complete lesion of the left optic radiation
9 = Right homonymous hemianopia (with macular sparing) from a posterior cerebral artery occlusion causing ischemia of the calcarine cortex of the occipital lobe


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Cataracts

Simply put, a cataract is a "clouding" of the lens in your eye. The lens, located just behind the iris, or the colored part of your eye, works like the lens of a camera. It picks up images, then focuses the lights, colors, and shapes on the retina - the transmitter located at the back of your eye that sends the images to your brain.

 

Definition-Simply put, a cataract is a "clouding" of the lens in your eye. 
The lens, located just behind the iris, or the coloured part of your eye, 
works like the lens of a camera. It picks up images, then focuses the lights, 
colours, and shapes on the retina - the transmitter located at the back of your
 eye that sends the images to your brain.
 
 
 
Normal lens v cloudy lens

CATARACT SURGERY - the information below takes you  through to Eye Northwest.

The crystalline lens in the human eye is situated behind the pupil. Its function is to focus light on the retina so that images can be seenThe crystalline lens in the human eye is situated behind the pupil. Its function is to focus light on the retina so that images can be seen clearly. The optic nerve then carries the images to the brain.


What are symptoms of a cataract?
Why do cataracts form?
How is a cataract detected?
How are cataracts treated?
What is cataract surgery like?
Do I have to wait for my cataract to be "ripe" before surgery?
What are the risks?
How soon can I get back to my regular activities?
Does a cataract come back?

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Corneal transplantation

What is the cornea?

The cornea is the transparent tissue on the front part of the eye. Not only is it important for the structural integrity of the eye, but its curvature and clarity helps the eye focus. A healthy cornea is required for normal vision. Diseases and injuries of the cornea are an important cause of blindness in our community.

 

Corneal transplantation

"What is corneal transplantation?

A corneal transplant is the way of removing your damaged cornea and replacing it with a healthy cornea from the eye of a suitable donor. The donor will be a person who has (or whose family has) given consent for their corneas to be used for medical purposes after their death. The donor cornea is thoroughly checked and prepared to ensure there is no possibility of it being infected.

(Australian Eye Banks  see CORNEAL PROCESSING IN AUSTRALIA  Article by Dr Graeme A Pollock

Centre for Eye Research Australia  - Corneal Donation)


The operation can be carried out either under local or general anaesthetic. This will generally be a matter of discussion between you and your eye specialist. The operation involves the removal of a circular piece of the affected cornea and replacing it with a piece of the donor cornea of exactly the same size and shape.

This new section of cornea is then sewn into place with very fine stitches. The stitches may be noticeable as they make a distinctive star-like pattern around the outer edge of the cornea. The operation can take in the region of one hour, although some may be more complicated and take longer.

Your eye is never removed and replaced during an operation.

At the moment a number of new surgical procedures are being tested and developed which may mean a quicker recovery from a corneal transplant. Current surgery provides excellent results in most cases, but developments in the future may mean even better results and recovery times for people with corneal dystrophies.- "this text with grateful thanks to The Royal National Institute of Blind People U.K.

Please read their web page for further information about Corneal Transplantation.
 

Also see

Keratoconus Australia - Resources Everything you wanted to know about corneal transplants and their care. ... Types of contact lenses for keratoconus ... Corneal Donation Service, corneal donation and corneal grafts in Australia ...

 

Aftercare -  care of Laser and Corneal surgery Associates.P.C. also  ienhance.com

N.B. It is very difficult to find clear information regarding the aftercare of the graft.

snip

"RETURN TO ACTIVITY

After surgery you may return to light activity as soon as you feel physically able. Walking, eating with friends or family, watching TV, reading, short trips away from home and light housework are all permitted. You may ride in a car or fly in an airplane immediately after surgery. You should not drive a car or pilot an airplane immediately after surgery since your depth perception and field of vision will not be normal. Sexual activity of a conservative nature may be resumed after a week (with eye protection in place).

The first month after surgery, you must avoid:

Lifting objects that weigh more than 5-8 pounds (children, pets heavy packages). You may lift light objects such as shoes, small packages, etc.

Bending from the waist especially when trying to lift something from the floor. You should always bend your knees or kneel to pick things up.

Bathing: Showers may be taken immediately, being careful not to allow the shower stream to strike the eye directly. Going to the beauty salon is fine as long as you use the eye shleld for the first month after surgery to protect against splashes or an inadvertent finger in the eye. Shaving may be done in the normal fashion the day after Surgery.

Athletics: Strenuous athletic activities can usually be resumed 3-4 weeks after surgery. Do not, however, return to any athletic activity without first consulting your doctor.

Return to work: Desk work can usually be resumed within the first week after surgery. Physical labor in most cases can be resumed in 3-4 weeks. However, do not return to any physical labor without first consulting your doctors

In general let common sense be your guide... If you think you probably should not do something, don't do it." ( Laser & Corneal Surgery Associates,web,2006)

 

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Updated on 25/12/2007

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