Eye-movement therapy with Eye-Search

 I started eye-movement therapy three weeks after the stroke.  I found Eye-Search during an online Google search.

Eye-Search is a free online eye-movement therapy for people with hemianopsia (loss of vision to one side) and spatial neglect (loss of attention to items on one side). It was developed by the Institute of Neurology of the University College London, UK. (Click here to access their website). 

The therapy involves playing a online game that has 16 levels of increasing difficulty. Each level involves 400 repetitions.  During each repetition, a ball rolls across the screen and jumps unexpectedly to the other side.  The player has to find it.  

This is a picture I took with my iPad of what the game looks like on the computer screen when you start. If you click here you will access a video on the Eye-Search website with a demonstration of the game. 

The purpose of the game is to exercise the parts of the brain that control eye-movements. Research has shown that lots of practice with an eye movement task improves visual search and visual exploration of the environment (1,2,3). Research has also shown that eye-movement training changes brain activation in the visual cortex (4,5).

When I started my eyes were slow tracking the ball. I had more trouble locating the ball when it went on the right side, my blind side, than on the left.  My eyes got easily tired moving left and right. But slowly, with repeated practice, the eye movements became faster and more efficient. I exercised every day, sometimes twice a day, and reached level 16 in two weeks.  Then I continued to play on level 16 trying to improve my reaction time.  When I started these exercises my reaction time was 2.2 seconds. With practice it got down to 1.2 seconds.  By now  I have completed 10,800 trials.  These days I play the game once or twice a week only.

What were the benefits from these exercises?  

• After the stroke my eyes felt slow and not well coordinated.  As I exercised them they became faster and better coordinated at tracking, focusing and scanning both during the exercises and afterwards in the "real world". 
• In the beginning I had trouble tracking the ball and at the same time finding where the cursor was on the screen.  Now it is all done in one fluid, easy eye movement. The ease of scanning has transferred to visits to the supermarket, scanning bookshelves, scanning plants to prune.
• Searching on the right side, the side of the blindness, was slower than searching on the left. The speed of detection on the right has improved, but still lags compared to the left. I think that with continued practice the two sides will become equal.
• Reading became easier, but I also used Read-Right, a free online reading therapy program that helps with reading difficulties .

Another interesting aspect of this therapy program is that at the completion of each set of 400 trials there are four tests to check one's progress. (Click here to access the tests). One of these tests is a visual field test. The Eye-Search therapy is not meant to improve the visual field. However, the visual field test at the end of every 400 trials gave me a chance to check how the acupuncture in combination with the exercises were improving my capacity to see and track my progress.  I included images of my results in my last post.

In a future post I will describe exercises I did in the "real world".


References

1. Rapid compensation of visual search strategy in patients with chronic visual field defects. (Click here to read abstract)

2. Comparing explorative saccade and flicker training in hemianopia: A randomized controlled study. (Click here for full text)
3. Current status of rehabilitation for patients with homonymous field defects. (Click here for full text) 
4. Eye-movement training-induced plasticity in patients with post-stroke hemianopia. (Click here to read abstract)
5. Eye-movement training-induced changes of visual field representation in patients with post-stroke hemianopia. (Click here to read abstract)