Do our newsletter readers recall the 1,000-piece Netherlands jigsaw puzzle I was putting together last month and that prompted me to consider all the visual skills needed to accomplish the task? Well, I finished it. But, as I looked at — and contemplated — the completed puzzle, I could not help but reflect on how a large, complicated initiative with many parts to it challenges a person’s sensory systems and truly exemplifies the difference between “eyesight” and “vision.”

What do I mean by that?

Eyesight simply refers to seeing something. Vision is the ability to interpret what one is seeing. Why is Walt Disney, for example, considered a “visionary” for his time? He saw swampland in Florida – just as others did – but, instead of simply dismissing it as a poor investment, he had a “vision” of what it could become, namely one of the world’s greatest entertainment and theme parks – Disney World. That’s why he purchased the land to the wonderment – and criticism – of those who only saw swamp.

“Vision” happens when one’s sensory systems are intact and in synchronization with all kinds of other systems. “Vision” is both external and internal.  It allows us – externally – to judge puzzle-piece shapes or swampland and – internally — to decide how the various parts must come together to create a whole. Visualization also allows us to predict future trends or relationships.

The retina is an extension of brain tissue and sends signals to more than simply our eyesight center.  Retinal signals combine (partially beneath a conscious level of awareness) with other sensory signals – from hearing, smell, taste and touch. Further brain processing synthesizes that information and reacts and responds depending on internal sensory signals. The retinal chemistry affects signaling in various nervous systems.

Such “retinal processing,” – what I often refer to as the mind-eye connection — allows us to “see” a project and then gives us the “vision” to set up as efficient system as possible for completing it. For example, friends who opted to work with me in doing the super-difficult jigsaw puzzle soon became frustrated. They tried scanning groups of 150 or more pieces by shape to find connections among them – not the most effective approach. My strategy was to separate items first by color and content — grays here, reds there, thus giving me many fewer pieces in each pile to find links.

The eye, or more specifically, the retina, serves as a planning tool. In the case of a puzzle, the eyes scan the pieces, but the brain is telling the eyes how to scan, how to plan and what to look for. Sometimes, the best strategy is to search for shape, other times for color, other times for size. All those attributes are governed by peripheral eyesight – the portion that is cut off and minimally assessed during a 20th century eye examination. The instrument you look through has a small hole blocking off peripheral eyesight.

Many of those who sustain brain injuries or suffer from brain disorders procrastinate. They “put off” projects because they lack the “vision” of how to complete them. They are overwhelmed – and uncomfortable. If brain circuitry is out of sync because it has been disrupted by injury or disease, or is under-developed, people can become confused about their surrounding environment, have too narrow of perception and awareness, and exhibit inappropriate reactions and responses or experience difficulties in learning. When eyes and ears are not coordinated, people have to continuously monitor their attention, and that effort becomes exhausting,

A youngster who has “vision” and is told by parents to write a “thank-you” note to grandma for a holiday gift before going out with friends will usually view the project as a quick, one paragraph. A child who lacks “vision” because of, perhaps, a learning disorder may “see” the assignment as having to write an overwhelming bunch of words, prompting the complaint, “I don’t know what to write.”

At the Mind-Eye Institute, we help children build visual skills and guide brain-injured patients to rebuild visual skills – or develop new ones – by emphasizing projects that are both comfortable and interesting to them. People will do what is comfortable, but not eagerly perform that which is not. So, development of skills is individualized to each patient. If parents bring us a child with strong interest in basketball but difficulties in reading, we might emphasize – at the front end — the importance of a visual skill program in enhancing basketball skills. That’s because we know the child will work hard to build the visual skills needed for what he or she enjoys – basketball. At the same time, we know those same processing skills also will help correct the child’s reading and spelling deficits.

The mind-eye connection is unique to each person’s processing system and experiences. Neuro-optometric rehabilitation is able to use the concept of mind-eye testing – versus conventional eye health and eyesight testing – to prescribe therapeutic methods on a very individualized basis in order to bring sensory systems into synchronization.

We have entered a new year – 2020 — and the end of a decade. That means we are already about 20 percent into the 21st century. As optometrists, our challenge is to move from simply eye care to “brain care.” It takes “vision” – not merely eyesight — to realize that swampland may not be just swampland. For that reason, let’s leave standard 20/20 eye acuity testing, which was developed 150 years ago, where it belongs – in the 20th century — and add testing to update assessments of peripheral processing.

Deborah Zelinsky, O.D.
Founder, Executive Research Director
Mind-Eye Institute