Peripheral Sight Plays Key Role in Pilots’ In-Flight Decisions
Mind-Eye Optometrist Says 20/20 Eye Exams Not Sufficient for Pilots
Peripheral eyesight – glimpsing – strongly affects piloting decisions.
So, says Deborah Zelinsky, OD, founder and research director of the Mind-Eye Institute in Northbrook, Ill., speaking recently at the Aerospace Medical Association (AsMA) Annual Scientific Meeting, where she emphasized that standard eye testing alone for pilots is insufficient because it checks only the clarity of central eyesight when fixed on a non-moving target.
Peripheral eyesight can affect a pilot’s “how am I?” in flight, triggering physical reactions like tightening of muscles, speeding of heart rate, and increased adrenalin levels, and the “where am I?” causing changes in concentration, attention and awareness of surrounding environment, she explained during her presentation.
Her comments were intended not only to inform, but to underscore the crucial role of 21st century optometry in pilot eye testing. AsMA membership includes aerospace medicine specialists and pilots, flight nurses, physiologists, psychologists and researchers.
“Optometrists can impact brain function,” said Dr. Zelinsky, whose more than 30-year career has focused on neuro-optometric rehabilitation and development of advanced methods for assessing brain function. “Changes in luminance on the eye affect how the brain interprets and reacts to information about the environment and impact a person’s spatial awareness, body movement and selective attention to sound.”
Both standard eye testing and neuro-optometric evaluations are important, she said. A neuro-optometric examination considers many systems in addition to the traditional central identification of letters. Tests include peripheral navigation systems; isolation of eyes from neck movement; awareness of midline; spatial orientation; various perceptual pathways; sensory integration abilities; and visualization, among others.
Today’s eye testing needs to be seriously updated to include an evaluation of how environmental stimuli might alter a person’s use of his or her peripheral eyesight, she stated.
Highlighting the importance of the “mind-eye connection,” Dr. Zelinsky reminded meeting participants that they experience various stress factors in flight, such as hypoxia, fatigue, gravitational pull, spatial disorientation and visual illusions.
Autokinesis, for example, is a “false perception of movement caused by fixating on a bright light against a dark background, such as a bright star in the night sky,” she said. “To prevent this, a pilot should continually keep up a normal eye scan, vary the distances at which they focus and avoid fixating on any certain object for more than a few seconds.”
Other “illusions” can be created by the width or slope of a runway when landing an airplane, a “featureless terrain,” or rain and atmospheric haze on a plane’s windshield, she said.
“An absence of ground features, as when landing over water, darkened areas or snow, can give the illusion that the craft is at a higher altitude than it actually is. The pilot who does not recognize this will fly a lower approach,” she said.
As for runways, “the wider they are, the closer they will seem and the higher a pilot might fly.” Dr. Zelinsky said.
“Rain on the windscreen can cause a sense of being at greater height than one actually is; atmospheric haze may create the illusion of being farther from the runway.”
Dr. Zelinsky is internationally recognized for her ground-breaking work on the retina and the retina’s impact on brain function, physiology and mental health. Her patented research in novel uses of retinal stimulation has been described in publications and courses worldwide.
She developed the Z-Bell Test℠, a simple, but revolutionary, method of integrating a patient’s visual processing with listening. The test has allowed Dr. Zelinsky and her team to prescribe eyeglasses that normalize the balance between a patient’s central and peripheral processing receptors in the retina, while improving the connection between eyes and ears.
“Using the proper mix of filters, lenses and/or prisms, we can readjust a patient’s visual balance and eye-ear integration,” she said.
As early as the 1920s, Dr. A.M. Skeffington, considered the “father of developmental optometry,” noted that “sharpening central eyesight often distorted peripheral eyesight” and that “clarity alone was not necessarily the optimal endpoint,” Dr. Zelinsky stated during her AsMA presentation.
“We must leave 20/20 in the 20th Century by revolutionizing the way eye-prescribing is performed, using our advanced, 21st century knowledge and the state-of-art, computerized technology now available to us – technology that was non-existent in 1862 when 20/20 eyesight testing and standards were introduced,” she concluded.
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'Dr. Zelinsky Is Renowned'
~ Norman Doidge, M.D. & Clark Elliott, Ph.D., Dr. Patrick Quaid and Patricia S. Lemer praise her accomplishments:
"Zelinsky fit Elliott with a series of eyeglasses designed to improve the perceptual damage that made his life so difficult... Getting fitted for Zelinsky's eyeglasses is like no eye appointment you've ever had... Now, Elliott says, he is almost entirely symptom-free, able to problem-solve, multi-task and find his way easily — all abilities he lost in the auto accident in 1999. When he put on his Phase VI glasses he felt something that he hadn't felt for years: "I felt normal."
Review: 'The Ghost in My Brain'
- The Chicago Tribune
"One brilliant Chicago-area optometrist I know, Deborah Zelinsky OD, FNORA, FCOVD, has developed a unique, patented, easy-to-administer evaluation called the Z-Bell Test. This test measures the efficiency of integration between visual processing and listening....A 2014 study at Vanderbilt University found that children with autism do not synchronize their seeing and hearing...I have watched Dr. Zelinsky administer this test to disbelieving colleagues, who were astounded by its accuracy and results...Over the past two decades, The Z-Bell Test has become internationally recognized by the scientific community.”
- Patricia S. Lemer, Licensed Profesional Counselor (LPC)
"I visited Dr. Zelinsky, and she showed me how she can use optical lenses to alter sensory filtering, by directing light to different retinal cells and brain circuits. This can influence activity in the brain and the hypothalamus to better regulate body chemistry, sensory integration, and even some auditory processing. [Dr. Zelinsky] works frequently with patients working with learning and cognitive disorders as well as TBIs."
- Norman Doidge, M.D.
"I was delighted to have Dr. Zelinsky personally contribute to the book. Her wealth of knowledge in the area of visual development and visual processing is widely known, not just through her contribution of eye-care to the author of “The Ghost in My Brain”, but also via her Mind-Eye Institute and the lectures and training their provide. Dr. Zelinsky is not just colleague and a friend, but also a valued member of the neuro-optometric community and an invaluable bridge to other allied professions treating brain injuries. Her contribution to the book is deeply appreciated."
- Dr. Patrick Quaid, MCOptom, FCOVD, PhD