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I fell and injured my back a couple months ago, and, as part of my journey to recovery, had to learn how to manipulate a walker. Maneuvering a walker in an out of bathrooms or down stairs may seem like a whole lot of physical work, and it is, but I later realized that the acts of plotting and then carefully following walker-suitable routes to get where I need to go expended at least as much, if not more, mental energy.

Indeed, the walker drastically reduced my awareness of space. Although my eyes were capturing signals from all the surrounding space, my brain was ignoring everything around me and paying almost total attention to the ground and objects directly in front of me. There was a tunneling effect. Much of what I usually would do beneath the level of consciousness now had become calculated, weighed, fully considered because, physically, I was not normal. My mind was attempting to compensate by shifting a huge majority of attention to my pain and impaired movements – and that kind of mental work drained what Clark Elliott,PhD, author of Ghost in My Brain, referred to as a person’s energy batteries. 

Dr. Elliott discussed A, B and C batteries, with A being a person’s daily amount of energy, which replenishes during sleep; B, the reserve energy that requires a few days to recover; and C, the deep, “only to be used in a super emergency” reserves, which, if depleted long enough, canlead to disease. 

Of course, as is the case with many of my firsthand experiences, I compared my challenges to the struggles that many Mind-Eye patients face. I contemplated why some of those patients do so well in recovering from traumatic brain injuries, stroke, and other neurological disorders and why others do not. The word that came to mind was “resiliency,” a topic I recently explored for an issue of Brain Health Magazine.

The term resiliency encompasses “the range of personal protective factors, environmental supports, and resources, as well as self-regulatory processes, engaged in response to adversity,” according to investigators writing about recovery from traumatic brain injury (TBI) for the publication Disability and Rehabilitation.

Resiliency occurs at two levels – physical and mental. One level involves a person’s drive and commitment to overcome physical disabilities and do whatever necessary to regain functions lost in an accident, sports activity, medically related event like a stroke – or a fall that injures the back and puts one in a walker. At a mental level, patients with a brain injury are often stuck in fight-or-flight mode. The fighters have much greater capacity than “flighters” to go beyond their comfort level and address and resolve problems. Other patients either “freeze “ – they cannot accept their new situation – or “flop” – they surrender to stressors and meekly submit to whatever happens. The Mind-Eye Institute team has found that patients with innate mental resiliency seem to do better at re-building their brain functions after an injury.

Fortunately, I am neither a “flighter” nor “flopper” when it comes to injuries. I can be a “flighter” and run the other way when faced with a stack of paperwork to be completed, but mental activity and physical activity are influenced by independent, yet interconnected, brain pathways. Back injury or not, I had to fight my way back to the Mind-Eye Institute to help address the backlog of patients and reduce the workload stress on my colleagues who had picked up the slack while I was recovering.

But life is not always black and white. Some scientists suggest resiliency may be as much a component of brain chemistry as it is a mix of personality traits, psychological characteristics, mental toughness – and, certainly, a backlog of patients. And, if that is so, cannot the ability to accept and successfully respond to challenges of a brain disorder or learning difficulties be restored or enhanced  through changes in brain function? 

Quite possibly! In fact, experts suggest neuromodulation – modifying brain chemistry and function – may be a treatment protocol for enhancing successful rehabilitation of brain-injured patients or patients with other neurological dysfunctions.

One important mechanism for neuromodulation is retinal stimulation. Following this logic, optometry is an underused method of altering brain activity. Since the retina is composed of brain tissue, how the retina processes environmental signals – through both image-forming (eyesight) and non-image-forming (non-eyesight) pathways — influences overall physical and mental health, including a patient’s power of resiliency. 

Retinal circuitry is composed of both image-forming cells – those allowing us to ‘see’ – and non-image-forming cells, which have nothing to do with eyesight but generate signals that communicate with critical brain structures below the level of consciousness. These structures govern a person’s basic physical, physiological, and psychological systems. I suspect, during my convalescence from back trauma, the signals from non-imaging-forming cells were at low levels because of my concentration on central eyesight and efforts to peer directly ahead of me with all due caution.

The Mind-Eye Institute uses therapeutic eyeglasses, filters, and other optometric interventions to stimulate retinal processing and influence brain pathways. The right mix of prescriptive optometric appliances can influence and change the spatial and temporal distribution of light on the retina in ways that modify the dynamic relationship between the mind’s visual inputs and the body’s internal responses. 

“Customized changes” to the brain are what oftentimes bring relief to patients experiencing the headaches, brain fog, concentration and attention problems, sleep disorders, and even learning difficulties due to brain injury or neurological abnormalities and disease.

Indeed, authors of a University of Iowa Health Care study appearing in a 2022 issue of the journal Brain contend that resilience against mood disorders like depression after a brain injury depends on which of two brain networks is affected. One network is associated with increased risk of developing depression and the other with decreased risk and greater resilience.

Meanwhile, investigators, writing in a 2022 issue of Molecular Psychiatry, contend a surge in stress hormones after a traumatic event can affect the brain in diverse waysand in different people. Some people are more resilient against post-traumatic stress disorder (PTSD) anddepression than others.

Bottom line: retinal processing is far-reaching, and its effects are not yet fully researched. The field of optometry holds so much future promise for being at the forefront of influencing brain activity. Until then, though, time for me to get off my back and start seeing patients.

Deborah Zelinsky, O.D.

Founder, Executive Director of Research

Mind-Eye Institute