Ocular Motility Service

Hi All,

I have had a telephone call from Ophthalmology, who I have been visiting since my stroke, as I have some double vision (convergence). I’ve been doing the exercises they gave me with little change & have recently tried some prisms which haven’t really helped either.

They think i’d benefit from a referral to Ocular Motility but I was wondering if anyone had been referred to this service? I’ve never heard of it & they don’t have the service in our local area so i’ll have to travel to it.

The double vision I get doesn’t bother me too much but it does affect some of my reading ability & when I look at my iPad particularly if i’m lying on my side.

Any help on what I can expect would be appreciated. It’s a long wait I’m told :grin:

Thank you

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I hadn’t heard of it either

I found stuff on the web

There’s nothing on here been written by anybody else using the title that you did, but @Rups has several posts where he referenced that self-study of “ocularmotor dysfunction” has helped devise useful ways of achieving progress

Ocular and occular turn up a few posts on here…

Simon

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Thank you Simon @SimonInEdinburgh

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At night, I get the feeling I am going cross-eyed. I have blepharitis and MGD, but now I am losing my eyebrow (on the stroke side). My lower eyelashes have nearly all gone. When I lie on my side it also feels like my eyesight changes. Something does. My eye is unsettled but I don’t even know how to describe it. And, despite the above, for the moment I have 20/20 vision.

Odd, odd, odd, Roland

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That does all sound odd Roland @pando
Stroke does seem to do some strange things. I wonder whether some of it is the brain rather than the eyes.

Really hope your eye issues improve.

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it’s all neurological, I believe…
Thx, Roland

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it’s all neurological, I believe… :shushing_face:

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Noswaith dda, @Mrs5K, I’m not sure what kind of stroke you had. I’ve looked back on the forum but at the moment my symptoms have regressed so I am about as useful as a toothpick at a lock picking party. If this is an issue with convergence, I would go directly to Brock Strings, this is where the focal points meet. However, and I almost want to cry, no exercise seems to work unless it is practiced over months and years. I thought I was through to at least a point of satisfactory living but am now going over everything again. Who knows what disrupts progress. If your double-vision is minimal, I say, let it exist. If it isn’t painful or disruptive then it is a side-effect, maybe of stroke damage or medication. However, it isn’t indicative of the wonderful person you are to all of us here on the forum.

I am planing on writing something on acute oculomotor here as soon as I see a way to do that. Did you just see what I did then?

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Hello Ann @Mrs5K. I have posted before about my double vision, caused by third and sixth cranial nerve nucleus damage due to my midbrain stroke. Dissected internal carotid artery.
I have seen gradual improvement but only during the first six months, 2 and 1/2 years on now. I was discharged from opthalmology in July ( 2 years on )with advice that surgery was the only option I had, it may make things worse and as I have a usable area of single vision which makes reading and stationary tasks possible I should accept it and patch one lens on my glasses if I need to move or drive.
I tried prisms with virtually no improvement. I think they only gave me them because I asked, it was a box ticked.
I have never had any exercises suggested to me and was categorically told they would not help when I asked. It would either improve or it wouldn’t.
My management has had to be learning through trial and error which glasses for which task, my close ones are not patched, patched ones or prism ones for moving around. Apart from cycling proficiently, due to not being able to look over my right shoulder as that lens is patched, I do all the things I need to.
It may be that our problems are different but I had many mixed messages throughout the 2 years I was under the care of the hospital. I just had to work stuff out for myself. If offered further therapy I would take it but at the same time be mindful that there are no givens. Part of being a stroke thriver methinks.
Good luck with your decision and I hope someone else can give you a more positive experience. Julia x

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Hi @JuliaH

I’ll bet if you shared some of your discovered insights other people might find things useful to them and they might share their own discoveries and that might build up for everybody’s benefit ?

When I googled exercises for double vision after stroke I got a lot of hits. Have you tried any of them? Some from sources I respect like flint and saboe others random YouTubers or medical publications, agencies etc

I just wonder because I think we’ve all heard the “you’ll never walk again” followed by now “regularly climbs mountains” stories and for every one of them there are a hundred or a thousand people who have had pessimistic pronouncements by people who have never had their condition and have gone on through determination to make impossible improvements.

There is a danger that “you can’t improve” predictions are self-fulfilling prophecies as much as “the more you work the more return you’ll get” are. Of course there are also cases where improvement in quality of life is only via strategies/compensations and not by recovery - these are valuable too :slight_smile:

I don’t know if it’s a parallel example - my middle two fingers would not obey my attempts to move for at least 2 years. then in the last few months My hand has started to respond in a more complete way. not all the time in every orientation.
initially only in one orientation, now in more ways. the more it works the more I can extend use. the more I extend use the more it seems to grow in strength, speed, unless it shakes etc

2¢ in the hope it is helpful reflections

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@Rups thank you for your reply. I had an Ischaemic stroke in my occipital lobe & a small part of my parietal lobe.

I have been doing the hospital version of the Brock string exercises for almost 2 years now & not really seen any improvement. It’s not a massive hindrance & i’m inclined to agree re leaving it to be. Will see what happens re this referral then take it from there.

I’m really sorry to hear you’re having to go over everything again. It’s strange how things seem to regress when you’ve worked so hard at improving things. I hope you get back to where you were much quicker this time.

I look forward to reading about acute oculomotor when you’ve had chance to write it.

Sending my very best wishes

Ann x

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@JuliaH thank you for sharing your experience. My stroke was caused by a dissected carotid artery too but affected my occipital and parietal lobes.

I have many pairs of glasses now too & have been managing my issues for 2 years aswell. They did say surgery could make my issues worse so I’m definitely not going down that route.

I’m definitely going to see what this service can offer as you just never know but I don’t want to go back & forth for another couple of years for no gain.

Hope you do get some improvements in your vision.

Take care

Ann xx

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