When both your eyes don't work together: understanding Oculomotor Dysfunction

Imagine being in school when your teacher is picking random people to read passages. As each person stops reading you pray to not get picked. As the class finally reaches the last paragraph, you start to feel relieved. But then things take a drastic turn, you get picked to read the last paragraph. As you start to turn the page, your palms start to sweat, you start panicking to find where to start. As you commence to speak, magically lines pop up and you’re confused on what to read. You continuously say "uhm" and try not to embarrass yourself. As the lines become normal, your eyes become tired leading you to become frustrated and embarrassed. This is a similar scenario of what my friend "Mehtab" faced. 

This is a condition called Oculomotor Dysfunction, when the eyes struggle to move correctly even when eye muscles and vision might be normal. This condition can negatively impact concentration, reading, and daily activities.

Causes🧬

  Causes can vary but the most probable and common cause are concussions or head injuries (most common in teens and adults). Neurological disorders like MS, Parkinson’s can also trigger the disorder. Development issues can also cause oculomotor dysfunction as it is shown in childhood typically. Strokes, genetic, or congenital brain disorders are also causes for this disorder

Oculomotor Movements Affected are

Your ability to do quick eye movements like reading one line in a book and going to the other will be negatively impacted. Tracking down objects, which are watching a ball soar through the sky won’t be as efficient when not dealing with disorder. Looking from your phone to the dog across the street will be difficult because your eyes won’t be synced together like they always are supposed to be. Last but not least, your ability to stay focused on one object would be affected as one eye might look left and the other might look up.

Symptoms of this condition🧠

The symptoms can vary for this condition. I will tell you the main 4 symptoms of oculomotor dysfunction. They can include blurry vision or double vision which can be seeing a persons face not clearly and seeing two exact same faces. Difficulty tracking objects, for example, it could be difficult to track a tennis ball while playing tennis or it would be hard to track the way a car is going. This symptom that is next is really common with victims of the dysfunction, reading problems. With this condition your eyes don’t move or see correctly, which then takes a toll on trying to read a passage as you will have blurry and double vision alongside while reading. Finally the last one is, eye fatigue and loss of interest. As you are doing your homework, it becomes a thousand if not a million times harder to read. Your eyes start to strain causing you to discover pain in your eyes. With this pain many people become frustrated and stop what they are doing, negatively affecting their focus and productivity.

Test and diagnosis🧪

 A optometrist typically a neuro - optometrist or an ophthalmologist will be taking your tests and diagnoses as they specialize in conditions like this. Tests they will conduct is Eye movement testing (saccades, pursuits, vergence), Visual evoked potential (VEP), King-Devick test, Functional vision exam, and a Dynamic visual acuity test. These tests give your doctor the best knowledge on how severe the condition is.

Conditions That May Occur Alongside OMD💡

These conditions aren’t guaranteed to happen but sometimes they can occur. Convergence insufficiency, where the eyes can’t work together when looking at a close object. Which could be looking at a book but the lines are really blurry. Another condition is Strabismus, this is where the eyes are not coordinated. One eye could be looking right while the other eye would be looking up.

Treatment options🏥

There are various ways to treat this condition. Vision Therapy (VT) is the most common process people choose. In this process you are given customized eye glasses to help and lessen the severity of the condition. This will be done with a trained vision therapist or optometrist as they will know what is best for you. This process may last weeks or months depending on how bad the condition is. Prism glasses are glasses with special lenses toto enhance eye coordination. If the doctor decides that your condition is not severe but still needs to be fixed, they will most likely tell you to do eye exercises at home. If you are having most trouble with reading you will most likely be treated with colored overlays or filters to help your reading. And last but not least, neurological rehabilitation is the treatment you will receive if caused by brain injury. There are many treatments that you can have to overcome this condition.

Real-Life Case Example 🧠

Now coming back to my friend, Mehtab. When he was in middle school he had trouble reading, concentrating, and was experiencing countless of headaches and blurriness. This became a daily struggle for him. Words on passages used to swim off the page. He lost his place, felt constant eye strains, spent hours frustrated on how he can finish his homework when he can’t read a single word on it. Teachers assumed he had attention issues, but nobody knew what he was dealing with. Mehtab at the time was a victim of Oculomotor dysfunction too. After weeks of suffering with this disorder he then went to a optomologist. His doctor made sure that Mehtab was safe and secure. His doctor did everything in his will to help Mehtab overcome this uneasy lifestyle he had been living. He had been in a Vision Therapy to eliminate this disorder. Weeks later his headaches eased, reading became much easier, and he was significantly more focused with his studying than before. This frustrating chapter of his life became the foundation of his purpose. When it was time to decide what he wanted to do in life “Mehtab” was determined to give that same affectionate and caring feeling to other patient. He immediately thought about medicine because he couldn’t stop forgetting that period of his life when that doctor with such compassion, caring, and devotion made Mehtab regain confidence. Now Mehtab is in his 3rd year of university in a BS/DO program that almost guarantees you a ticket to medical school.

Conclusion on Oculomotor Dysfunction

Oculomotor Dysfunction is more than just a flaw with “eye movement”. It’s more like a battle of you trying to attain freedom by defeating this torturous disorder. It’s a battle to live life with imperviousness, not with an unease feeling that you might be embarrassed. When someone is going to get a cure for a horrible and annoying disorder like this then instead of asking why is it so important we should feel happy and excited for them because maybe your life won’t change but theirs will. They will be able to drive, study, read, and be confident. The human body can be given all sorts of problems and it’s our job to educate ourselves and learn more about these problems so we can have knowledge on how to solve, overcome, and handle these problems. Around 15-20 percent of children face this disorder. Having our eyes move and work together is a crucial step and essential to have. Without it life becomes hard and sometimes impossible.