AWARENESS THROUGH VISION — DR. HARRY SIROTA

This article, by Barbara June Appelgren, was printed originally under the title of "A New Vision" in Impressions, a quarterly journal published by the Claymont Society for Continuous Education.

You go to the optometrist after getting a new prescription and complain to him, These don't feel right and he says to you, Don't worry, you'll get used to them.

And, if you don't put them away in a drawer, you do get used to them. What you may not realize is that by getting used to them you may, little by little, with each prescription change, lose your ability to orient yourself in three-dimensional space, to move without undue tension, to hold yourself erect, to read aloud without stumbling over words, or even your ability to be in the presence of other people. These difficulties are often attributed to physical and psychological problems while the influence of vision on such problems is discounted. If you can pass a test to read the letters on a flat surface certain distance away, your vision is considered adequate.

The first story I'd ever heard that awakened my interest in this question was when a teacher of mine told me of a gruelling time in his life. He was diagnosed as having muscular dystrophy. His symptoms included slurred speech, irregular gait, and tripping on stairs and curbs. Only after batteries of tests, and anxiety intensified by keeping his desperate condition secret from his wife, did an astute doctor uncover the fact that these symptoms developed soon after his eyeglass prescription had been changed. A bizarre story perhaps, but not that distant from the experiences of many people who turn up at the office of Dr. Harry Sirota.

Dr. Sirota whose business card reads Awareness Through Vision has kept an unpretentious office on Uptown's Sheridan Road in Chicago for about thirty years. He tells of how his awareness of the implications of vision developed. As a beginning practitioner he noticed that about one-third of his patients complained about their new glasses. He consulted with more experienced optometrists and found that these figures were not unusual. And he heard the standard remark, Don't worry, they'll get used to them.

He noticed something else. When people complained, they said, These glasses don't feel right to me. He remembered a pair of glasses he'd had fitted for himself years before. He could see with them but they hadn't felt right so they were designated to a drawer. With his sense of inquiry newly aroused he had another pair made for himself: "I noticed one time walking I took the glasses off I felt something changed in my balance, in my posture. I put them on. I felt another change and I kept on doing that until I got hold of the feeling that was involved. And the feeling was such that it distorted my body... there are emotional feelings too." He spent hours experimenting until he could sense the subtle differences in his body and emotions.

He became aware, that one's ordinary movements were affected by lenses. He was able to observe changes in himself and his patients in posture, the relationship of the head to the shoulders, how the arms and legs moved alternately, the distance of the feet in opposition, the distribution of body weight on the feet and balance. In addition, he studied theories of vision and experiments that correlated body movement with vision and even correlated the general learning process with vision.

Most importantly, he expanded his knowledge by observing the patients who came to him. He listened to them carefully as they described their difficulties or enacted them. And through their experience, he developed a different way and purpose in working with vision.

Dr. Sirota was visited by a patient who was dissatisfied with his glasses. To every question that Sirota asked, the patient answered, I can't put my finger on it. Finally after the fourth or fifth time, Sirota began to wonder. He asked the patient to put his finger tip down on Sirota's upheld finger. The man missed touching this finger by a foot.

"Are you trying?" Sirota asked. "Are you fooling around?" The patient assured him he was making a sincere effort. They played with numerous lenses and finally hit upon something that was quite different from what standard methods of testing would have, and indeed already had, prescribed.

Another time Sirota was getting ready to test a new patient who looked down and around but never at the doctor. As Dr. Sirota moved back to the repair table about thirteen feet away, the patient, for the first time, looked directly at him. The optometrist stepped forward to point out a screw was broken on his glasses and the man looked away. As Dr. Sirota stepped back to put his screwdriver on the table, the patient looked at him again. He stepped forward and back several times and sure enough the pattern repeated! "You know, you look at me when I stand back here. I take one step towards you and you look away. Do you know that?" The patient hadn't been aware of this. The doctor encouraged him to continue looking at the doctor as he stepped toward him. It was a struggle and the patient required several attempts before he could do it. When he was able to continue, he described that the doctor appeared to become huge. Again, experimenting led to lenses quite different from what the ordinary tests had suggested.

The optometrist, still insecure in his findings, gave the man the glasses free and told him to try them out for awhile and return to tell him about the results. This patient came back reporting he was able to make friends for the first time in thirty years. The doctor didn't understand the connection. Well, just think, said the patient. If you came closer than thirteen feet, I couldn't look at you because you looked huge. It's impossible to make friends with anyone when you can't look at them.

From these experiences, Sirota began to think that there was something wrong with the basic approach. The standard tests had not really examined his patients satisfactorily . For some people, corrective lenses seemed only to compensate for problems with reading printed language and just did not address other fundamental visual needs.

Sirota explains, "The eyes are telereceptors. They're there to pick up whatever's necessary for you to pick up from your environment and then to do something with what you see... Neurologists have stated that the visual fibers that are there in the brain are pervasive throughout the entire brain. There are interconnections between every area of the brain and the visual cortex. They estimate that twenty per cent of the optical fibers don't go into the brain but go directly down to the postural centers of the body; control, balance and movement" Sirota realized that reading is only a small portion of the work the eyes do and that we have little awareness of vision's other functions.

I asked Dr. Sirota to describe the traditional way of testing eyes. He described the retinoscopy which uses a light that is shined directly into the eye from the front. The doctor can see a certain reflection of the light in the pupil of the eye. He looks to see what the eye does with this light how the light moves. He repeats this through different lenses until he finds one where there doesn't seem to be any apparent movement at all. (Actually, there is movement but it's so quick that there doesn't seem to be any). At this point, theoretically, the eye has been neutralized and the lens that does it is generally close to something that would be prescribed.

Good sight is not synonymous with good vision, says Sirota. Sight is the ability of the eye to see things. Vision is the ability to make sense out of what one sees. Because of incidents like those described, Sirota began to question the degree to which this test is relied upon. But it was not until the following situation occurred that he found a way to build on the traditional test.

One day, as the doctor was examining a very myopic patient, the phone rang. He had just neutralized what is called the against movement of light in the myopic eye and as he answered the phone, he told the patient to keep looking straight ahead. Dr. Sirota continued to shine the light in his eye from an eccentric point of view, perhaps thirty degrees off the normal frontal position. The movement of light in the eye was completely different from this angle. He noticed a heavy with movement which is characteristic of the hyperoptic or farsighted eye. This disparity in the readings was quite large and Sirota wondered why. Dr. Sirota tried a range of lenses on his patient, asking him to look around the room with each until he found the lenses to be comfortably clear. The man stopped him at lenses which were about midway between the two readings. When Dr. Sirota checked his acuity, however, he couldn't read even the largest letters. Nevertheless, the patient insisted that these were the lenses he wanted. Sirota, once again on unsure ground, made the glasses up for him and asked him to come back to let him know what happened.

After this incident, the optometrist called his school to ask about the retinoscopy. His question was dismissed; he was told to ignore the difference because what he'd done wasn't the correct way to do the test. Then he found a reference in optometric literature which described the variation he noted when looking from off the visual axis. But again, the advice given was to ignore the disparity of readings. Although no one was concerned with why the readings were different, it appeared significant to Dr. Sirota because we do not, after all, see only with the central part of our eyes; we see peripherally, too.

When Sirota's patient returned a couple of months later, he raved about the glasses as being the best he'd ever had. Previously, he had all but given up reading and also found it difficult to sit still. Now he could read and his ability to be still had improved tremendously. It inspired him to go out and get a new job. He was delighted to be making these changes and improving his attention as well. Furthermore, when the doctor tested him, he was able to read the 22/100ths letter which was a big improvement over having been able before to read only the 22/35ths. In other words, there seemed to be some factor, some feeling or sensation that helped this man choose a lens that enabled him to see better.

From this situation, the doctor clarified his own intention of using his craft not only to compensate for poor vision but to encourage better vision. He realized that good vision included factors more complex than being capable of seeing a small letter on a chart out of context with everything around it. Good sight is not synonymous with good vision, says Sirota. Sight is the ability of the eye to see things. Vision is the ability to make sense out of what one sees.

Through the years Dr. Sirota has developed a series of tests in addition to the traditional means of testing the eyes. They involve balance, flexibility, size constancy and spatial orientation. The doctor carefully watches his patients' movements, breathing, muscular tension and the subtle changes caused by different lenses.

One test that Sirota does is to have someone stand solidly on their feet. With his open hand he gives them a gentle push forward on their lower back. Some people are very rigid and tight. Others, who have little resilience, almost fall on their faces. Some move up on their toes and return not exactly an appropriate flexibility. All these responses change with a change in lenses.

Seeing is a projection of what's going on in the individual at the moment, projected out into space, says Sirota... The person doesn't see distortion, instead, his or her behavior makes the adjustment by becoming distorted warping the body or mind. Dr. Sirota asked one patient to wear an old pair of her glasses for a while before he would prescribe new ones. Each day she had been struggling tensely to drive on expressways where meandering lanes were blocked by wooden horses. She was shocked to find, however, that with her twenty-year-old glasses the drive was much easier.

Apparently, her current glasses distorted her depth perception and size constancy in a way the old ones did not. The tension produced by her inability to perceive distances manifested in tightened muscles in her arms, shoulders and neck, and tiredness from the effort of the drive.

As the doctor questions and experiments, the patient's awareness increases. A young man, for example, wearing his usual prescription reads from a book. Then, wearing lenses that Sirota's tests indicate, he almost bursts into tears not from the content of the passage but from the realization of what happens to him when he views the world through his current glasses. He could sense a lack of contact with his feelings and a sense of rigidity in his thoughts making him colder, harder, less alive.

This was the result of his lenses being too strong with too much light peaking in the central part of the eyes. Dr. Sirota says this often happens. The person sees only what is directly in front of him with a constriction of the peripheral field and a loss of figure/ground relationship. Seeing is a projection of what's going on in the individual at the moment, projected out into space, says Sirota. The vertical, horizontal and to/from coordinates within the individual should not be disturbed in any way in relation to the external coordinates of space. If they are, a distortion is caused within the individual which is projected out as a distortion in space. The person doesn't see distortion, instead, his or her behavior makes the adjustment by becoming distorted, warping the body or mind. One of Sirota's patients described her experience to the doctor by saying, You're giving me insight and reducing my outsight. She was referring to her previous need to focus sharply on points far away. She does not see as sharply now, but she sees more solidly. She can get the feeling of an object with her eyes.

It is not easy or comfortable to be a patient of Dr. Sirota's. One cannot be a passive onlooker fitted with lenses according to the doctor's standards only. He demands that they work to improve vision to improve contact with the world. He can help by observing and listening, but he describes his practice as a fifty-fifty proposition with his patients. It's the only way it works, he says.

One of the easiest ways to experiment for oneself is not to wear one's glasses, or to wear an old pair, and do safe things that you ordinarily do. Observe your experience. Ask yourself a lot of questions. Have others observe you as well. What do you think you can not possibly do without your glasses? Do people or objects, when seen from a particular distance, seem larger or smaller than they actually are? Do you favor one leg when you walk? Is your speech slurred when you read aloud? Do you hug one side of the hall when you try to walk down the middle? Is the height of a curb difficult to perceive? Does the world appear hard-edged or flat? Do you think you need your glasses to answer the phone? Does lack of unneeded detail cause you anxiety? Don't take anything for granted. Dr. Sirota didn't and because of him numerous people have discovered through vision some of their potential for change and for growth.

Dr. Sirota is a very easy person to talk with so feel free to contact him in Chicago at (773) 561-8918. His office is at 5052 Sheridan, zip code 60640-3118.

This article by Barbara June Appelgren was printed originally under the title of "A New Vision" in Impressions, a quarterly journal published by the Claymont Society for Continuous Education. (Found at http://galen.med.virginia.edu/~pjb3s/vision.html)