This is a deeply human story, a true account of defeat, discovery, and, in the end, the defying of expectations. At the same time, it is a robust tale laced with three “display technology” subplots, each timely in its own right. Let’s begin by ‘weaving’ the threads of our story.
The Case Study
Let’s introduce the protagonist of our story, Tyler. Tyler is a bright, active, athletic, inquisitive and delightful six-year-old boy living in rural Colorado. He is particularly skilled in math, physically strong for his limited years, socially adept, and a deeply kind soul. But upon entering first grade, something began to go drastically wrong. In short order it became apparent that he was not reading at grade level. In fact, he was soon scooted off to the “strugglers” category of early readers by his school, that is to say, he was placed in a reading group that was below the lowest-labeled reading group at his grade level.
To make matters worse, his self-esteem about learning and school plummeted, while other children not-so-quietly mocked him about his poor reading skills, spiraling him further downwards. His teachers tried everything in their power to help Tyler, but with 23 other students in his first grade classroom, individualized help was a scarce commodity. Even school testing was a dismal failure, because Tyler seemed to have even more difficulty with the school’s computer-based reading assessments than with print media. (Incidentally, in Colorado almost all standardized learning assessments are conducted on computer screens.)
Everyone was worried. Tyler read more slowly and less ably than any of his peers. His teacher wondered about placing Tyler on an Individual Education Plan (IEP) and creating accommodations for computerized school testing; his mother was concerned that dyslexia might be the culprit; his father questioned whether special education placement might be in order. What else is there to do when you’re reading efficiency is at 30% of normal and your comprehension of that material is less than 60% of average performance?
Instead of settling for common educational solutions, a different pathway was pursued: Tyler was taken to the largest vision clinic in Boulder, Colorado, for a comprehensive vision evaluation. The battery of tests, administered by Dr. Jennifer Simonson (OD, FCOVD) at Boulder Valley Vision Therapy, included an array of clinically effective display technologies, including displays designed to track depth perception using virtual reality and 3D imaging, and eye-tracking screens designed to measure peripheral vision. The display-based vision assessments were accompanied traditional optometric devices, along with paper-based, kinesthetic, tracing and eye-fixation recording equipment.
Here Tyler is using the OPTO app, testing for depth perception and localization. Each fish is located at a different 3D depth. You have to combine the information from both eyes to see all of the fish and identify where they are in space. If a fish is missing, it is easy to identify which eye is having difficulty.
Dr. Jennifer Simonson from Boulder CO demonstrating the OPTO app.
These tests produced some startling revelations. The diagnosis: convergence insufficiency, saccadic eye movements, and other specified disorders of binocular movement. Explained in ordinary English, Tyler was unable to maintain alignment and teaming of his eyes while reading; focused his eyes poorly for near reading; struggled with the ability to focus back and forth (from near to far) as he read the book in front of him or observed macro-activities in the classroom; suffered in keeping his eyes steady on a target; and demonstrated below average range for speed and accuracy in reading.
The Optics Trainer uses infra-red technology to track the eyes, assessing peripheral vision. Here Tyler plays Asteroid Defense, which is an activity for increasing peripheral awareness and accurate eye movements called saccades. The asteroids come in from all directions at different speeds. To defend your spaceship, you have to quickly and accurately move your eyes to glance at the incoming asteroids to make them explode before hitting the spaceship in the center of the screen.
The good news was this was not the feared “dyslexia” and did not require a special education referral. The problems rested just in his eyes. International data suggest that more than 14% of children worldwide have similar vision problems; and that this percentage increases in lower socio-economic settings. And, most importantly, that is fixable with the help of vision therapy. Then Tyler was introduced to a doctor not far from his rural home: Dr. Ron Mearsha (OD), a doctor with a strong interest in “developmental optometry” and using vision therapy to improve classroom performance for students.
After ten sessions of once-a-week vision exercises with the kind and child-centered optometrist and visual therapist, Dr. Mearsha, Tyler soon found himself at 70% of the capability of other children. After consistent summer exposure at home to computer-based software designed to improve eye-teaming, he improved even more with the home-based support. Although Tyler had fallen way behind his peers during the school year, he rapidly caught up to grade level in both reading and writing (yes, there’s a connection between vision and writing) by the end of the summer.
Dr. Ronald Mearsha, Greeley CO
The Analysis
The above case study recounts an impressive and touching success story, but let’s be more intentional about the role of modern display technologies in this remarkable situation. As I stated previously, there are three nested subplots in the above case study that I would now like to bring to your fullest attention. I should also mention that the many pictures embedded in this article softly echo these same themes:
The rapid spread of display technology into vision and optometry clinics.
Displays are rapidly making their way into offices and clinics that previously only had a presence at the cluttered desks of customer-facing receptionists or in waiting rooms. Now, screens of every size are pushing their way in to the hands of doctors of optometry, paraoptometric staff, and vision therapists. Even virtual reality is making a bold entrance. It’s an entirely new and emerging niche market for displays of all types and sizes: mobile displays, instrumentation panel displays, diagnostic and therapeutic displays, and even eye-therapy software that goes to the patient’s home screens. Most importantly, these are not one-off implementations, displays that are merely “nice to have’– no, these are rapidly becoming vision-saving, life-supporting essentials.
The benefits of virtual reality and 3D displays.
In an era when newspaper articles too often lament the downsides of too much screen time, it’s nice to hear about some of the beneficial aspects of display technology in promoting vision health and quality of life. In this case study we have seen the telling role of both Virtual Reality and 3D displays in both the diagnosis (Dx) and treatment (Tx) of vision disorders. And we’ve seen the huge potential for displays at the nexus of 3D, virtual reality and learning for diagnosing and treating vision-based learning disorders.
Here Tyler is completing an activity on Optics Trainer VR called “Tappy Birds.” This assessment requires the use of both eyes to see images presented in the headset. When fused in the brain, it becomes a 3D image with one bird closer or further than the rest. He reaches out with the controller to locate the 3D bird, matching the location and distance where it appears.
The increasing role of display technology in school assessments.
Assessment of learning, as seen in standardized state achievement tests and less formal classroom- and skill-based assessments, has increasingly moved towards online, i.e., display-based measures. This presents a huge problem for more than 14% of the overall student population with apparent vision challenges, who, like Tyler, will struggle with computer-based reading and assessment. Dr. Mearsha beamed about Tyler’s success for this reason, as well: “I am pleased especially, because using the computer was one of [his] struggles. I feel that he will be doing great [with computers] by the end of the summer if not sooner!” In a coming article, I will touch upon this particular challenge facing the display industry—the assessment challenge —and provides some very good news.—Len Scrogan
