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Fixing My Gaze: A Scientist's Journey Into Seeing in Three Dimensions

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Do you have depth perception, that visual ability to judge what is closer and farther away?

If you are reading this review, the answer is yes. From the time of the Renaissance, artists have made use of cues for depth to endow their canvases with a sense of life: streets become narrower in the distance; subjects that are closer are also larger and overlap those that are behind; there is the slightest haze in the distance, a subtle indistinctness of form, a difference in shadow. These devices trick the mind into perceiving depth whether we have one eye or two.

There is a second, more vivid form of depth perception, however, which requires the use of two eyes. To experience it, try the following experiment: Hold your hand at a forty-five degree angle to your face about ten inches in front of your eyes and spread apart your fingers. Closing one eye at a time, view the hand first with one eye, then the other. You'll find that each view is different, that the fingers have different separations depending on which eye you use. Next, open both eyes and see how your perspective changes, how the fingers seem now to be separated by more air, how there is an increased sense of space. This two-eyed form of depth perception is called stereopsis. Those individuals who have a "crossed" or "wall-eye" (strabismus), rather than combining the two views into a three-dimensional percept, typically see one of the views while ignoring the other.

Dr. Susan Barry, a neuroscientist, and the author of FIXING MY GAZE: a Scientist's Journey in Seeing in Three Dimensions was one such individual. Her eye crossed when she was three months old. Three surgeries between ages two and seven cosmetically straightened her eyes, but-as is frequently the case-the surgeries did not restore the brain's ability to combine the information from the two eyes. Sue's doctors, basing their opinions on the science of the day, assured her that she would never develop stereopsis.

The story of "Stereo Sue" regaining her depth perception at age 50 and astonishing the medical community was first told in a 2006 article by Oliver Sacks in a New Yorker. FIXING MY GAZE, however, is far more than a fleshing out the Sacks article. The book is a touching and sometimes lyrical tale of perseverance in overcoming obstacles. It's an excellent resource on Optometric Vision Therapy, the treatment through which Sue regained her vision. It's a wonderful overview of the science and neuroscience underlying the perceived changes. Most importantly, it's the best book ever written about how subjective experience changes during the journey from one-eyed to two-eyed seeing.

The story is completely accessible to nonscientists, the more technical discussions appearing in over fifty pages of endnotes, including copious references. As for who will benefit from or enjoy the book, there are many possible audiences: 1) Those who like well written success stories that also increase their understanding of the world. 2) Those who have ever had strabismus (a condition in which an eye turns in toward the nose or out towards the ear)-whether or not the condition has been "corrected" surgically. 3) The parents of those with strabismus.
4) Those who feel their own vision makes life more difficult. 5) Those with an interest in psychology or the brain. 6) Those doctors, whether ophthalmologists, optometrists or pediatricians, who profess to care for patients with strabismus. And finally (7), those who have pondered the topic of human consciousness: Sue, a neuroscientist, knew practically everything there was to know about stereopsis, but her world and joy of seeing changed profoundly when she experienced stereopsis. To share the excitement and insights of that change, read this outstanding book.

I ordered this new book just after meeting the inspirational Dr. Barry at this year's meeting of the Vision Sciences Society. The book arrived this last Friday and I spent the day reading it. I confess to be blown away by her story, as well as the scientific and clinical implications of her work. Add me to the list of people who loved the book!

Sue Barry's astonishing development of stereopsis at age 48 changed - profoundly - the way that many scientists (me included) view visual development and plasticity. Somehow we had tuned out, en masse, one hundred years of successes using vision therapy (including the extensive the work of Frederick Brock). The stuff of vision therapy was ignored, relegated to the fringes of sensible vision care. Instead, several generations of us took the Nobel Prize winning research of Hubel and Wiesel as gospel truth, going beyond the data by wrongly concluding (perhaps unlike the Nobel laureates) that stereopsis could only develop during a critical period during infancy. It took Barry, a well-established neuroscientist and keen observer, to bring us to our senses.

And yet now, having read her new book, I see that the story is much deeper and profound than I thought. First off, she's a very entertaining storyteller in her own right. The human drama escalated as she went through frightening surgeries as a child (including an encounter with a deceptive anesthesiologist); as she experienced shock and disappointment at being exposed as stereoblind; as she had her vision problems dismissed by one ophthalmologist as a psychiatric disorder; as she experienced steropsis bursting out at her for the first time; as she gained steam and knowledge, recognizing the scientific, clinical, and human implications of her story; as she brought celebrity neuroscientists on board. And so it is a story of empowerment for Barry the patient, Barry the scientist, Barry the teacher, and Barry the instiller of hope.

I believe that Susan Barry has demonstrated for many of us that stereopsis is, indeed, important. I, for instance, was trained to believe that binocular vision and any advantage it afforded us wasn't that big a deal. Sure, I loved stereo viewers and all that... But as an undergrad at Berkeley in the early `80s, I recall a visit by Bela Julesz, of cyclopean vision fame. Two of my academic heroes, Russ and Karen De Valois rose to challenge Julesz, eventually (as I recall) suggesting that two eyes really aren't that much better than one. As I read Barry's book, as well as her descriptions of the consequences of her visual deficit, I realized that my early academic training (as a I had encoded it) was quite wrong. The book makes it clear that lack of stereopsis, and having two eyes that don't fuse images properly, has profound consequences for people like Barry (e.g., her driving, her energy level, and her sense of efficacy). Moreover, it is fair to say that Barry is an extraordinary observer of stereoscopic experience, and that she uses her newfound, developing perceptual ability to achieve scientific and clinical insights that are elusive to us who grew up with normal stereopsis.

One of the epiphanies for me was when I read and grasped the following paragraph: "Just as I could not imagine a world in stereo depth, an individual with normal normal stereopsis cannot experience the worldview of a person who has always lacked steropsis. This may be surprising because you can eliminate clues from stereopsis simply by closing one eye. What's more, many people do not notice a great difference when viewing the world with one eye or two. When a normal binocular viewer closes one eye, however, he or she still uses a lifetime of past visual experiences to re-create the missing stereo information."

People interested in stereopsis will find excellent coverage of the basic issues and the key scientific figures past and present (e.g., Wheatstone, Hering, Helmholtz, Eileen Birch, Shin Shimojo, Denis Levi, Uri Polat, Chris Tyler). It is nice, if not surprising, to learn that the already positive, cool Oliver Sacks played a positive, cool role in Susan Barry's story.

If you have strabismus or some other disorder of binocular vision, you will find what you need here. You will find out how to find an appropriate vision therapist. You will find extensive, understandable information about the theory and science of binocular vision. More importantly, you will learn in marvelous detail about the experiences and practices that can in some instances lead to acquiring stereopsis late in life. My guess is that vision therapy patients will use this book as a guide for years to come.

One last thing: I recommend listening to two NPR interviews (2006, 2009) featuring Sue Barry, as well as other key scientific figures in the story, including Sacks, Hubel, Levi, and, briefly, the heroic Theresa Ruggiero. The NPR programs are available online and go quite well with the book.

Two thumbs up! (one with uncrossed disparity; one with crossed disparity).

My 17 year old son, like Susan had three eye surgeries as a child and he does not have depth perception ("stereoblind"). "Fixing My Gaze" was a real "eye-opener" for me in understanding how he sees his surroundings, his choices in activities (ball toss sports are not his favorite...), and how he manages to determine depth when assembling models, driving, etc.

The book was very well written, easy to read, and has just the right mix of science and personal experiences. Since I could relate to the subject matter it was one of those few books that I didn't want to put down and I read it slowly so that I could savor it!

I can't wait for my son to read it (but it's off limits until he finishes his ACT/SAT tests in a few weeks!)

As a final endorsement, "Fixing My Gaze" is only the second book that I have thought highly enough to send copies to friends.

Thanks Susan!

If you see double or if you have(had) an eye(s) turn, you should try the Brock string. Barry writes, "When I learned to use the "Brock string," I received the feedback that I needed to know where my eyes were pointing and then to redirect them so that they were aiming simultaneously at the same point in space." (p. 90) My guess is that Barry believes this was the single most important exercise of her visual therapy.

The Brock string is a simple setup. Tie a string to a knob, hold the other end to the bridge of your nose. If you put a bead or clip about a foot or so from your nose, you'll see an X as you look down the string to where the bead resides. How you see the X, what you can do with it, and whether you can easily move the juncture point of the X along the string...all of that is the stuff of some visual training which worked for Barry.

I have a childhood history of visual therapy (I'm now 66). I did not use the Brock string, because I guess my therapists didn't know about it. But, I did many, many other exercises. I remember many of them from Barry's descriptions. There is, however, one she doesn't talk about. It involves holding a straw at arms length and feeding a pickup stick held with the other hand into hole at the end of the straw. It's harder than it sounds, even if you are not visually impaired. Now, put on a set of prisms that disjoints and distorts the visual field, and the rapidly-put-the-pick-into-the-straw game becomes even better (read that harder--harder is what visual therapy is all about.)

Physical therapy worked for me; were you to look at me you'd never realize that my gaze is a bit cocked. Some might also argue that it didn't work; it converted a situation of a right eye turn into seeing double. For the most part, this has never really bothered me. Perhaps I've just successfully learned to fake stereopsis. I'm able to substantially suppress the image of either eye when I want to. I have no problem seeing or at least judge depth at any distance. Fusion? Impossible. I long ago gave up. Nevertheless, I enjoyed a rerun of visual therapy using the Brock string.

Barry's book is a must-read for anyone who has gone through some type of visual therapy. It also is a must read for a parent of a child with this type of visual impairment. But, such a read should not conclude that visual therapy is to be preferred over eye surgery for the very young. And, such a read should not necessarily conclude that you too can do what she did. But, such a read certainly will make you want to try to fix your gaze.

This book is a well written explanation of how vision therapy can resolve sensory processing difficulties, mainly for acquiring visual perception of the 3-dimensional spatial world. I was most interested by the careful and detailed first-person descriptions. As one clinician's point of view, Seeing Through New Eyes by Dr. Melvin Kaplan is a nice complement and expands on the use of ambient prism lenses for vision therapy, especially for children having developmental challenges.

I have suffered from Congenital strabismus all my life, I had 2 surgeries as a young infant and underwent some vision therapy in early life from my recollection, however, like most strabismics, I never developed bionucularity or stereopsis. As a child/teenager I was never good at ball sports, particularly small ball sports and never knew why, I always thought I was just naturally poor at most sports, which was hard socially and psychologically for me at the time. It wasn't until my teen years when my eyes began to turn again that I realised there was a problem. A routine eye exam in early high-school picked up my monocularity, however I was told not to worry as I had good vision in both eyes and what I lacked wasn't so important. Not fully understanding this at the time I went on with life as normal, into my late 20's/ early 30's my eye turn began to get worse to the point that it became cosmetically distracting and people would look at me differently and some would make comments and ask questions, so at the age of 34 I decided it was time for my 3rd surgery to realign the eyes once more. At this point I also began to research the topic of strabismus and stereopsis and after failing fusion and stereopsis tests conducted by my opthamologist, I set out to see what can be done to correct this. Coming across Sue's book and lectures on youtube gave me the inspiration to pursue the same course of treatment she underwent. My eyes are now almost normally aligned, just a little off horizontally/vertically, after surgery and I have begun vision therapy with a developmental optometrist just as Sue did. To my surprise using the brock string has made a huge difference so far! I can see the "x" when I cross my eyes!(which has required alot of effort to learn) and as a result I am now getting better at fusing both images with effort! Hopefully in time this will develop further and also potentially unlock/develop redundant bioncular areas in my visual cortex and help me experience the wonderful world of stereopsis as it did for Sue!

This book is a MUST read for any adult with congenital strabismus and monocular vision! It brings hope for all those individuals affected by this condition by outlining Susan's path to depth-perception/stereopsis after close to half her life was spent viewing the world with monocular vision. Susan's story is an enjoyable read and explained in a way that even non-medically minded individuals will understand. I rate this book very highly!

WOW! I am now even more inspired and motivated to pursue binocular vision therapy! I first read about Susan Barry's 3D journey in the New Yorker magazine three years ago. Before that, I didn't know that my being born cross-eyed made me only see in 3D. I owe it to both Prof Barry and Dr Oliver Sacks for having made me aware of my vision.

While reading "Fixing My Gaze", I sometimes felt like I was reading my own story. Those of us with strabismus have suffered from our lack of depth perception in similar ways. We hate merging in traffic and parallel parking is hard for us to gage.

The proximity of her story to my own made me cry at times and have to put the book down to digest her pain and remember my own.

For the past three years, I've done some vision therapy, but have not been consistent. After reading about Prof Barry's renaissance with her newfound abilities, I am motivated to be a serious student of binocular vision therapy.

At some point in her moving memoir, Barry says that those with 3D vision and those with 2D vision speak different languages. I feel that by viscerally identifying with her 2D life and appreciating her 3D discoveries, that I'm able to understand a little of the 3D world to which I am currently blind.

Thank you for being my bridge!

Sincerely,

SUSANNA ZARAYSKY

A fascinating account of Sue Barry's acquisition of stereo-vision at an adult age. As a professor of neurobiology, she does an excellent job of explaining the science behind the vision change, but it is the personal details of seeing steering wheels floating in space and dinosaur bones posed to attack, told in a clear, flowing style, that truly bring this story to life. I would recommend this book to anyone.

This book is the story of a happy ending. The author, a professor of Neuroscience, was cross-eyed as a child and remained unable to see in 3-D for most of her life; yet she recovered depth perception when she was around 50, after visual therapy with a developmental optometrist. _Fixing My Gaze_ conveys Susan Barry's wonder at the transformed world revealed through this change in perception. When she walks into a snowfall, Barry is overcome with happiness because - for the first time - she can actually SEE that the snow surrounds her. A visit to Manhattan surprises her with skyscrapers that no longer appear as a flat backdrop.


_Fixing My Gaze_ tells other stories as well. The author explains how our eyes and brain work together to allow us to see volume and depth but also to organize our perception of the 3-D space we live in. She discusses both the complexities of vision and the devastating effects of any disruption in this system. Barry explains the science behind visual therapy and how each of the exercises she practiced works.


There is also a painful story here. Although she grew up to be a scientist, Barry had trouble learning how to read. That led her to be moved out of the third grade classroom where all her friends were placed and into the special-problems class. In the beginning of the year, the assistant principal came into her classroom, told her to move to the other class, and asked a boy to drag her desk behind her as she went down the corridors. The desk, she tells us, "made an awful noise as it scraped along the floor." The understated and disquieting humor of Barry's recollection makes us sharply aware of how wasteful it is to embarrass a little girl into assuming that everybody thinks she is dumb, and how easy too.


This book is also the work of an accomplished writer. Barry weaves science and personal memoirs into a short, readable book. Even as she remembers her difficult childhood, Barry centers her account on the gift of depth perception.

[...]

"Fixing My Gaze" fuses an accessible primer in the neuroscience and the geometry of stereovision with a personal account of developing that skill in adulthood. It's a both expert and emotional testament to the plasticity of the human brain. With scientific restraint, Barry focuses on the implications of her experience for therapeutic optometry. If deliberate effort can rewire sensory processing at 48, though, what other astounding feats might our grey matter manage with the right training?