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Grand Forks man addresses eye concerns with vision therapy

Wayne Young is connected to special equipment that determines how efficiently his brain uses limited energy resources to focus. If too much energy is spent on focusing, less is available for reading comprehension . photo by Eric Hylden/Grand Forks Herald1 / 2
Optometrist David Bieberdorf, left and Ass't. Prof. of Psychology Dmitri Poltavski have teamed up to study "inefficiencies " in the way the brain processes information when vision problems occur. photo by Eric Hylden/Grand Forks Herald2 / 2

As a real estate paralegal, Wayne Young spends most of his day reading -- intensely.

Since starting last year at The German Law Group in Grand Forks, he began experiencing eye strain, blurred vision and headaches.

"In the mornings, I'm pretty fast," he said. But by the end of the day, his eyesight was not as sharp.

"By 3 o'clock in the afternoon, I'm shot. It's frustrating."

At workday's end, he had difficulty deciphering street signs on the drive home. He thought he might need stronger lenses or that his condition may signal something worse.

"I thought I might be going blind," he said.

Early in his life, signs pointed to vision abnormalities but none that were worrisome.

"I remember as a kid, I couldn't cross my eyes," he said. "I'd try, but I just physically couldn't do it.

"In hindsight, I think, 'Oh, that's the reason I couldn't cross my eyes.' It's one of the things they're having me work on now."

He sought help from Grand Forks optometrist David Bieberdorf who put him through basic vision testing where "you flip through images," he said.

Convergence insufficiency

Young learned he has "convergence insufficiency," a condition which affects his ability to focus properly and maintain that focus over time.

The line, or axis, of his focus is too far apart, he said. "I'm on the edge of seeing double."

Basically, his eyes are not working together as efficiently as they should. This causes the brain to use too much energy to maintain the target in focus, depleting the limited cognitive resources which are needed to process and understand what is read.

"The poorer the quality of the message, the more the brain has to work," said Dmitri Poltavski, assistant professor of psychology at UND, who conducts research with Bieberdorf and fellow UND professor Thomas Petros.

Reading should be automatic, said Bieberdorf, who practices at Valley Vision Clinic in Grand Forks. But in some people with vision problems, the way their eyes function reduces their ability to pay attention and comprehend.

"For most people, their focus drifts off, especially after you've been reading a long time. In people with these issues, after 10 minutes, their focus is not working right."

Young "probably has had this condition for a long time," Bieberdorf said, but people in his shoes learn to compensate for it.

'Pencil push-ups'

Following Bieberdorf's advice, Young is taking 12 weeks of progressively more demanding vision therapy.

"He's 38, too young for these problems to be showing up," Bieberdorf said. Problems of this type "usually occur more in people 42 or 43 years old.

To "retrain" his eyes to function more efficiently, Young does vision therapy exercises for about 30 minutes before bed each weeknight. Each exercise takes about two or three minutes.

His therapy doesn't require medication, and he meets with a Valley Vision therapist every two weeks.

He begins with "pencil push-ups," using a sharp pencil held lead-point up at arm's length.

In vision therapy, "it's like getting warmed up before you start exercising at the gym," he said.

He slowly brings the pencil toward his face, keeping his eyes focused on the point and stopping when the point appears double.

"You hold that for 10 to 20 seconds, and then start again."

Another exercise uses a 16-foot string, with three beads spaced evenly, and is stretched from his nose to a door handle. He focuses on one bead, in succession, and lets the others go double.

This is meant to strengthen the eyes and train them to rapidly switch focus to objects at different distances.

The exercises "are really a workout," he said. The dull pain he feels vertically in the center of his forehead afterwards does not disturb his ability to fall asleep, he said.

Even though Young is only a couple of weeks into his vision therapy, he's pleased with the effect so far.

Young still can't cross his eyes, but 'I'm getting better," he said.

"It's pretty neat. Maybe it's the placebo effect, but I feel like it's already improved," he said.

He's glad his underlying vision problem is being addressed, he said. "A lot of doctors would have said, 'here's your bifocals.'"

Even combined with a stronger prescription, that probably would not have solved the problem long-term, Bieberdorf said.

"It's a wonderful alternative," Young said. "It feels good that I can take charge of this part of my health. It's like if you have a bad heart, you take steps to deal with it...

"I'm excited, even blessed, that I can do this."

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