One-sided World; Bizarre Brain Injury

May 14, 2008

Imagine half of your world disappearing before your eyes in a split second. You wait for it to come back, but it never does. Everything you see is cut in half! I recently met a man that experienced this odd and rare brain condition.

This senior-aged man arrived in our practice in a wheelchair saying that he couldn’t see to his left. He had recently suffered a stroke in the right half of his brain and had lost complete function of his left arm and leg. After some testing, we discovered that indeed the entire left side of his vision was gone due to the stroke. This made sense since the right brain receives left side vision information.

However, I wasn’t expecting what he said next, “I have to turn my plate around to see the food on the other side.” You see, if just the left side of his vision is missing all he’d have to do is look a little more to his left to see the other side of the plate. I diagnosed him with hemispatial neglect (AKA left side neglect). He’s only aware of the right side of objects!

Patients with this condition will eat only the food on the right side of their plate, notice only the right side of a picture, and only draw the right side of a clock. This is an actual drawing from a hemispatial neglect patient. Some severe cases have even demonstrated the amazing ability to flip the neglect in their mind’s eye. For example, after being shown an upside-down picture of a face, the patient will mentally flip the picture right-side up and neglect the left side of the face!

We learn a lot about brain function by studying the devastating, but fascinating effects of brain damage. From neglect patients we’ve discovered that the right side of the brain is responsible for spatial interpretation. The eyes collect data about our environment, but the brain interprets and organizes it.


Visual Auto-Completion

April 7, 2008

Have you ever had the annoyance of typing away on your word processor and had it automatically “correct” something you knew was already correct? My favorite is when I type “i.e.” and it thinks I meant to type “I.e.” Your computer thinks it’s smarter than you are. I’d like to think I’m smarter than it.

Your brain also has a built-in auto-completion or auto-correction function. And just like your word processor it often auto-corrects correctly and sometimes not. Here’s an example when it guesses incorrectly.

Most people say that they can see a white triangle. Your brain tries to complete the alignment of the individual shapes. If you look closely you may even “see” faint lines that make up the perceived white triangle. However, there are no lines. In fact, there is no triangle.

An example of when the brain correctly auto-corrects is when it conceals the blind spot in our vision. This blind spot is formed when 1.5 million tiny nerves from our retina squeeze together and exit out the back of our eyes on their way to the brain. There are no light receiving cells in this part of the retina. In other words, we should see a small black hole to each side of our vision, but we don’t, compliments of the brain’s auto-correction feature.

Want to find your blind spot?

  1. Cover your left eye with your left hand. (Make sure you can’t see through your fingers.)
  2. Hold your right thumb up at arms length directly in front of you.
  3. Look directly at your thumbnail. Without moving your eye from that position, slowly move your thumb slightly to your right about 8-10 inches.
  4. You should notice that your thumbnail suddenly disappears.

Congratulations! Your vision has now been auto-corrected.


What’s Up With My Eyebrows?

December 28, 2007

The other day my four-year-old asked me out of the blue, “Dad, why do we have eyebrows?” I was baffled for two reasons: 1) that my son was so pensive and 2) that despite being an eye doctor, I didn’t have an immediate, scientific response. I replied how any baffled parent would and shot the ball to his court, “Why do you think we have eyebrows?” He replied after a brief pause, “So we don’t look funny.”

Reason #1

Eyebrows are one of those things that we take for granted until we have to do without them for a while. After doing some searching, I found many stories from individuals who, for one reason or another, had their eyebrows removed. Many said that liquids like sweat or rain would run right into their eyes. So that’s reason #1 for the existence of those furry things on our face. The arching shape and sideways hair growth direct liquids and debris away from the eyes.
muscles_of_facial_expression.jpg
Reason #2

A less critical, but important social function is to aid in facial expression. Communication of emotions such as surprise, fear, and displeasure is executed with the eyebrows. If you’re interested in facial muscle anatomy and the expressions of each muscle, visit artnatomia.com to play with a simulator. The picture shows all superficial muscles that control facial and scalp movement. (Courtesy: http://www.medicalook.com)

EDIT (June 2, 2008): A recent U.S. study from the journal Plastic and Reconstructive Surgery indicates that eyebrow shape was deemed to be the greatest indicator of mood, drooping of the eyelids was considered the biggest indicator of tiredness, and raising the lower eyelid and the presence of crow’s feet were associated with happiness.

Unibrows

Those individuals with the fortune (or misfortune, depending on your perspective) of having one long, continuous eyebrow perhaps have the best eye protection. So think twice before you wax that unibrow into two brows. By the way, the fancy-schmancy scientific term for unibrow is synophrys.


Why Don’t We Get Dizzy When Moving Our Eyes?

December 19, 2007

Have you ever heard that the eye is like a camera? Generally that’s true. But look through a camera and move it from side to side. Notice the churning sensation in your gut and how it feels like you’re watching the car chase scene from The Bourne Supremacy all over again. Now move your eyes from side to side. Immediately you’ll notice a significant difference. We normally don’t loose our last meal every time we look around with our eyes.

suppression.pngThe brain is very good at minimizing sensory input so we don’t get over stimulated. (Autism is where the brain doesn’t do it’s job and allows too much stimulation, making it extremely difficult to pay attention to anything.) A camera, on the other hand, can’t filter out motion.

Experiment #1

Ok, ok, enough suspense. Let’s find out how the brain filters motion. To demonstrate this phenomenon, let’s set up an experiment, which I actually did in optometry school. An observer is seated in front of a large section of construction paper at eye level bend into a semicircle. Points A and B are just marks on the paper. Directly in front of the observer is a narrow cut-out section through which a light is seen. (Here’s the impressive part.) If the observer looks at point A then quickly looks at point B (or vice versa) the light is not seen. During this quick movement, we know at one point the eyes were briefly pointed directly at the light. Why didn’t we see the light? The phenomenon here is that actually the eye DID see the light, but the brain didn’t.

Experiment #2

Just about everyone has already done this experiment. Simply sit in a rotating chair and spin yourself really fast. Did you get dizzy? Ready for a second chance to taste that spinach salad with walnuts you had for lunch? The spinning simulated quick eye movements just like shifting our eyes from points A to B, but why did we get dizzy this time?

The Brain Categorizes the Type of Motion

To filter the visual sensation of motion, the brain considers not only the motion the retina sees but also if the eye is in motion at the time and if the motion was initiated by choice (voluntary) or forced (involuntary). Imagine (don’t try this yourself) numbing up the eye, then someone gently grabbing the white part of your eye with tweezers and having that person moving your eye side to side for you. (We actually do this in the exam room on certain patients to determine neurological dysfunctions.) You would get dizzy because your brain isn’t filtering out the motion.

Wow! That’s Cool!

Let’s put this all together now. Here’s a play-by-play of what happened in our experiment #1 that caused the brain to filter.

  1. The observer looks at point A.
  2. The observer starts to move their eye away from point A.
  3. The retina, sensing an image moving across it, sends impulses to the brain. (But, as we saw from experiment #2 and the tweezer test, this isn’t enough for the brain to filter.)
  4. Nerve impulses are sent to the brain from the eye muscles that initiated the movement. This combination of retina and muscle input tells the brain that the observer made a voluntary eye movement.
  5. The brain shuts down the visual system for a split second during the eye movement. This is called visual suppression. We’ve been using the layperson term “filtering” in this post.
  6. Once the eye reaches point B, the retina and muscles send impulses again to the brain telling it the eye movement has stopped.
  7. The brain turns the visual system on again. That explains why we don’t see the light in experiment #1.

You, being the bright person that you are, would now ask, “Why don’t we see black when the brain turns the visual system off?” This is quite a complex process, but suffice it to say, the brain has the amazing ability to cover up visual interruptions. Our world doesn’t go black each time we blink either. I may go into more detail on this in a future post.


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