Let this simple dialog with Dr. Bates tease your mind and your eyes into an "ahah" of clear vision. Notice how he demonstrates what works and what does not work, to cleverly bring your mind around. His creative approach is very inspiring. This article appeared in Dr. Bates' Better Eyesight Magazines and was originally titled "The First Visit". - gm
In the beginning of treatment, as well as later, it has been found to be a great benefit to have the patient demonstrate facts. It is better to avoid stating results expected, and instead let the patient discover the results for himself.
Rest Improves the Vision.
The first fact to be demonstrated is that rest improves the vision. The patient is told to close his eyes and rest them, forget about them, let his mind drift, remember pleasant things. After half an hour, more or less, he is told to open his eyes and read the distant test card as. well as he can. If he finds that his vision has improved the next question is:
"What did you do that helped your sight?"
Obvious as the answer to this question seems to those familiar with the treatment of defective vision by relaxation some patients find extraordinary difficulty in replying to it, and one has to ask them a number of leading questions to get the proper answer, "Rest."
The amount of relief obtained from this procedure differs greatly in different cases. Some get none at all, and others very little. Others again may be cured at the first visit by this means alone. Why some people can close their eyes and rest them with so much benefit, while others fail, is not always evident; but one can often tell at the outset what the result will be. One case cured by this means rested comfortably for half an hour without any change whatever in his position. A case not benefitted was very restless, moved around in his chair, got up, opened his eyes every few minutes, and was decidedly uncomfortable. For him there was no rest with his eyes closed, and his vision was not improved. Later a cure was obtained by other methods, but with much trouble.
After having rested the eyes by closing, the patient is told to cover his eyes with the palms of his hands in such a way as to exclude all the light. Usually, not always, he is able to obtain more rest in this way than by rnere closing. Those who succeed in relaxing completely see a perfect black, but this is rare, and the patient may consider himself fortunate if he is able to begin by seeing an approximate black.
Having demonstrated that rest improves the vision the next step is to have the patient demonstrate that effort lowers it. The patient is directed to look continuously at a letter which he can see distinctly on the distant test card, and after a part of a minute the question is asked:
"Do you see better or worse?" The answer is usually:
"I see worse, it makes my eyes pain."
He is then directed to stare at other objects instead of letters, to make an effort to see them, concentrate on them, and to note that lowering of the vision, with fatigue, discomfort, or pain, is produced. After he has demonstrated these facts he is told that persons with imperfect sight always attempt to hold their points of fixation too long, even when the lowering of vision is caused by an injury, or by a foreign body in the eye. In short, they stare, thus not only spoiling their eyesight but making themselves conspicuous and uncomfortable.
"You have your choice," I tell them. "Stare and have poor sight and other troubles. Avoid the stare and have normal vision."
Occasionally a patient thinks that staring does improve his vision. In this case I tell him to keep on staring and improve it still more. It does not take long for him to convince himself that the improvement that results from staring is only temporary, and is followed by a lowering of the vision.
Patients who have lowered their vision and produced pain and discomfort by staring are glad to relieve the strain by closing the eyes or palming. After they have alternately stared and rested for a while it would be hard for anyone to convince them that anything is to be gained by effort when one wants to see, and they instinctively close their eyes in such a case instead of straining them.
Shifting and Swinging
Having demonstrated that staring lowers the vision, a patient is easily able to demonstrate that if he wants to see an object distinctly he must shift constantly from one part of it to another; but often he does not easily realize the apparent motion produced by this shafting. In demonstrating the facts to a new patient I usually begin by having him wall: around the room and note that the furniture seems to be moving in the opposite direction. Then I have him take one step forward and one back and note that the furniture seems to move backward and forward. Next I have hint hold his hand six inches in front of his face, and move his head far to the right and far to the left, alternately, without looking at the hand. Almost invariably he is able to note a very pronounced movement of the hand. After this I have him hold a small card in his hand and note that it appears to move with the former. Having noticed the movement of the card in his hand, it is usually easy for him to look from one side of the test card on the wall to the other, and note that it appears to move in a direction contrary to the movement of the eye. After this the shortening of the swing until he becomes able to look from one side to the other of a letter of diamond type and imagine that it is moving is a mere question of practice.
Memory and Imagination
The use of the memory or imagination is an important part of the cure of imperfect sight, since a perfect memory or imagination means perfect relaxation; but I do not begin by explaining this to a patient. Instead I say:
"Can you remember a small letter o?"
Some patients can do this at once; others cannot. Those who can usually think that they are remembering the letter all alike and stationary. In order to demonstrate that this is impossible they are asked to imagine a black period on one side of the o, to keep the attention fixed upon it, and to imagine that it is perfectly black and stationary. Generally the patient finds that he cannot do this. The period usually moves in spite of all his efforts to imagine that it is not doing so. If it does not, it becomes gray and finally disappears. Having demonstrated that you cannot remember the period continuously unless it is moving, it usually becomes possible for the patient to realize that his attention is shifting constantly from one part of the o to another, and to note an apparent movement in a direction opposite to the imagined movement of the eye.
One difficulty in getting patients to make this demonstration is that the effort of remembering an unchanging object, even for a few seconds, is so great that some people cannot or will not make it. It is easier to let the attention shift naturally.
Some patients are unable to form any kind of a mental picture, and it may require much ingenuity and long practice to enable them to do it. Some become able to form mental pictures when they are able to imagine that the things they see are moving. Others are helped in remembering a black letter by imagining that it has a very white background, whiter than the card on which they saw it.
Mental pictures are formed first with the eyes closed, then with the eyes open, and as the ability to form them with the eyes open increases the vision increases.
In every way possible the fact is impressed upon the patient that he can be cured only by rest; that he must learn to let his eyes alone; that whatever he does to improve his sight must be wrong. For home practice three general plans are recommended: