Dr. David Cook on When Your Child Struggles and The Shape of the Sky.

Denise talks with developmental optometrist, Dr. David Cook about his 45 years of experience in vision therapy and two of his books, When Your Child Struggles and The Shape of the Sky. You won't want to miss this one!

Dr. Cook’s website:

https://www.cookvisiontherapy.com/the-shape-of-the-sky/

Request your free ebook copy of When your Child Struggles:

https://www.cookvisiontherapy.com/when-your-child-struggles/

To purchase The Shape of the Sky

https://www.oepf.org/product/the-shape-of-the-sky/#

Want to hear more from Dr. Cook? 

He was the guest of Danny Jones on the Koncrete podcast, February 15, 2023.

“How to improve intelligence by fixing your vision.”

https://www.youtube.com/watch?v=Yw6hLi90B14

Click the link above to message me directly. It comes to me as FAN MAIL! How great is that? Just click on the place that says, "If you liked this episode CLICK HERE:"

Transcript

Denise: Welcome to the Healing Our Sight podcast.

I'm your host, Denise Allen, and today I have as my guest Dr. David Cook.

And he is a world authority on the training of depth perception. Lecturing on the subject to optometric audiences across the globe, he's served both the National Board of Examiners in Optometry and the International Exam Board of the College of Optometrists and Vision Development.

Now they're called the Optometric Vision Development and Rehabilitation Association.

He lives with his wife, Thuy, and their Polish lowland sheepdog, Lucy, in metro Atlanta, Georgia, where for 40 years (now 45), he has limited his practice to vision therapy.

So I am so excited to talk to you today, Dr. Cook. Welcome.

Dr. Cook: It's great to be here, Denise.

Denise: I wanted to talk about so many things. It was hard to pin down what we should start with. But when I decided to come to China, I have to tell you, I brought one book with me because all of the other books that I wanted to bring I could get as an ebook.

And so here's the book I brought.

Dr. Cook:: Wow.

Denise: The Shape of the Sky.

I'm trying to redeem myself because when we met at the COVD conference in Toronto, Canada, in April of 2023, I brought my book, When your Child Struggles, and I had you autograph it.

Do you remember that?

Dr. Cook: I do.

Denise: Okay. And it was.

Dr. Cook: It might reduce its value on ebay, you know, my writing in it, but it's okay.

Denise: No, no. And it. And I. And I followed Melissa Daniels having you autograph her book The Shape of the Sky, and I could tell it was such a letdown that I hadn't brought the correct book.

And I was kind of embarrassed. I was like, oh, I should have really had The Shape of the Sky and had that one be the one that you autographed.

So that's why I'm redeeming myself now, because this is the book I have with me. Okay.

So the. The reason, though, that that book was so important to me was because it's the reason that my daughter got vision therapy.

Dr. Cook: Wow.

Denise: Yeah.

I don't know if I told you that or if that was even evident.

You were busy signing a bunch of books and talking to a bunch of people. And so that might not have been even what I said, but it's kind of a big deal to me.

And so having you today on my podcast really means a lot.

Dr. Cook: That's great.

Denise: When you first printed that book in 1992, that was over 30 years ago. What's the difference in the current edition versus what it looked like back then? I'm just curious.

Dr. Cook: The current edition. The main difference is we've updated the references.

The studies that have been done about vision therapy since the original book came out. There are some very good studies. In 2008, studies were done on what's called convergence insufficiency, which is just a difficulty using the two eyes together.

And the studies compared looking at a pencil up close, looking at a computer screen, or doing in office vision therapy, where you actually ask people questions and get them exploring and get them looking at what's going on.

And the in-office vision therapy success rates were over 70% compared to 40% with the pencil and 30 some percent with looking at a computer screen.

So it showed that working with people when the study was controlled actually made a big difference in how they did.

So those new studies were just in the appendix of the newer edition. That's about the only difference though.

And I mentioned convergence insufficiency by name, rather just focusing on it.

Denise: Okay. Because it didn't have that designation back then. Correct.

Dr. Cook: It wasn't that popular as it is now. You find it all over the Internet at this point and, and they do have very detailed studies about working with people.

Denise: Yeah. I've. I may have mentioned previously in my podcast, I'm not sure. Not that everyone's listened to every episode anyway, but my son actually has convergence insufficiency and we didn't find out until he was about 16 and at that point he had pretty much given up on school.

Dr. Cook: Yes.

Denise: And it was really difficult for him to even want to do Vision Therapy.

Dr. Davies said it was the worst, probably as, as bad of a case of that as he had ever seen.

Dr. Cook: Wow.

Denise: Yeah. And he still hasn't overcome it. And I told him, you know, it's not too late to go back and do it. You know, he's 29, so he, he hasn't chosen to do that yet, but I'm hopeful that at some point he will.

Yeah.

Dr. Cook: You do get those changes as, as people go on. They, you have people who are very bright, the same people that you love seeing when you go to have your car worked on or any type of work done pretty much in your house anywhere.

There are people that you gravitate to. You say, now this is somebody that knows it all.

And many of those people did have problems comfortably using their eyes for reading. And so they stayed away from say, white collar type things and.

But they're everybody as intelligent as anyone else when it comes to just living life, understanding things, working through things and they always feel a little stupid, actually, just because they know they had a lot of trouble reading and the person next to them didn't.

And so. So that's a shame because they are every bit as bright as any of those other people who had an easier time reading.

But when you read and the print blurs in and out, what can you do?

The print doubles up, you lose comprehension rapidly. You have to reread things.

All of that makes reading so hard that it's hardly an open book playing field or a level playing field.

Denise: Well, he. He can figure out how to do anything he desires to figure out how to do. You know, you bet you chooses different ways to. To learn it. You know, you go on a YouTube tutorial or, you bet, you know, he can.

He can get through whatever it is he really wants to do. He just didn't want to get through whatever they were asking him to do at school. Yeah.

And that just. It always made me sad that, you know, that's kind of what happened.

Dr. Cook: Yeah. Well, we never know. It could be that his life will be better this way. We just don't know. But it is nice to have the option, and that's what we're after.

We would like people to have the options to go either way, and which way they go is special to them.

And so I don't worry about that. I just would like them to have that option where they don't push reading all the way out of their life. And I've had people.

I had a gentleman in his 20s, years ago. He came in, we worked with him. He went back and got his training that he needed. A few years later we saw his child and now we're seeing nieces and nephews many, many years later.

So everybody's different.

Denise: Yeah, well, he's definitely been exposed to all the options, so we'll see what he does with that.

I noticed in the third edition that you endorsed Sue Berry's book and you included mention of your book the Shape of the sky as well. And so I'm glad that you pointed out that the studies are in there because I'm going to look closer at those.

And I wanted to let my listeners know that the reason that I even have that third edition is because I contacted your office because the website said I could get an ebook for free.

And so that was sent to me and I was able to review the book because obviously I left it in Utah instead of bringing it to China.

And it was nice to be able to just review all of those different things that the book teaches.

I've actually been reviewing both books and I remember in. I don't know which one, but one of the books says that something like 20% of the population have an eye condition that can be helped with vision therapy.

Is that okay? Am I right?

Dr. Cook: Yeah. And we've spoken about this. It's like anybody could be helped to do better on their seeing. It's not limited to a percentage.

Somebody had to see for longer periods of time or see more quickly or get the information and effortlessly so they can really think about it.

Driving at night. Many different things could be helped.  20% are people that kind of fall outside the normal range where. And they don't have normal visual skills. And so with those are the ones we're talking about there. And in truth, nobody comes to us because they have a broken convergence insufficiency or some little eye problem. They come to us because homework that should take 20 minutes drags on for three hours and ends up with a child crying. Mom is oftentimes upset. Dad comes home and gets right in the middle of it. The other children are ignored because all the time it's going into the child that takes so much time on the homework.

So the whole family is disrupted. And that's why people come in to see us. They could care less about their diagnosis for the most part, but they very much care about their life is disrupted and they want to see that change.

Denise: Right. I wanted to tell my listeners the part of the book that was the key thing for me, realizing that my daughter needed vision therapy. And I think it's the people that think they know the most sometimes that are even more likely to miss it, that people that know about or think they know about vision are likely to not see those certain things.

Dr. Cook: Twenty years ago, that was very, very true.

The people who were the best educated about vision were the least likely to find these problems because there was only one source of information.

Denise: Yeah.

Dr. Cook: That source of information was filtered through surgeons who weren't too excited about the concept of vision therapy.

And so that the people who had researched things the most had looked in the surgical literature.

When the Internet opened up for people where they could actually put in their diagnosis and find out what other people were saying and find that there is literature in various different professions, not just one profession.

Then we now have people come in who have read a lot of information before they ever get to us. But 20 years ago, the best-read people were the ones who were least likely to help their children. And it was kind of ironic.

Denise: Well, my experience was that I took my daughter to the regular optometrist and I was already in vision therapy or I'd already found out about vision therapy. I don't think I was in it yet. And I said, can you tell me if my daughter is okay? And she, was mini me. I mean, she had glasses when she was And he looked at her and he goes, oh, she's fine. And he professed to know about vision therapy even.

And so I thought, well, I have to concentrate on me because I have the really bad eye turn, you know. And when I took her to Dr. Davies, it was because I had read your book and I had asked her that question about when you put your hands up and you move your fingers and you say, do the words ever do this?

You know, and she told me that the words did do that, that they, you know, they were going double.

And I had no idea before that that she was actually seeing double, even though I was in vision therapy.

Dr. Cook: Yes, you never do. And if you ask the question, do you see double? The child has no idea what you're talking about. One of the things on our seeing, I don't know really how you see.

I just imagine that you see like I do. That's pretty much true of all our perceptions. We never really know what somebody else.

One person might say their pain level is a 5 out of 10, and another person might say the same thing. And yet they might have very different perceptions of pain.

We would never know. And so you ask questions and you can't actually know exactly how they're seeing. So you have to put the pieces together. We might put an instrument in front of the child and compare how that child performs through the instrument compared to other people.

And if we see that performance is way, way off. And the child says, when I read the words do this, all the pieces fit together. And we feel very confident about that one.

Denise: Well, and I have a whole family of people that have, you know, vision issues like me don't see in 3D. And yeah, and they, they didn't struggle in school. You know, my, my siblings didn't really struggle in school. I didn't struggle in school. They have advanced degrees. My, my one brother played college basketball, you know, and I'm thinking, okay, accommodated really well for this problem.

And maybe other people aren't accommodating as well.

Dr. Cook: And you say that you don't have good three dimensional vision.

Denise: None of my only, only one of my siblings actually can see in 3D.

Dr. Cook: Okay.

Denise: Yeah.

Dr. Cook: So if you had, say a patient has an eye that turns in a little bit, maybe not visibly, but both eyes don't point in the same place at the same time.

You can learn how to get that eye out of the way and essentially act like a one- eyed person. Well, the one-eyed person may not have any trouble at all using their eyes for extensive reading and so forth because they don't have to fight to make their eyes work together.

If you have a child whose eyes kind of work together but not very well, they're the ones that have the double vision, they're the ones who see the print blurring and the ones who can't stick with it.

The person whose eyes tend to want to turn either in or out may not have those types of problems at all.

But driving at night won't be as much fun as it's. your three dimensional vision becomes very important at night when you're driving because all the one eyed ways of knowing where things are kind of disappear when the illumination is dim. And so it becomes much more important to have two eyes working together for depth perception on that. I'll leave you there.

Denise: Yeah, no, that makes sense. Now I'm starting to worry about my brother that rides motorcycles. I'm thinking you better not be riding it at night. He told me he wasn't going to come in for vision therapy until he had a problem.

Dr. Cook: There you go.

Denise: And I guess the problem hasn't surfaced yet.

Dr. Cook: Let's hope he never has a problem.

Denise: Yeah, I'm not wishing problems on him.

Dr. Cook: Yeah, yeah, it would be better that he, he never had a problem.

And, but that's again it goes back to people see us because they have goals in life that they're not able to achieve.

Denise: Right.

Dr. Cook: And, or they're putting an awful lot of work into it. I've had people who have had a lot of difficulty reading who've gotten straight A's in college.

And I had a lady once and she said she was a seventh grade teacher and before she would read to her class she would have to go home and practice because she'd be stumbling around when she was reading.

And this was a straight A student in college but she couldn't read smoothly because her eyes would jump and stutter across the page.

And we had worked with her and that all came true to where her eyes were working. And she went back and got her masters which she had put off because she knew she couldn't do all that reading.

But again she had a goal. We worked with her daughter later on and had it set up so she never ran into those problems.

But it's quite gratifying. I've been doing this for 45 years and have no intention of retiring because I really enjoy what we do and we love seeing people's lives change.

Denise: Yeah, it's amazing. How often do you see kids come in that have been diagnosed with add, adhd, dyslexia, or, you know, they're in special ed or whatever and they maybe have been misdiagnosed or it's just, you know, the vision problem has been missed.

Dr. Cook: Yeah, there's two ways to look at that. One way is that in what was once called the learning disability disabled population, about 90% have vision problems that add to whatever else is going on and those vision problems get in the way a whole lot more.

If I, let's say I have, I'm not a natural reader. If you want to call that dyslexia, fine. But if you just wanted to say, for some reason I have to work harder than other people to read now, if I have a vision problem with that, it's magnified.

If I'm a natural reader, one of those kids that reads at age 4, they just start reading. You don't even have to teach them. They figure it out.

A child like that with a vision problem will go on and be a reader. They may not read for a long period of time, they may get away from it quickly, but they won't have any trouble reading.

So that's one way to look at it, that the vision problems of people who have learning disability are magnified. They get in the way much, much more for that group than for the group who are natural learners, natural two-dimensional learners.

They look at a page of print and they have a, an effortless time with that.

So their vision problems are not going to affect them. Now, you do have other people that would come in and they've been told they have attention problems.

So you want to find out what's going on. If you have a child, you can read to them and you can read to, they'll sit there for half an hour at a time and listen to every word you say and understand what you're talking or what you're reading to them and maybe ask questions about it, but they're really with you.

That child doesn't have an attention problem. Okay. When it comes to getting in information through his or her ears, that works. When it comes to getting the information in through the eyes now they start to avoid, since it's uncomfortable looking at things, their eyes are wandering around the room a lot.

So they actually watch them during homework. They look a little bit, but then they're constantly looking around the room or trying to talk to you. Doing anything other than look at that page.

That will act exactly like an attention problem. When you do your questionnaires, the questionnaires won't look any different. So that could be a vision problem masquerading as an attention problem. Or you could have somebody with both.

They have an attention problem. And attention problems could be if you had trouble coordinating the parts of your body, for instance, the two sides of your body, you would constantly be moving as you're trying to get your body balanced.

So, if you had been occupational therapy type of problem, it could also masquerade as an attention problem. So, when you get to an attention problem, you pretty much ruled out all those other types of things, the food allergies, the general coordination problems, the vision problems.

And despite having none of those problems, they still have a lot of trouble with attention. To me, I would look at, well, there's definitely something there that we're not finding on all these other areas.

Um, and so as far as the. The vision masquerading at it, it does. Just like I said, if you have the child who listens very well, pays attention when they're listening, when they use their eyes, they just can't pay attention at all.

Writing, reading, there's a lot of avoidance, then you would be suspecting that the vision may be the. The primary source of the problem.

And then I use that word vision. And of course, I'm not talking about reading tiny letters on a chart 20 ft away, which we would call 2020 Vision. Being able to see tiny things.

I'm talking about being able to look with both eyes and not see double or look with both eyes and not have things blur in and out. Or look with both eyes and know where things are.

Denise: Exactly.

Dr. Cook: And not have to work to get the information in. Those are more visual problems of the type we're talking about, but we're not talking about. Just can't read the chart.

Now, if you can't read the chart and you're trying to do board work, you're in big trouble. Of course, now that so much of the work is done on a tablet, if you are a little nearsighted, you may be in good shape for that tablet, even though you can't see across the room. Times change.

Denise: Yeah, that's true. Well, and you said that people are more likely to find vision therapy now, which I agree, but I'm still seeing a disconnect. When I go on those vision support groups, you know, the strabismus support groups on Facebook and stuff there, there's still seeming to be way more talk about surgery than there is about vision therapy.

And, you know, I'm one of those people that goes in and says, well, have you considered vision therapy before you go under the knife? And it still seems to be so prevalent.

Dr. Cook: Well, I just looked at the American Academy of Ophthalmology website, and I think they quoted something like 1.2 million procedures per year, which seems high to me, but that's what the website said.

And so when it comes to eyes that turn, you're much more likely to hear about surgery.

And some of those surgeries are very, very successful for what they, they do. I mean, I saw a child not too long ago, had had surgery as a baby, and the eyes are all but perfectly aligned, not quite, but just about.

And depth perception is a little off, but still, that was a very good surgical result.

The surgeon did a great job. And I'm not against surgery per se, but I mean, we just did a series, it'll be published, I believe, in next month, where we worked with 75 school age children and adults who had eyes that turn in.

And of them, about 85% showed improvements in both aligning their eyes and in their depth perception.

So in that older group, there's just no doubt that they can have improved depth perception. They can function better in many cases, not have to worry about how their eyes look, because that's a big concern.

If, if a person is worrying about, what are people thinking about my eyes?

Are people treating me differently because my eyes don't work?

When I go for a job interview, am I not getting the job because of the way my eyes work? And so these are like major concerns. And when adults feel the eye not working, they oftentimes will think, oh, my eyes look funny now, which may not be true at all.

It could be that their eyes look great, but they can feel that it's not working, and so they'll feel that. And so it's for that group of people who have eyes that drift, there's oftentimes more help than they know is available.

Denise: Let me just make sure I understand what you said. So you, was it like a study that you did with these five people? And so we can, you know, quote it as a study that this is what this was found when you did vision therapy alone with them, Is that right?

Dr. Cook: Okay. Some of them had had surgery when they were younger.

Denise: Okay.

Dr. Cook: Oftentimes we'll see adults who, they had surgery and their eyes were cosmetically aligned. And then as they get older, the eyes want to deviate again. And perhaps they weren't too excited about the surgery the first time and didn't want to do a surgery again. And so looking for an alternative, I'm not interested so much in arguing which is better.

I prefer to tell patients what we can do for them rather than, I would say, if you have questions about surgery, go to see a surgeon and ask the surgeon.

Surgeon does that all day. They ask them. But as far as what we could do for you is we could improve your depth perception. We could get your eyes so that they would look like anybody else's eyes, so that nobody would notice that your eyes aren't working.

And personally, like with the shape of the sky, it's all about seeing in three dimensions. And I think that's all very exciting. And the patients that we work with who had trouble driving because of depth perception problems are typically very excited also when they're getting the better depth perception.

Denise: So when they don't get the results they want, are you suggesting that they go talk to a surgeon? And working with the surgeon, maybe, like with my situation, Dr. Davies finally said, maybe you need to do the surgery.

Right. Do you ever do that with any of these people?

Dr. Cook: Sure, I always. And I give them when I'm talking to patients. If surgery is one option, I will say that could be an option. There are people. A combination of surgery and vision therapy can be helpful.

There are vision therapists who are vehemently against surgery and have nothing good to say about it. And there are surgeons who are vehemently against vision therapy and have nothing good to say about it.

So we take each patient as they come and see what combination of things. In my thinking, vision therapy is going be part of their treatment. In most cases, surgery may be part, it may not.

Denise: You have a certain doctor you work with that you will refer to, or is that not. . .

Dr. Cook: Yes. I have somebody I know from the past who's done excellent, excellent work. Surgery is an art.

Denise: Oh, yeah.

Dr. Cook: And vision therapy is an art. It's kind of like vision therapy. We have dozens of different theories about why we do vision therapy. We have hundreds of different procedures.

So each practitioner draws from that wealth of information to develop things that work for them. And that is the art of vision therapy has having tools. And I think it's better if you have more tools to draw from.

And the surgeons are the same in that some of them are just brilliant at what they do, others less so. So if a surgery is good, it typically is not going to cause problems.

It could. They never know 100% what's going to happen after the surgery. But certain surgeons cause certain problems during their surgeries and others don't. Others are very good.

Denise: Yeah, Surgery is definitely a tricky subject. And I was grateful that that's what ended up working for me, you know, because I did so many years of vision therapy with pretty much no results.

And then once my eyes were aligned, I could do all the exercises that I couldn't do before, you know, and I beat myself up for a long time thinking I should have been able to just relax my eyes, do all the natural things.

And I had to just finally accept the fact that that was my path, you know, and be grateful that I can see in 3D.

Dr. Cook: Well, that is one of those. Let's say you've had, I don't know, let's say you've had two or three surgeries and your eyes are not straight and you do vision therapy and now your eyes are straight.

You might say that, oh, the vision therapy was successful and the surgeries were not. That's not true.

Your treatment was a combination of those surgeries and the vision therapy. The same thing is true for what you just described.

You did vision therapy to get your mind. So it wasn't trying to not have the eyes point in the same direction so that your eyes could probably up close, work together, like in here, but it didn't extend outward.

Then you did the surgery. It extended your eyes outward to where they would work over a large range. So your treatment actually included both the therapy and the surgery, and the two of them together gave you the results you gave.

Even if I see a child who had two or three surgeries when they were very young, and now we're seeing them as teenagers or adults, their treatment includes everything that was done.

And I think that's an important, important way to look at it. It's a combination of all you had, and so you didn't really waste your time.

But it sounds like you had a lot of frustration.

Denise: I didn't feel like I was wasting my time at all.

Dr. Cook: Yeah. But those are all tools. I look at surgery, it's a tool for somebody whose eyes don't point in the same direction.

That's one of the tools available for them. Vision therapy is a tool that's available for them, and it's not a contest to see who can straighten the eyes. It's a person and the person would like to have confidence that their eyes look good and that they're able to see in three dimensions.

And so that's the goal is for the patient himself to feel good about things.

Denise: Yes. I have all of these different dialogues going on in my mind about people who, I've read their stories online and thinking, okay, well what, who should I ask about next?

You know? But one of the things that I've noticed is that there's some frustration for parents of young children, say birth through four. They're kind of young for vision therapy. Maybe a four year old's been in vision therapy for a year even and it's really challenging. What kind of advice do you give to that parent?

Dr. Cook: Okay, on the study I just said it was children ages 5 through adults. We had some in their 40s and 50s. And so that type of vision therapy is one thing. And in our office, we have pushed more in that direction.

My experience working with younger children, occasionally you'll see fairly quick results. There are younger children who glasses alone will fairly much straighten their eyes.

And there are children whose eyes are straight part of the time and turn part of the time. On those type of children, they're a lot easier to work with. If you had a child whose eyes are turned 100% of the time, that is going to be more difficult.

And I should say it'd be more difficult for me. It might not be more difficult for, oh, I don't know, Dr. Kurt Backstrom in the Washington area. He seems to enjoy working with infantile strabismus is what they call it. But kids whose, whose eyes turn probably by age six months.

Denise: Right, okay.

Dr. Cook: And. But there are many different types of it. And so if it were my child, I would prefer that they had straighter eyes and how they're going to do that. If I could do that without surgery, I would prefer that. That's my prejudice, being trained as a vision therapist. But it's also, I just think it makes sense that if you could avoid a surgery, that would be good.

But if I wasn't seeing fairly rapid progress on it was my child, I might consider a surgery. And I think there are vision therapists that think that would be just terrible to do that.

And I'm fine as long as the eyes are getting straightened and the child's developing as you'd like to see them develop.

Denise: I know some people say, oh, I've talked to this doctor and they don't want to see me in vision therapy until my child Is five. What can I do before that? You know?

Dr. Cook: Yeah, well, there are things that we do. And the other thing is, if we're talking about an eye that turns in towards the nose or an eye that turns outward, if we had an eye that turns outward towards the ear and the eye is straight part of the time and turns part of the time, there's no surgical reason why that has to be handled right.

Then there were surgeons who were trained, since if you overcorrect an eye that turns out to where it turns in and then you lost that patient, the patient could lose vision in the turned eye and could lose their ability to have depth perception.

Some surgeons have been trained to do that surgery a little later. Okay, so I'm on that. If it were my child, unless the child was doing a lot of dating at that point and they were concerned about the way their eye looked, I wouldn't be in a big hurry to do surgery on that just so the child would look better on their Facebook dating profile.

On eyes that turn in, you would like them to be working somewhere. So, if they were working here, the brain is still learning to use them together. If they're not working together anyway, that isn't that helpful. So again, it goes back to every child is different.

It's interesting. You say, what would the parent do? And that's just it. As a parent, you are the only one who's going to care about your children 20 years from now. No doctor that you see is going to care about your children 20 years from now.

So parents are the ones that are in that hard position where they have to decide how can they do the best for their child. And I don't know if being bullied is the best way to do that, where you're forced into doing things that don't feel good to you as a parent because you're the one that has to live with the consequences.

But certainly you do want to do the best job. And you can get opinions. When you get more than one opinion, though, and you decide which way to go, you're the one making the decision. It wasn't the person giving you the opinion that made the decision. So it makes it hard. And so if you're doing something and it doesn't seem to be working, whatever it is, you kind of wonder about this.

The same way with surgery. If you do this surgery and the eyes flip back in, you do the surgery and the eyes turn outward. Now you start wondering, is this going to be the best way?

Because there are children and adults who do not like both eyes to point in the same spot at the same time. It's like one adult I worked with, we put him on a procedure where he had to use both eyes together.

And he says, this is just what my eyes felt like after the surgery. And he'd had a surgery and his eyes hadn't turned back in, so he wasn't able to coordinate his two eyes together.

And so, I mean, it's. It's just not necessarily simple, and it's not a one approach fits all type of thing. And in my thinking.

And then if you have a doctor who has worked with many, many, many young children and has had a high success rate, well, you know, I would definitely listen to that doctor.

And you should be seeing us. Things improve on that. You know, the eyes should be straightening as you go along. But there's not a straightforward. This is always going to be the answer. At least I don't, so.

Denise: Well, if there was, you would know by now. Right?  After how many years you've been doing.

Dr. Cook: This, all I can talk about are my own limitations and what I've been the most successful with. And I have had children of all ages who have shown improvements, and I have had children we've worked with, and they've had ended up having surgery, and the surgery has been useful for him.

And I have children. I see and none of my suggestions are followed, and I feel that's a parent's right. But I feel they should also then find another doctor to go ahead and work with them that they feel comfortable with, and that's okay.

Denise: Sure.  So, I wanted to talk about The Shape of the Sky today, too, and we've used a lot of your time already, so I'm feeling a little bit sad that we haven't talked about this book yet.

Do we want to do that as a separate podcast or how. What do you think we can talk.

Speaker B: About The Shape of the Sky? It's just we select a large area to see or a small area to see when you read.

If. Let's say if we looked at this page of print, okay. And I were to ask you, is that clear? And you would look at the page and you'd say, yeah, it's clear. And I say, is it all clear? And you'd say, yes. Yeah, it's all clear. I see it fine.

If I had you hold your fixation, hold your eyes on one word at the top of the page, you couldn't see the other words.

Denise: Right.

Dr. Cook: You would.

I can't see them now. Okay. But actually, you wouldn't say that. You would move your eyes and look at the other words, and I'd say, no, let's look at this word. And you would find that you can only see a certain amount at a time for small things like reading.

Denise: Okay.

Dr. Cook: Seeing the world, like driving is quite a bit different in that instead of selecting a small area to see and then selecting another small area to see and another small area and another small area, and adding those all together in your mind where you feel like you saw them all at once, but you didn't, that's quite different than opening up and seeing a large area all at once.

Denise: Okay.

Dr. Cook: You can't see the freckles on a bug's ear doing things that way, but you could see the sofa in your room and the table in your room and. And the walls of your room all at once.

Denise: Right.

Dr. Cook: When you open up and see that way, it improves your depth perception. Okay.

Denise: So right now, it relaxes my eyes, too. They kind of just don't feel that tension that they feel when I'm looking at something small. Like this computer screen.

Dr. Cook: Exactly. Now, if somebody is watching this podcast, they're probably looking at our faces on the screen.

Denise: I don't ever put the visual out. I only do the audio.

Dr. Cook: Well, then you're okay. But if you were looking at a screen, if you opened up and saw the difference and distance between yourself and the screen, if you were aware of how much space there is between that screen and opened up and saw that the computer had a position in the room and it was a dozen inches in front of the wall and that the screen was a couple of feet from you and you were aware of all that space at once, you would be more aware of the position of the computer screen in the room than if your attention were on somebody's eye.

Denise: Or if I'm trying to read my notes.

Dr. Cook: Yes. And I've had patients ask me questions like which eye should I look at when I'm speaking to somebody? Which means they're selecting a very small area to look at, or they're not seeing both eyes at the same time.

They look at one eye in detail and then the other eye in detail, as opposed to opening it up and seeing the person's whole face in front of them. And they're not counting eyelashes when they do that.

Denise: Right. I think that that's an interesting concept, though, because I've heard people say that they've talked to someone like. Someone like me that has strabismus and their eyes are wonky. Someone Says I don't know which eye to look at because I don't know which way you're looking at me.

It's really the person who's looking at them that also has a problem with vision if they're worried about which eye.

Dr. Cook: To look at somewhat. But I mean that's just if you have two eyes and they don't do what you expect them to do, what the way we see is, we, we see things that don't belong.

When you are thriving as long as everything belongs like it should, you're driving along fairly effortlessly. If all of a sudden there's a child on a tricycle that's on the shoulder of the road that does not belong there.

So right away you're slowing your car because you saw something that didn't belong. It's like that is what you see, and you say, whoops, this could be terrible, I better get that car stopped.

Because we don't know what that child's going to do.

Okay, the child didn't belong there. So, if somebody looks and sees an eye that's turned, it doesn't belong. And so it pulls their attention on that eye.

And when the eyes are, if you have an eye turned to the side, somebody doesn't know if you're looking over there or if you're looking at them. And so they think maybe somebody's behind me.

And so they will turn and look over their shoulder, which is as devastating if it's happening to you as the person with the turned eye.

On the other hand, I was just looking at a number of sports figures. Tom Bradley has an eye that turns out. Wilt Chamberlain, who was a seven foot tall famous basketball player had an eye that turned out.

Jackie Robinson, the famous baseball player had an eye that turned out. Marilyn Monroe's eye turned out. From time to time we got pictures of that.

Hedy Lamar, Rita Hayworth, famous actresses from the 1940s and 50s, they had eyes that turned. So the fact that your eyes turn doesn't necessarily affect others like you might imagine. Oftentimes the person who has the eye that turns is more aware of it than someone else might be.

So I say that because I don't want people all that self conscious and upset by things that sometimes don't have to be. And then there are some that have very noticeably turned eyes and I wasn't one of them. So I wouldn't know exactly what that feels like.

Denise: Well, yeah, and I definitely know what that feels like. So yeah. Yes, it can be devastating.

Dr. Cook: Yes, it can. Yeah. But in the shape of the sky. In the book, we talk about seeing bigger areas. And if you had an eye that turned, for instance, and you were using your central vision, look at this detail. Look at that detail. That makes it much harder to use your eyes together.

And if you open up and see a bigger area at once, that kind of allows both eyes to point in the same direction.

And you can learn to do that at the same time. You're seeing small.

So a good example would be if you looked up and saw a tree or a couple of trees. If you opened up and saw both trees at the same time, you would all of a sudden see if there were clouds in the sky.

You would see those clouds kind of spring away from you. In other words, if you opened up and saw a bigger area, you would also see the clouds go further away.

You would have better two eye depth perception. That's true of all of us.

If we open up and see a larger area, we're more aware things. So the shape of the sky actually comes from that idea.

The trees help give the sky its shape.

You could have a building giving the sky its shape. If you open up and see a big area now, the clouds appear further away than the building. So as you see the shape of the sky as you open up now, that doesn't mean you're looking at one spot and then another and another, just like you're reading a book.

It means you actually are seeing a bigger area, which means absolutely nothing to somebody who hasn't done it. Yeah.

If you were to talk to a group of doctors, most of whom are seeing one little part at a time, they would have no idea what you're talking about on that.

It's just. But if you have seen both ways, then you can understand what that is.

Denise: When I got the book and I started reading it, you have a little warning in the beginning. I have to admit that I kind of was put off by it a little bit. And I was like, oh, maybe I have no business doing this by myself. The warning says, welcome to this instruction manual for doing vision.

Those who have successfully used an instruction manual to build a house, construct a nuclear weapon, or build a time machine should be able to make do with this manual. For the rest of us, professional care is advised.

That's. And that's when I went, oh, no.

Dr. Cook: Essentially, to equate doing something you've read in a book with actually having somebody help you would be hard. Okay.

Denise: Yeah. And I bought it after. So, I had already done the professional help part, you know, and. But I was still kind of worried about what am I. What am I doing?

You know, and. And so then when I finally just went to your website and I pulled up all of the images from chapter 6 and I. I tried them all and I went, oh, I'm just confirming that I did learn how to see in 3D. And I can do all these exercises. This is awesome.

Dr. Cook: Yeah. I always suggest people contact us and get digital images. I'm not sure if the Optometric Extension Program has digital images available on their website. They may. It'd be something you could call them about.

But the images in the actual book, which are red and blue on a black background, are nearly as good as if you get them digitally and then you can really see the three dimensions. But those you either see three dimensions or you don't. And if you do, it certainly is only beneficial. And if you don't, it's certainly not going to bother your eyes.

Denise: Good to know. I have another question about that too, because I also played around with putting this. The glasses the opposite direction. Right. So. So that the image would go in and then it would pop out based on which way I was using the glasses. And then I went to a place where there was a ceiling that was vaulted that had a design on it. The way the ceiling was made, it was possible to. do that same technique. And so I saw the ceiling that was vaulted come down. Is that, Is that like a weird thing? That's just me, or can anybody that's trained their eyes that way do that?

Speaker B: Anybody who's weird like you can do it.

No, I'm sorry. Okay. You could look at a corner, and if you were very good at seeing is something we do.

And if you're very good at manipulating how you do that thing, you could look at a corner and see it come towards you instead of away from you.

That would be. That would be very difficult.

Denise: That sounds extreme.

Dr. Cook: Yes, it would be extreme. And it wouldn't be very useful.

Denise: No.

Dr. Cook: So I really don't know for sure what you were seeing on the vaulted ceiling, but certainly you were doing it.

And you've done some therapy in the past so that you are more familiar how to vary your seeing than somebody else would be anyway. So it's hard to say how much of that was your past work, but as far as seeing those 3D images, those are in chapter six. And if you can see, those would be great for anyone in some of the earlier chapters, Chapter four, I think they have to do with seeing things when Your eyes are out of alignment and are useful for somebody who has crossed eyes or somebody.

They're better off not to practice using their eyes together when they're in the wrong position.

Denise: Okay.

Dr. Cook: The only way you can see the three-dimensional targets is put your eyes in the correct position and then you see the 3D. So, there's never a problem with straightening your eyes. There can be a problem in learning to use your eyes together when they're not straight.

Denise: Okay.

Dr. Cook: And that's what causes double vision and those types of things. So that's kind of what I was talking about. I think I mentioned it again in chapter four about. Don't do this chapter if you're, you know that your eyes don't work together.

But chapter six, it's just a three-dimensional chapter. Three dimensional images. If you get them, it just means you've had your eyes are better aligned at that moment and it's a. So it's a positive thing.

Denise: Yeah, well, I figured I've done the work, I should be able to do chapter six. Right. So, yeah, so that, that was exciting though for me to just confirm it and say, oh, it's not as scary of a book as I thought. Yeah, it warning the beginning, it could.

Dr. Cook: Be a lot scarier. But it doesn't have my picture in it, so it's okay.

Denise: Oh, I think that it should have your picture in it, doesn't it really? Wait a second. It's an old picture of you.

Dr. Cook: Oh my gosh, that's good. My face was still held together by all the dye in my beard at that time, you know.

Denise: Oh, well, I probably need to let you go because we're running out of time from what I promised you and you have things to do today.

I didn't know if you had one last bit of advice you wanted to give to my listeners before I let you go.

Dr. Cook: Well, vision is something that we do and we can always learn to do it even better than we're already doing it. And so there is. Anybody could see better, but it's typically people that have a reason to see better that do something. So, in sports, for instance, sports figures typically have vision that's much, much better than most people.

And even they can have their vision enhanced to where they can do even better. So you're taking people who are already at the top of the stack and you're making them even better. So that'd be one thing. But the thing that I hate to say is if you have a child who is just struggling for a reason, they don't have to struggle and that's really like when your child struggles was the name of the one book and that can truly be life changing for a child who isn't able to learn because of jumbled images so that they can learn that is something we don't want to miss.

Denise: And I think that I caught it with my daughter at the right time because she told me she was she liked to read in bed because then she could cover one eye while she was reading and then turn over and cover the other eye and she was 10.

So, I think everything would have just gotten harder if we hadn't addressed it when we did.

Dr. Cook: Yeah. And that's a perfect time anyway. That's when they're starting to read a lot.

Denise: Yeah, it worked great. Well thank you for all of your great tips today and hopefully we can do this again.

Dr. Cook: Okay. It's great to spend some time with you Denise.

Denise: Thank you.