Orlando Alves da Silva
PDS patient presenting visual symptoms, pain and fatigue
Birth:
Delivery with forceps
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From early age:
Clumsiness and falls resulting in serious injuries
Difficulty going up and down stairs
Diplopia and triplopia during ball games
Dislike of stripes and highly contrasting colours
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Aged 6-7:
Anxiety when asked to read due to:
Headaches and retroocular pain
Text moving/swirling around
Words like spiders walking around or doing a complex dance routine
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Aged 7:
Diagnosed with both Meares Irlen Syndrome and Convergence Insufficiency (CI)
Coloured lenses improve reading speed by 70%
Slight improvement of CI with visual therapy
Reported increased attention span
But *Persistent headaches and abdominal pain*
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From age 8-9:
Misses 30-40% school
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Aged 10:
Emergency appendectomy after 6 weeks of abdominal pain
But *appendix found to be healthy*
Following the appendectomy, experienced long lasting severe migraines both ocular and abdominal
Possible triggers identified include coloured text, computer screens, videos on large screens
Aged 12:
Severe visual stress and ocular migraines lasting several weeks with aura and visual loss
Acute abdominal migraines
Medical tests all negative:
MRI scan; abdominal; psychological
Paediatric team suggested ocular and abdominal migraines could be a consequence of visual stress disorder
Prescribed medication:
Zolmitriptan (migraine) and Ondansetron (nausea) for acute episodes
Pizotifen for migraine prevention
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By July 2019, 7 months of regular abdominal nausea, and fatigue and *1 day of school in 2 months*
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At the time of consultation with professor Orlando Alves da Silva (July 2019):
Presented with a pallid complexion, slumped standing posture with cervical rectification and abdominal protrusion
Limitation of head rotation to the left, and head extension shorter to the left side
Hand eye-test error of localisation of 90mm
Positive test for SDP mixed pure with left predominance
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Prescription
Active prisms RE: 2Δ (125º) LE: 3Δ (55º)
Refraction added to Active Prisms RE: Sph -0.25; Cyl -1.00 (90º) LE: Cyl -0.75 (75º)
Postural reprogramming and proprioceptive insoles
Wearing the test glasses:
Symmetrical head extension and head rotation, achieving rotation of 90º to the left and to the right
Localisation error corrected
Gains colour in her cheeks
Immediately reports feeling much better with less nausea
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Before wearing the Active Prisms:
Her environment would ‘wobble’ and move around
A tree might seem like it was standing up and doing a jig
Walls would bend, curve and move
Words on a page would look like they were doing a complex dance routine
Eyes are hot coals burning in the head (would put cold water on the eyes but it didn’t help)
Objects as ‘blobs’ lacking in clear detail
Objects merge into one and other
Impossible to get to know her surroundings well
Impossible to find her way around her locality (school, the local town) with any confidence
Constant stomach pain that lasted weeks. It felt like there were little people in the tummy scratching at the inside with their fingernails or punching the stomach from the inside
Nausea, it felt as though the tummy was eating itself constantly churning around and twisting in on itself
After wearing the Active Prisms for a few hours:
patient is able to distinguish both forms and detail
e.g. patient describes seeing cars clearly, including the number plates and noticing cars have different logos (Mercedes, Peugeot); flowers, trees with a sense of wonder
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Patient is continuing to “feel great”:
Her sight feels better than it ever has
Enjoys seeing everything around her
Tummy feels better than it ever has
No ill feeling in her gut at all
Says that it is way better than her ‘normal’
Doesn’t remember feeling this good (at the time of posting, 16 July 2019)