PLATO Spectacles and Aristotelian Logic

One of my favorite off-beat magazines is Mental Floss, with its irreverent style almost bordering on the flippant, yet managing to inject just the right amount of facts.  They earn their tag line, which is:  Where Knowledge Junkies Get Their Fix.   Take for example posing the question about the difference between Socrates vs. Plato vs. Aristotle.  The dilemma, they suggest, is that there has to be more to the popular notion that once you’ve seen one smart old Greek guy in a bedsheet, you’ve seen ’em all.

The same holds true for amblyopia, a term with the Greek derivation of  “amblys” meaning dull or dim, and “ops” meaning eye.  This gives rise to the poorly termed vernacular of amblyopia as “lazy eye”.  Perhaps one day Mental Floss will do some investigative reporting about why we’re politically correct about abandoning judgmental terms for mental and physical disabilities – we speak now largely in terms of impairment.  Yet the term “lazy eye” remains prominent in popular culture even as much as it is misunderstood and misapplied.

The PLATO I’m referring to here isn’t the philosopher himself, but a pair of spectacles that trades on his name for the acronym representing Portable Liquid-Crystal Apparatus for Tachistoscopic Occlusion.  Wow, that’s a mouthful.  PLATO was an intriguing idea based on getting kids to wear these dorky glasses so at timed intervals there could be a passive form of vision therapy delivered by occluding the better eye through its liquid crystal shutters.  Suffice it to say the idea has never taken off as a clinical tool, though the thought remains intriguing.  Its Canadian developers have largely persisted with the PLATO visual occlusion spex as a research tool.

It was in this vein that optometric researchers from Australia and England teaming with Moorfields Eye Hospital in the UK used PLATO spectacles to study eye-hand coordination skills in children with and without amblyopia. Although the full article is copyrighted and requires a subscription or fee service, you can read an abstract here.  The study highlights something important:  that developmental deficits in binocular reaching and grasping abilities in amblyopia initially generalize to the non-amblyopic eye as well, with performance  showing adaptations later in life.

Now here’s the part that really rocks, and I’m going to quote it for you verbatim since it’s pretty powerful:  “This generalization to the dominant eye is perhaps our most unanticipated finding. It is also of considerable clinical relevance, since most strabismic and many anisometropic amblyopes rely mainly on the fellow eye in everyday living, as vision in the amblyopic eye is completely or partially suppressed. The impaired dominant eye performance, relative to control subjects, of children with either type of amblyopia thus implies that they will be notably disadvantaged in habitual daily activities requiring close coordination between the eye(s) and hand.  Evidence further implies that abnormal binocularity may affect their educational attainment, as reading speeds with both eyes open are significantly slower than normal in children who have microstrabismus with reduced SA.  Indeed, recent evidence indicates that this problem may be worse in adults with strabismus lacking measurable stereopsis and that, in these cases, the reading impairment affects the fixing eye as well and is associated with abnormalities in its movement, manifest by longer fixations and more backward (regressive) saccades between successive text characters.”

Aristotle departed from the line of thought employed by his predecessors, Plato and Socrates, relying more on sensory input as a source of knowledge.  His logic proved to be the gateway to what is now accepted as scientific method, though the technology of his time did not lend itself to precise experimentation.  The PLATO spectacles used in this study add further evidence to the emerging picture of amblyopia and strabismus as visual conditions that compromise visual functions well beyond eyesight and stereoscopic vision resulting in many adaptations and tradeoffs over time.  It should come as no surprise therefore that therapeutic and rehabilitative programs must do more than patch an eye or cut a muscle here and there to reposition an individual for optimal success.

– Leonard J. Press, O.D., FCOVD, FAAO

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