Hillary Clinton’s Double Vision


This isn’t a political statement.  Nor is it a tribute to the band, Foreigner.

It is a statement regarding awareness of one of the more common sequelae of Acquired Brain Injury: double vision.  Here is a very famous individual, on a very public stage, thrust deeper into the public eye because of her binocular vision problems after closed head injury.

clinton-fresnel-prism-glasses-620x446

The vertical lines that you’ll notice on Secretary of State Clinton’s left lens indicates that the lens is a Fresnel Prism, a type of membrane lens that is cut out and applied to the inside surface of a spectacle lens.  The more vertical lines you see, the higher the power of the prism, so the prism Hillary is wearing is pretty powerful.  Her double vision must therefore be of a significant amount without her prism in place.

Hillary AdjustingThe New York Daily News was among the first media outlets to comment on the observation.  Coverage of the story however has been impoverished by the meager discussion about Hillary’s concussion, without a single source that I’ve seen speculating on what caused the double vision, what her treatment has been, and what the outlook for resolution is.  But perhaps you’re thinking along different lines, possibly something like Hillary’s now famous line at the Benghazi hearing where the now famous Fresnel photos were taken:  “Is her double vision due to a brain bleed, or due to the concussion she experienced when she passed out and hit her head in December?  What difference, at this point, does it make?  It is our job to figure out what happened and do everything we can to prevent it from ever happening again.”

Padula Book

There’s been alot of attention drawn to concussions related to sports injuries, and efforts at prevention, but comparatively little attention has been paid to the visual sequelae of passive episodes such as Secretary Clinton experienced.  While I respect anyone’s right to privacy about their own health   issues, this is a golden opportunity for Hillary to both open up about what she is experiencing, as well as broadening awareness of vision rehabilitation for ABI.  OEPF recently published an excellent and timely overview of these issues in a book authored by Padula, Munitz, and Magrun.     The most likely explanation for Hillary’s use of the Fresnel prism in her glasses is double vision due to strabismus.  However, she could have elected to wear her contact lenses together with a more attractive pair of glasses incorporating prism.  Our colleague Dr. Padula coined the term Post Trauma Vision Syndrome, which includes not only binocular vision problems, but a tendency to stare, as well as light sensitivity.  Hillary wore contact lenses prior to this episode, and her reduced blink rate no doubt makes her more comfortable in glasses.  She can be seen in several of the images fiddling with her frames, adjusting them one suspects to obtain best focus, or to lessen her double vision.  In some of the other images she appears to be cupping or shielding her frames at the edge, possibly to reduce glare or disturbance from the periphery of her vision.

So Hillary, if you or one of your team is reading this, please contact a rehabilitative optometrist who has experience with helping patients improve visual function after acquired brain injury.  Much like concussions in sports, this has been an area in which the visual problems experienced by patients are often overlooked.  Through sketchy media reports it sounds like your visual challenges will linger without active optometric guidance and therapy.  Of course, you may already be working with such an individual and if so, we’ll look forward to seeing your progress!

12 thoughts on “Hillary Clinton’s Double Vision

  1. Dear Lenny,

    Thank you for addressing the Hillary controversy, which has ranged from her stylish glasses to her awkward behavior at a news conference. It is ironic that the medical perspective has been limited to the discussion of her concussion and the blood clot in her brain. After the heroic efforts in the hospital, we are led to believe that life has returned to normal for Hillary.

    Patients, who have concussions or traumatic brain injury, suffer significant and lingering visual problems. It is fairly obvious that Hillary has been prescribed Fresnel prisms or vertical line lenses (media’s interpretation) because of a binocular deficit.
    Although this approach may have value, optometric vision therapy would be a more appropriate treatment approach. She should at least have a binocular work-up.

    Hillary’s case is a perfect example of the limitations of our current medical model. We are constantly dealing in the realm of crisis care. Although we maybe able to remove or dissolve a growth or clot, there are significant residual deficits caused by these events. In other words, a patient’s quality of life may be severely compromised. There have been no reported problems in Hillary’s case beyond her initial diagnosis.

    Hopefully, the public will become more aware of the devastating symptoms of concussion/TBI, which can range from double vision, blurred vision, headaches, loss of concentration/attention and headaches. AND more importantly that optometric vision therapy can address many of these visual problems and ultimately improve a patient’s QUALITY OF LIFE. It may not eliminate all of these deficits but it is a better alternative then ignoring the problem or hoping that time heals all of these symptoms.

    Thanks again for bringing Hillary’problem(s) into a concern beyond her new look in eye ware.

    Richard

  2. Perhaps Hillary should check out the latest Wow Vision Therapy video production on Convergence Insufficiency….it might open her eyes a bit! Pun intended.

  3. I note the left lens has quite a lot of minus, therefore decentration of the optical center might have effected the diplopia without the fresnel? Medically speaking the fresnel might have been used with the hope the TBI causing the diplopia might over time resolve itself, with or without VT. Then the fresnel would be pulled off and the left lens saved without change? At any rate it does look like her eyes are straight with the glasses she is wearing. Still we all agree that VT would be nice.

    (POLITICAL COMMENTARY REMOVED)

    August

  4. Thank you Dr. Press. There is so much that Rehabilitative Optometrists can do to help Secretary Clinton, and I truly hope that she is referred to one of us. We help patients like her everyday. Double vision is uncomfortable and can be dangerous due to loss of depth perception and spatial localization. If anyone makes contact with her, please direct her to http://www.nora.cc for more information and to find a Rehabilitative or Neuro Optometrist.

  5. I’m extremely inspired together with your writing skills as smartly as with the layout for your blog. Is that this a paid topic or did you modify it yourself? Anyway stay up the excellent high quality writing, it is uncommon to look a nice blog like this one these days..

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