UPDATE
I have updated this article, originally published on 4th December 2017, to include information from Prof. Andrew Huberman, Neuroscientist at Stanford University, who is providing information and tools based on the latest high quality science. His episode on the eyes appears to support much of what I originally wrote below.
INFORMATION FROM THE HUBERMAN LAB PODCAST
In the episode Science of Vision, Eye Health and Seeing Better , Dr Huberman discussed how the use of our eyes has critical impacts on the nervous system, metabolism, mood and, particularly relevant to people with Parkinson’s Disease, dopamine production. He suggests several eye exercises that can optimise these aspects of health, which align well with those I covered in the original article below.
Here are his suggestions.
Get ten minutes of sunlight [but not through a window] in the morning before 10 am, and ten minutes in the late afternoon. This is critical for circadian rhythm and hence restorative sleep. I, and other people I know, have been doing this since Dr Huberman first suggested it some weeks ago in an earlier episode, and it has made significant impact on being able to get good sleep.
Get outside for two hours total a day. This is not just to get enough light into the eyes, but also to get enough time in which the eyes are relaxed by being able to look in to the far distance.
Move around outside such that the scenery is flowing past in peripheral vision while the eyes are relaxed by looking into the distance. Huberman calls this "Self-Generated Optic Flow".
Track things moving smoothly, e.g. a bird in the sky.
Raise your chin and look up frequently.
Sleep in a completely dark room.
Practice blinking.
Practice alternatively focussing on something nearby and something far away.
If living in a built environment that totally blocks seeing panoramic views or prevents seeing in to the far distance, one thing I've been doing for a while, which I describe below, is looking up to the sky and tracking clouds. It seems I stumbled onto something, as this appears to combine several of Dr Huberman's above suggestions in one!
It also seems pertinent and of interest that I explained below how, for as long as I can remember before diagnosis, I would always automatically walk around with my head down, looking at the ground just in front of me, lost in verbose thought. From what Dr Huberman is saying, this could have itself been an major impact factor, reducing dopamine production further, in the lead up to my diagnosis. I wonder if this is true for other people with PD too?
At the end of the article, I have listed the timestamps from the episode descriptions of the Huberman podcast where he discusses things which are relevant to the eyes and vision. I will endeavour to keep this updated.
ORIGINAL ARTICLE
THE IMPORTANCE OF EYES AND VISION
I highly recommend anyone with a chronic illness or nervous system dysfunction of any kind to do their own research into the connections between our eyes, movement and mobility, neurology, and the regulation of our nervous systems. Indeed, eye problems abound in conditions such as Parkinson's Disease:
THE EYES AND PARKINSON'S DISEASE.
Also, many of our cranial nerves are important in operating the complex muscles of our eyes and in vision control. These nerves and their malfunctions have critical roles in Parkinson's Disease too:
THE CRANIAL NERVES AND PARKINSON'S DISEASE.
I do not believe these points can be co-incidental.
Indeed, the connections between eye health and general wellness are phenomenally strong, and so being mindful of how we use our eyes is a very important part of the jigsaw to progressive symptom reduction. Here, I will cover some of the things I've learned and what I've found actually helps me. Primary sources are Dr Eric Cobb of Zhealth Education, Cheryl Townsley - Wisdom Coach, Dr Joaquin Farias - developer of the Farias Technique for movement disorders, and Dr Stephen Porges - developer of the Polyvagal Theory.
Eyes and Nervous System
Our eyes and vision are strongly tied in with inhibition and arousal of various parts of our Nervous System, and hence feed in both to self-stressing and to our self-relaxing activities and behaviors. Many of the things we do these days with our eyes, unfortunately, feed self-stressing. In particular long periods at a computer, with a narrow, near field focus of our eyes, is not associated with relaxation. This is because when our nervous system detects a threat, we tend to go into a tunnel vision like state too, with fixed eyes, making us hyper-focused on the source of danger (a lion say!). Since constant close computer work mimics this tunnel vision, it can apparently arouse a stress response. We also tend to live in built environments, where the distant horizon is not visible, so exercising our long distance vision is not always easy either.
Meanwhile, "orienting" activities, including turning the head or twisting the neck in order to look around, using our peripheral vision, looking into the far distance, and tracking moving objects, all involve the muscles controlled by the Para-Sympathetic and Social Engagement Nervous systems. These parts of our Nervous System programming act to inhibit fight-flight-freeze responses, see
THE NERVOUS SYSTEM AND PARKINSON'S DISEASE
and
SOCIAL ENGAGEMENT AND PARKINSON'S DISEASE
for my thoughts on how these relate very directly to Parkinson's Disease specifically. Thus engaging voluntarily in such visual activities or "somatically experiencing" the world around us, helps to calm the system, inhibiting or interrupting stress responses.
Eyes and Thought Patterns
Next time you are lost in your own thoughts, as you come out of the reverie, see if you can be cognitive of what your eyes were doing while you were "in your own head". What were your "unseeing" eyes actually focused on and was the focal point near or far? Which direction, with respect to your nose, were they looking? I believe most of us will find that the answers to these questions are different depending on whether we are daydreaming pleasant thoughts or locked into anxious ones?
My experience
Long before my Parkinson's Disease diagnosis, I was consistently walking with my head down, looking at, but not consciously seeing, the ground just in front of my feet. I was always lost in busy or anxious or stressful thoughts (mostly about work). I do know this was the case because people close to me would comment about it often, especially when they were talking to me and I didn't respond became a point of contention - my conscious brain simply didn't register that they were even speaking to me as it was consumed by own thoughts. Mostly, my hands were in my pockets too. In essence, I had disconnected myself from the world, was not present to my life, was not actively noticing or sensually experiencing what was going on around me. Indeed, I was walking around a bit like a person with PD long before the symptoms became apparent.
I can also remember, even before diagnosis, when actively looking at awe inspiring panoramic natural views while in scenic countryside, I still felt disconnected, as if I was looking at a flat picture, rather than standing in the scenery myself. I believe many people with movement disorders will have had similar behaviors and experiences in the prelude to diagnosis?
NOTICING EXERCISE
Some of the best vision exercises that I've found which work for me involve combining eye movement therapies, eye muscle training and active noticing. These exercises have the benefit that they can be done (are probably best done) while symptomatic - when the PD medications have worn off or are not working well. However, it is important to note that eye exercises are very tiring, especially when first starting, and so overdoing it can make symptoms worse initially. Start slowly, restrict to a minute or so, and build up gradually over time.
LOOKING OUT THE WINDOW
I have arranged my bed, so when lying on it to rest, or when forced to lie down due to being very symptomatic, I can look out of the window it is adjacent to. I will lie on my back, and turn my head on the pillow.
There are, in fact, lots of good vision exercises to be achieved simply like this. The first is just to look at the sky and clouds. This exercises the very far distance focusing muscles and nerves of the eyes. Another is to move the focus forwards, from the clouds, for example to the trees, the fence in front of these, the window frame, the wall in front, to the tip of the nose, pausing for a couple of seconds at each station, before reversing the processes.
Tracking exercises are also possible, by just watching the cloud formations go by, and by watching birds fly by. We seem to be near a flight path, so I can also watch planes move across the viewing window too.
I read somewhere that looking up and to the left is the most stimulating direction for stimulating the Para-Sympathetic Nervous System, and I do find there is something in this, so I will look out the small window pane at the top left for a minute or so to exercise this directional positioning of the eyes.
Another exercises is to simply look straight ahead out of the window, but then bring my peripheral vision into action by trying to notice what I can see as far into the room from all sides of the window, in every direction, but with eyes still fixed looking out. This "window watching" is, of course, a great way to top up on light therapy on brighter days.
I know when I pushing my system with these exercises, because my eyes will start to close and it will be hard to keep them open. At this point I just let them close and rest.
NECK MOBILIZATION USING THE EYES
A stiff, rigid or painful neck is very common in conditions like Parkinson's Disease. Keeping our necks mobilized, therefore, is not only very important to prevent faster degeneration, but is also critical to strengthening the Social Engagement Nervous System. Indeed, turning the head to look around, and especially over ones shoulder is part of "orienting" (allowing the Nervous System to get its bearings) which can help calm the body/brain down from a frightened state. In fact, one of the major cranial nerves, important in down-regulation of excited (stressed) states, called the Accessory Nerve is involved in flexing the muscles required for neck and shoulder movement. Hence practising neck movements is actually also vital to maintaining good cranial nerve tone.
However, turning our heads while in an "off" PD state can be one of the hardest motions for us to do (no co-incidence). Yet, I've found that there are potentially very simple ways to bring the eyes into play to achieve neck and shoulder mobility too. The process I describe below hence combines eye movement, tracking and peripheral vision exercises with neck mobilization, so the benefits double up.
Neck and shoulder mobilization may be even more important than we thought, as recently scientists have discovered that the brain has lymph vessels and that the brain hence removes toxins and waste through the lymphatic system. Since this drains via the neck, constrictions there may prevent proper drainage, thus resulting in toxins and waste building up in the brain. Indeed, the build of heavy metals and of problem proteins are known to be part and parcel of PD.
I discovered if I fix my gaze an object, as I walk past, then my head will turn automatically to keep my gaze on the object. For example, if I walk down a clear corridor and focus on a light switch on the wall and slowly move past it, then, concentrating on keeping my eyes on the switch, my head will begin to turn, and if I keep moving forward, then I can turn my neck quite a lot, even to the point that I am beginning to look over my shoulder. My eyes will have then also turned in their sockets to the object, thus exercising my eyeball-turning muscles, and hence stimulating those cranial nerves responsible for the eye muscles too. Furthermore, if I can walk far enough (a long enough room or hallway) I can build in to exercise trying to actively notice when the switch leaves my sight, thus stretching my peripheral vision. Walking back the other way, I can then do the same, using the same switch as turn my head and eyes the other way.
Another variation on this theme is to walk through a doorway, and keep eyes fixed on one part of the door frame. For example, if fix my gaze on the top of the frame, then my head will move backwards automatically as I walk under it, stretching my neck barwards. Or if I look at where the door frame meets the floor, I can get my head to turn downwards.
These exercises are very tiring while "off" and it is important not to try to stretch too far until the system gets used to it, increasing the range of movement over time and being mindful of any pain/trigger points. For those of us who have difficulty walking at all or poor balance, I believe these exercises can still work if we have someone willing to push us up and down in a wheelchair.
TRAMPOLINING
Here is a video, pointed out by a reader, of another description of the link between neuromuscular [movement] and visual exercises:
This is interesting, given how beneficial I found my rebounder [mini-trampoline] in my progress symptom reduction:
HUBERMAN LAB EPISODE TIMESTAMPS
How to Learn Skills Faster | Huberman Lab Podcast #20
01:22:02 Protocol For Increasing Limb Range of Motion, Immediately.
How To Build Endurance In Your Brain & Body | Huberman Lab Podcast #23
01:48:00 Leveraging The Visual System During Effort, Milestones; Dilation & Contraction; Pacing.
The Science of Vision, Eye Health & Seeing Better | Huberman Lab Podcast #24
00:04:51 Protocol: Concurrent Training For Endurance, Strength, Hypertrophy
00:07:24 The Senses, Vision, Seeing & What We Should All Do To See Better
00:10:35 Our Eyes: What They Really Do, & How They Work
00:14:30 Converting Light Into Electricity Language: Photoreceptors, Retinal Ganglion Cells
00:17:00 We Don’t See Anything Directly: It Is All A Comparison Of Reflected Light
00:19:35 Dogs, Cats, Snakes, Squirrels, Shrimps, Diving Birds, & You(r View Of The World)
00:24:05 Everything You See Is A Best Guess, Blind Spots
00:25:50 Depth Perception
00:28:00 Subconscious Vision: Light, Mood, Metabolism, Dopamine; Frog’s Skin In Your Eyes
00:32:00 Blue-Yellow Light, Sunlight; & Protocol 1 For Better Biology & Psychology;
00:35:00 Protocol 2: Prevent & Offset Near-Sightedness (Myopia): Outdoors 2 Hours Per Day
00:42:00 Improving Focus: Visual & Mental; Accommodation, Your Pupils & Your Bendy Lens
00:48:50 Protocol 3: Distance Viewing For 20min For Every 90 Minutes of “Close Viewing”
00:52:20 Protocol 4: Self-Generated Optic Flow; Move Yourself Through Space Daily
00:54:26 Protocol 5: Be More Alert; Eyelids, Eye Size, Chin Position, Looking Up Versus Down
00:59:21 Protocol 6: Sleep In A Very Dark Room To Prevent Myopia (Nearsightedness)
01:02:55 Color Vision, Colorblindness, Use Magentas Not Reds,
01:04:32 Protocol 7: Keeping Your Vision Sharp With Distance Viewing Every Day
01:06:05 Protocol 8: Smooth Pursuit
01:08:48 Protocol 9: Near-Far Visual Training 2-3 Minutes 3-4 Times a Week
01:13:33 Protocol 10: Red Light, Emerging Protocol To Improve Photoreceptors & Vision
01:16:20 Dry Eyes; Blinking, Protocol 11
01:18:40 Lazy Eye, Binocular Vision, Amblyopia; Triggering Rapid Brain Plasticity; Protocol 12
01:24:48 Protocol 12: Determine Your Dominant Eye; Near-Far Training
01:27:57 Visual Hallucinations: The Consequence of An Under-Active Visual Brain
01:29:47 Protocol 13: Snellen Chart: A Simple, Cost-Free Way To Test & Maintain Vision
01:33:00 Vitamin A, Lutein, Idebenone, Zeaxanthine, Astaxanthin, Blood Flow
01:44:20 Summary of Protocols, Vital Point About Blood & Oxygen For Vision
01:46:00 Episode Length, Captions, Zero-Cost Support, Instagram, Searching Topics.