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Instructions For Using The Wayne Vis-Flex Visual Flexibility Trainer

Introduction By Jack Liberman, O.D., Ph.D.

Vision accounts for eighty to ninety per cent of all Information an individual takes in daily. The eyes are wonder tools for the exploration and understanding of the universe, as well as primary source of social contact and self expression. Vision, our most dynamic process, constantly changes in accordance with our mental and physical state, making the possibility of vision improvement a reality for most people.

Look around you! No other problem is as obvious as the epidemic of poor visual efficiency. Yearly millions of people become visual cripples. It has been found that visual problems develop primarily In populations where higher education (reading) is stressed. Is higher education (reading) the problem, or is it the fact that the eyes are the most used, least cared for and most taken for granted organ of the body, combined with the goal oriented, performance anxiety manifested by most people during their educational process?

Since vision accounts for most of one's experiences, and since one is basically a product of one's experiences, the way that one uses his vision will play a major role in the development of his thought patterns, behavior patterns, and therefore the potentials reached in his lifetime. With this in mind, programs designed to enhance visual awareness and efficiency will in turn enhance learning skills, athletic performance, and in general, one's ability to navigate himself in all situations.

Navigation of the human action system requires such skills as vision aiming, clarity, and teaming. These skills not only aid in leading us around, but also let us know where things are, what things are, and give us the ability to sea things three-dimensional1y. They also help us to coordinate accurate body responses to things we see in our environment. When training eye movements, the primary aim should be to reduce the chronic over-controlling of eye movements, freeing up the eyes "to see for us" as they were meant to do. Vision clarity skills shouldn't be thought of as optical focus drills but should deal more with one's ability to fluidly and efficiently clarify things in his life, thereby making them more understandable. Vision teaming skills deal not only with the coordination of the two eyes, but more importantly with one's ability to see the forest as well as the tree and have the flexibility to shift attention effortlessly from one to the other. With this in mind, perhaps our focus therapeutical1y should shift from a remediative model of therapy to a process aimed at "sharpening awareness." Rather than trying to train an individual's visual skills, emphasis should perhaps be on the person gaining an awareness of how they interfere with his own level of performance.

Vision therapy is not the exercising of eye muscles, but rather the enhancement of one's intelligence. Vision therapy produces changes not only by improving visual/mental flexibility, but primarily by improving the awareness skills that allow one to see what their contributions is to his difficulties. You might say that it partially deals with learning how to get out of your own way. Although vision therapy deals with many individual as well as combined skills, the primary approach is very holistic and views the vision process as affecting and thereby involving the entire body and mind.

The Liberman Vis-Flex (Visual Flexibility Trainer)

The Vis-Flex was developed to provide an out-of-instrument unit which can be used by students, athletes, or anyone who needs to develop greater visual awareness, accuracy and fluidity in free space. As many as four to six individuals can use this unit simultaneously to enhance monocular or binocular eye movement control in any meridian of gaze, focusing flexibility and visual teaming at varied distances and speeds, and general visual awareness.

The Vis-Flex consists of a series of LED lights which can display various patterns at variable speeds (see Chart of Instrument Modes below) with or without auditory feedback. It can optionally be used with red-green glasses to train monocular skills under binocular conditions; or, with lens and /or prism flippers to expand accommodative and convergence ranges.

Getting Started

Setting up the tripod

  1. Release the tripod leg clamps, and pull out the legs to their full extension. Close the clamps to secure the legs.
  2. Note that there are three black thumb screws. Loosen them by rotating counter-clockwise. Also note that the panning handle must be twisted counter-clockwise to loosen all movement. Try flipping the top, using the flip-hinge, back and forth. Tilt the top, change the angle, rotate and lock in position using the panning handle. Raise and lower using the crank. Lightly tighten all black thumb screws. Note that the center post can be rotated to tighten all positions.

How to set up the operation of the Vis-Flex

  1. Mount the Vis-Flex on the tripod so that it can be easily flipped over using the flip-hinge. It is suggested that the tilt screw not be tightened; this will permit the Vis-Flex to be readly tilted for height adjustment, without risking the danger of damage due to excessive force.
  2. Plug the power plug into the power jack of the Vis-Flex. Note: some units do not have a power jack; the power is wired directly.
  3. Rotate the on-off control to fully clockwise direction. This is also the volume control.
  4. Set the program dial to "0".
  5. Set the toggle switch to the automatic position. In this position the lights will move automatically.
  6. Depress the remote start-stop switch (hand switch). This switch must always be depressed to start the activity.
  7. Set the speed of the lights using the speed control (located on the hand switch).
  8. The start-stop remote control will start and stop the light movement. If it is desired to have the lights move only when the button is depressed, flip the toggle switch to the manual position.

What Are The Controls?

On-off volume

This control turns the system "on", and also sets the desired volume.

Program

The dial selects the desired program; ie, setting the dial to "F" the lights will move to a new random position each time.

Speed

Sets the desired speed that the lights should move. To decrease speed rotate the control clockwise.

Automatic or manual toggle switch

When this switch is on automatic, the lights will move automatically to different locations at the preset speed. When this switch is in the manual position, the lights will only move one position at a time when the remote control switch is depressed; the button must be pressed each time a new light position is desired.

Note: The remote switch control is used to start and stop the light pattern when the unit is set for automatic operation.

Selecting And Setting The Program

Assume that the lights are numbered such that the number "1" light is next to the nose, and that the number "16" light is the furthest from the nose. This is the numbering sequence used in the program.

The left dial must always be set at zero ("0"); only adjust the right dial for the program.

The movements of the lights will be as follows:

Dial SettingLight Sequence
01,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,
16,15,14,13,12,11,10,9,8,7,6,5,4,3,2,1 repeat
11,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16 repeat
216,15,14,13,12,11,10,9,8,7,6,5,4,3,2,1 repeat
31,16;2,15;3,14;4,13;5,12;6,11;7,10;8,9;7,8 repeat
47,8;8,9;7,10;6,11;5,12;4,13;3,14;2,15;1,16 repeat
51,16,16,1 repeat
62,15;15,2 repeat
73,14;14,3 repeat
84,13;13,4 repeat
95,12;12,5 repeat
A6,11;11,6 repeat
B7,10;10,7 repeat
C8,9;9,8 repeat
D8,7,6,5,4,3,2,1;1,2,3,4,5,6,7,8 repeat
E1,8:8,1 repeat
FRandom

A Starting Program

ProgramSoundSpeed Lights/minMode switchViewing position
8on60ManualNose to plastic

Start this program by depressing the trigger switch on the hand controller. User is instructed to fixate on the illuminated light until it is sharp and clear. User should see only one light, and two white lines should appear to cross exactly at this light position. When user indicates that this is accomplished, depress the the trigger and another light will be illuminated. The lights will rock between two positions. When the individual is able to clear each light image correctly within one second, the mode switch can be changed to the automatic position. Adjust the speed control (knob on top of the hand controller) to permit the individual sufficient time to follow the lights, and clear their images.

Repeat the above procedure using the following programs numbers: 5,6,7,8,9,A,B,C,and E.

Suggestion: allow the user to set his own pace, by first using the manual mode and then switching to the automatic mode, and adjusting the speed to match the users speed.

Operating Instructions

  1. Mount instrument on tripod and adjust height to user's eye level or slightly below. Connect ac/dc adapter to instrument and plug into wall socket. Set program switch to number of program and turn instrument ON.
  2. Start activity by pressing button on hand-held switch. Adjust volume for comfortable level. Volume knob is located on same side as hand-held switch.
  3. Familiarize yourself with the unit by running it through all modes at various speeds, with and without auditory feedback.
  4. You can adjust tripod to do tracking procedures horizontally, vertically, obliquely, and on the Z axis (extending from bridge of user's nose).
  5. Have user stand or sit at one end of the unit while tracking the lights as they approach and move away from his nose to develop focusing and timing skills. The user can monitor his own level of binocularity (teaming) by making sure that he is looking at a single clear light. The white line connecting lights will act as a Brock-string.

Suggested Activities

Sequential Fixations

Purpose

To develop high level visual attention and dynamic ocular motor (eye movement) skills with minimal effort, accurate timing and heightened awareness.

Applications

All cases where ocular motor skills are less than adequate or when further enhancement is desired. Specifically useful with:

  1. Poor eye movement accuracy, control, fluidity, and stamina.
  2. Reading problems, tired eyes, short attention span, blur during reading, difficulty keeping eye on ball during sports activities.

Program

Always begin with program (00) as a warm-up until user has mastered this level with variable speed, sound, and distance from unit.

Sound

Always begin with sound ON to reinforce visual attention. Refer to section on options for further applications.

Mode

Always begin with manual mode in order to control speed while user is adjusting to new procedure. When user is sufficiently comfortable, switch to automatic.

Speed

Once user has progressed to automatic mode, speed can be varied according to user's skill level.

Viewing position

Begin approximately five feet from VIS-FLEX. User's face should be parallel to plane of unit.

Instrument position

Begin with unit in horizontal position. Progress to vertical and oblique positions in order to train all meridians of gaze.

Instructions

Begin program by rotating On/Off volume control clockwise. Adjust sound to comfortable volume. Toggle switch should be on Manual Mode. Set program on (00).

Patient should be seated in comfortable position. Press Start/Stop control switch and light will appear. Instruct user to continually fixate on the light as it changes positions. User should not move head and should be breathing normally. When user is able to do this with ease, change the mode to Automatic and once again press the Start/Stop control switch to begin the program. The lights will move automatically from one position to the next. User can sit or stand, but should be comfortable while following the lights.

Options

Programs can be changed as desired by changing Program dial. Start at (00) and progress to (OF).

Sound can be used initially at full volume (reinforce vision). Gradually reduce volume until silent. Goal is to develop visual functioning with minimal reinforcement.

Mode: Use Vis-Flex for multiple training in automatic mode.

Speed: Always begin at a speed below user's level and gradually Increase speed to desired level. Speed should be only as fast as the user can handle while remaining relaxed and breathing comfortably.

Viewing Position can be varied as desired. Start at five feet and gradually reduce the distance.

Special Cases

Astigmatism: Spend extra time on programs (05) to (OC) with instrument positioned 90 degrees from axis of astigmatism. This technique frequently reduces the magnitude of astigmatism.

Suppressions, Amblyopia and Strabismus: User wears red-green anaglyph glasses in order to train monocular skills under binocular conditions. Remember: only the eye behind the red lens will see the light. Therefore, orient glasses so that weaker eye is behind red lens.

Questions

Ask user: Are you breathing comfortably? Are you blinking your eyes? Do you feel a tightness in your body or face? If there is a tightness, release tensions until you can breathe and blink comfortably. How does the movement of your eyes feel? (e.g. smooth, erratic, light, heavy, accurate, etc.) 8e aware of how user feels, but don't judge the performance as good or bad. Just keep being aware, as the awareness itself is curative. Can you move your eyes smoothly while breathing and blinking? Which directions are most difficult for you to move your eyes? What do you notice about your eye movement?

Observations

Do user's subjective responses correspond to your objective observations?

Make sure user is not holding his breath or interfering with normal blink rate during any of the procedures. Remind user to "Keep breathing and blinking," and keep the speed of the activity at a level where user can easily breathe, blink and move his eyes smoothly. Tell user that objective is to develop relaxed and accurate visual attention without tension.

Techniques

  1. Any of the following procedures can be combined with red-green glasses in order to train monocular skills under binocular conditions. Excellent for suppressions, amblyopia. strabismus, etc. Striated lenses can also be used to evaluate binocular status during tracking skills. Examples of possible responses are:
    1. seeing this indicates stable binocularity
    2. or this indicates suppression of one of the eyes.
    3. or this indicates poor fusion.
    4. or this indicates diplopia
      Any response other than #1 indicates a lack of stable binocularity. Recommendations for these cases are:
    • Slow down speed to enhance ease of obtaining binocularity.
    • Implement basic binocular visual skills training or skills aimed at equating monocular skills. Once this is accomplished, you may begin the original procedures again.
  2. Prism flippers combining base-out and base-in are an excellent tool to use during tracking skills, and are especially useful when doing techniques on the Z axis. These flippers will expand binocular ranges dramatically. These are usually used by having user fixate on the incoming lights through base-out or base-in and fixating on the outgoing light through the opposite side of the flippers. Most users will initially notice that the targets will split into two and then fuse into one. As binocularity improves, speed of recovery increases.
  3. Plus/minus flippers can be used identically to the prism flippers to further expand accommodative (focusing) range and flexibility.

Electronic Brock String

Purpose

To simultaneously develop dynamic accommodative and convergence range, flexibility, neurovlsual rhythm and timing.

Applications

  1. This procedure is applicable in all the following cases:
    1. Poor or unstable range and/or flexibility of accommodation or convergence.
    2. Limited attention span.
    3. Strabismus and amblyopia.
    4. Deficits in stereopsis (depth perception).
  2. It is also useful for enhancing sports vision and far-near visual tracking skills.

See above section on options for further applcations.

Mode

Sound ON. Always start with manual mode. This enables you to control speed while user is adjusting to new procedure. When user is sufficiently comfortable, you may switch to the automatic mode.

Speed

Vary speed on automatic mode according to user's skill.

Viewing position

Put plastic guide in the open end of the unit. User places his nose or upper lip against guide.

Instrument position

Begin with unit in horizontal position. When this exercise has been mastered, move unit off-center. 8y doing this, accommodation and convergence can be trained in all the directions of gaze.

Instructions

Begin activity by turning On/Off control clockwise. Place toggle switch on manual mode and set program on (00). Always start with sound ON to reinforce visual attention.

Press Start/Stop control switch and light will appear. Ask user to fixate on the light and describe what he sees.

Suggested questions

  1. How many lights do you see (should only be one)?
  2. How clear are the lights?
  3. How does white line appear when you are fixating on the light? (User should see an "X" with the light centered at the intersection of the lines).
  4. Do the other lights appear single or double?

When user is able to see a single clear light centered in the middle of the "x", press the Start/Stop control to switch another light on.

Ask user what he sees. When user reports the expected response for all the lights, switch the mode to automatic and keep the speed moderate. Possible responses:

  1. Both eyes are looking at the same place at the same time.
  2. Only one eye is being used.
  3. Diplopia: eyes are underconverged and unfused.
  4. Diplopia: eyes are overconverged and unfused.
  5. Normal retinal correspondence to the light. Anomolous correspondence from the light outward.

Options

See above under Sequential Fixations.

Techniques

See above section under Sequential Fixations.

Using The Vis-Flex In Sports Vision Training

The Vis-Flex is especially suitable for the evaluation and raining of three crucial sports vision skills: dynamic convergence, precise fixation and rapid "leading with the eyes."

Dynamic Convergence

In almost every sport, the athlete must visually track a ball or player moving along the Z-axis. To do this properly, the player must have excellent accommodation and convergence skills and must use these skills together. If the player's accommodation is deficient, he will be likely to lose track of the moving ball. If convergence is deficient, he will frequently be tracking the ball with only one eye and will therefore be unable to judge distance correctly.

Both of these skills may be trained together by using the Vis-Flex as an "electronic Brock string." The best programs for this activity are those in which the light moves up or down the length of the unit in one direction. The athlete should be able to smoothly shift his focus between lights without experiencing blurring or "zooming" as the light shifts position. Start in manual mode and switch to automatic mode with gradually increasing speed as the athlete becomes comfortable with this exercise. If the athlete has difficulty performing the exercise using the entire length, try using the programs that use only the near half.

Precise Fixation

In addition to being able to track a moving ball or player smoothly, the athlete must maintain precise fixation on the target. If he is actually focussing ahead of or behind the target, he will be likely to react too early or too late (this can be demonstrated by using the Wayne Speed-Trac).

This skill may also be trained with the "electronic Brock String" using the same programs used in dynamic convergence training. Start off in manual mode. At each light position, verify that the athlete sees the white cross at the exact position of the light. Using base in/out prism flippers may be helpful here. Be sure that the athlete is fixating correctly in all light positions. When the athlete has mastered this skill using static targets, switch to automatic mode in order to train precise fixation in conjunction with dynamic convergence.

"Leading" (X-axis fixation shifting)

The athlete is frequently called upon to rapidly shift his fixation in the X-Y plane, frequently along the X-axis. An example wou1d be the quarterback who must suddenly pass to a secondary receiver. The eyes lead the body, and if the athlete takes too long to shift fixation or fails to correctly converge on the new target he will position his body incorrectly.

Use the sequential fixation techniques to train this skill. The athlete should be seated perpendicular to the Vis-Flex. Initially he should be facing the center of the unit, and the program should be set for back-and-forth motion. The athlete should be able to rapidly focus on each new light position (start out in manual mode). It will be very helpful to use striated lenses to verify that the eyes are working together. The next step is to go through the two-light programs with various distances between the lights, and finally to the pseudo-random sequence program. Once these sequences have been mastered with the athlete facing the center, repeat them with the athlete facing one end. You may also try positioning the unit at various angles to the Z-axis; this will bring all three skills into play

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Page last modified on July 09, 2007, at 03:31 PM