Tips and tricks that can help you in everyday life

In a static position, difficult situations are very rare (unless the visual environment is curved and does not offer a vertical line to catch the eye on). So the following tips and tricks relate to situations where the patient is moving.

On the proprioceptive level (bodily functions):

• Carrying loads: carry a balanced right-left weight: same weight in each hand, shoulder bag, or use of a backpack
• Dressing: dressing (putting on socks, underwear, pants, tights, etc.) with body support or sitting to avoid balancing on one foot.
• Shoes :
  • Choose shoes that are flexible enough to hug the foot and ensure a good return of the relief.
  • Danger if stilettos or rigid shoes such as safety shoes..
  • For women who have not given up, the lace-up ankle boot with a stable heel (5-8 cm) is possible. Make sure the sole is non-slip.
• Support point: Importance of an added sensory contact point and support point (widening of the lift polygon):
  • Hold on to the banister of the stairs or stay nearby just in case...
  • Hold on to others (spouse, friend) when the ground is uneven or in the dark, in narrow passages (walking on a board, a narrow sidewalk, etc.).
  • Put a finger (the elbow, or the bag you are carrying) in contact with the wall in narrow corridors, stairs...
  • Use a walking stick or walking poles as additional points of contact (additional sensorineural information) or support (widening of the lift polygon).
  • The cane, assuming a physical alteration, can prevent the interpretation of the patient's ataxic gait as a state of alcoholic intoxication (in front of an examination board where one has to move, for example).
  • Use a market trolley or even a suitcase on wheels.
• Some arereflexic patients have improved balance when squeezing an object (pebble) in one hand.
• Prevention of neck pain:
  • Pay attention to your body statics (posture), in order to prevent neck pain related to the immobilization of the head against oscillopsia. Physiotherapy and/or osteopathy follow-up can be a valuable help for many patients.
  • Possibility of performing targeted strength training of the neck muscles:
    • straight-head load port
    • Lying face down with your elbows on the floor, keep your upper body up
• Some patients are bothered by wearing a hat or helmet.

Visually (oscillopsia):

• Flashlight or "torch" application on your mobile phone so that you don't find yourself helpless in the dark (be ready and beware of turning off timers in toilets, stairs, cellars, garages, etc.). In the same spirit, open the exterior door of the accommodation to get some light before turning off the light inside. Be careful when exiting a cinema (semi-darkness with backlit floor lamp): in the absence of a flashlight, lean on a third person or seat to seat.
• Orthoptics brings, in some cases, real relief from the eye strain suffered.
• Wear sunglasses outdoors to avoid glare from intense light that disturbs balance. But be careful when driving while passing through a tunnel (sudden loss of visual information if wearing sunglasses).

Shopping in supermarkets:

• If possible, do them during "off-peak hours" (first thing in the morning), if you have to do them on weekends. The combination of the large crowds and the omnipresent neon lights is particularly painful.
• Don't let yourself be "carried away" by the visual: travel by car, train, metro, escalators... Look in the opposite direction.
• In case of orientation difficulties:
  • Make a marker on your trolley in a supermarket by putting a distinctive sign (e.g. a ribbon) on it to quickly visualize it in order to avoid having "dizzy" looking for it in this visually aggressive place (contrast of bright lights, crowds, etc.).
  • Locate your car left in a parking lot.
  • Prepare your itinerary by car, especially for unknown destinations.

Move and task overadded:

• Stop walking, moving, to read signs, street names, consult a map, a street map, or clean your glasses.

Rotation and loss of balance:

• Remember that any rotation on oneself leads to a loss of balance. It is recommended to fix with your eyes in advance, before rotation, the point of the space located in the field of vision at the end of the movement. If you are not resigned to systematically carry out this anticipation (stop before turning, turn your head in the angle of the rotation and then turn), you must maintain yourself in excellent physical shape to "absorb" the resulting destabilization.

Visual field changes:

• Be vigilant in situations where there is a narrowing of the visual field or when the visual field crosses a moving landmark, to avoid putting yourself in danger. Some examples: 
  • Looking through binoculars at the edge of the cliff
  • Driving a vehicle in the rain, snow, at night, passing through tunnels, narrowing the road, overtaking heavy goods vehicles...
  • Wearing a hat with a wide brim that drops in front of the eyes (be careful with the semi-transparent wedding hats that give the illusion of a satisfactory vision but totally destabilizing, due to the mobility of this visual reference in the foreground).

Difficulties when reading:

• Epubs are a solution to consider to make reading easier because they can be read in the font chosen by the reader, at the size that suits him. The Open Dyslexia font is incorporated into some readers (Thorium reader is a good example). Epubs can also be read aloud by most software.

With a baby or young child in your arms:

• Be sure to keep all possible supports, and only consider using a staircase with the utmost caution.

 For activities for which the patient already had a good level of practice:

• It is sometimes necessary to go back to theory in the "ocular vestibulo" activities (off-piste skiing in fog: rhythm, restart, leaning on outside ski; mastery of fast driving on 4 or even 2 wheels: gaze orientation, braking management and acceleration/turning).
• Perseverance so that the old activity becomes pleasure again, even if it is more costly neuropsychologically.

Always inform and warn your loved ones and friends about your deficits

• They can help you in the best possible way with their presence, their support... and to minimize the consequences of "reflex" actions that can unintentionally lead to an accident (e.g., thoughtless action on a switch that suppresses the lighting in a dark, steep staircase while the arereflexic patient is going down).

The comfort provided by the use of progressive lenses compared to the use of two pairs of fixed focal length glasses, justifies the try, knowing that in case of inadequacy, the option of two separate pairs of glasses can be substituted (to be noted on your ophthalmological prescription).

• Many AFVB members wear progressive lenses.