The Work & Wisdom of Dr . Frederick W . Brock

F W. Brock understood strabismus better than any other individual, yet most vision care professionals have never heard of his work. If they do recognize his name, it is probably in association with the Brock string. That is how I first heard of Dr. Brock. I was a 48-year-old patient in optometric vision therapy who had been esotropic since early infancy. Although I had undergone three childhood surgeries, I continued to alternately fixate, was stereoblind, and had a poor sense of the visual periphery. All of this changed as a result of vision therapy provided by my optometrist, Dr. Theresa Ruggiero. Fascinated by the power of the Brock string and other vision therapy tools, I wanted to learn more about Dr. Brock but discovered that many of his publications were difficult to obtain. He had, for example, published his visual training manuals in serial form in the Optometric Weekly of the 1940’s and 50’s.a, 1-6 I took trips into Manhattan to the library of SUNY’s College of Optometry where I would engage in marathon Xeroxing sessions of Dr. Brock’s papers. In 2006, my stereovision story titled “Stereo Sue,” was first published by Dr. Oliver Sacks in The New Yorker.7 A week later, an interview with me aired on NPR’s Morning Edition.8 Among the many letters and emails in response to that program was a letter to Dr. Ruggiero from a man named Bruce Alvarez. He wrote that he was happy to hear mention of the Brock string during the radio program since his wife’s grandfather was Frederick Brock. I contacted Mr. Alvarez and, through him, spoke by phone with Dr. Brock’s daughter, Dolores (Dee) Brock Partridge. From Mrs. Partridge, I learned that Dr. Brock was born in Switzerland in 1899 and came to the United States in 1921 to attend the Columbia School of Optometry. Dr. Brock loved kids and loved to help people with their vision. He tuned up the vision of young men who wanted to join the service in World War II. When a French teacher’s son needed vision therapy, he provided the training in return for extra tutoring lessons for Dee. At the end of our phone conversation, Mrs. Partridge added that she was about to move into a smaller home. She had a notebook of all her father’s papers and wondered if I would be willing to take them. All of the papers that Mrs. Partridge gave me were already present in the library of SUNY’s College of Optometry with one exception. There was an unpublished, type-written manuscript entitled “Lecture Notes on Strabismus” by Frederick W. Brock, and this document summarized Dr. Brock’s most important observations and insights.9 With Mrs. Partridge’s permission, I have now published the notes on my website.b A synopsis of this manuscript, along with my own thoughts are provided in the following paragraphs. Frederick Brock began his lecture notes with a list of his basic principles identified as “organismic laws,” and, from time to time, referred to people in general as “the organism.” These terms sound odd to modern ears, but they derive from Brock’s studies of the work of neurologist, Kurt Goldstein, author of the classic book, The Organism.10 Like Goldstein, Brock took a holistic approach to patient care and taught that a patient’s symptoms can often be understood as coping mechanisms for his or her condition. As Brock describes on pages 12 and 13 in his notes, strabismus may be as much an adaptation to, as it is a cause of, a poor ability to fuse. For accurate spatial orientation, an individual should receive similar, fusable images from the macula of each eye. Dissimilar, non-fusible images produce diplopia and visual confusion, requiring suppression of the macular image of one eye. If it is not possible to obtain fusion, then “a determined effort may be made to throw the two eyes into greater disalignment so that the non-macular image of the fixation object becomes so poorly defined (because of its peripheral location in the turned eye) that it can be easily suppressed.” I was very struck by Brock’s explanation of strabismus especially when I learned how I used my eyes for reading prior to optometric vision therapy.11 While fixating the words with one eye, I turned the other by 25 prism diopters. Hence, letters foveated by the fixating eye cast their image on the blind spot of the turned eye. Unconsciously, I had found a way to eliminate conflicting input from the nonfixating eye. It is the nature of the posture that determines the nature of the responses.