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Seeing Eye to Eye I lift my eyes with effort to read the menu above me, but they drop down again, unable to piece an image together at that height. What can I get for you? asks the barista.

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Um I mumble, my eyes flitting restlessly from her face to the counter as I try to gather the courage to chance another glance at the menu. I feel her searching gaze and think to myself, Just make this quick, but the tempting aromas of sugar and spice get the best of me. Looking up, I catch hold of a few words before my eyes start to strain and cross. I guess Ill just have a regular coffee, I say quickly, shifting my gaze to my wallet to hide my discomfort. As I rush away from the caf, I think for the millionth time that day how badly I wish I could explain myself. My eyes dont work together, or at least thats how its been described to me as if theyre immature kindergarteners who cant share, and not the highly sophisticated tools that they are. When theyre tired and cranky, they misbehave even more, a result of a neuromuscular problem called alternating esotropia. Esotropia is a disorder of ocular alignment that leads to diplopia, or double vision. To correct for this strain, my brain sometimes suppresses the image from one of my eyes; unfortunately, this correction can (and has, in my case) lead to amblyopia, or lazy eye. My eyes alternate hence, alternating esotropia so that one acts as my fixating eye, focusing on the image before me, and the other turns inward (Mravi!i! et al.).

! I do my best to manage these dysfunctions, wearing an eye patch to prevent double vision and to give my fighting muscles a rest. My days are structured by the condition of my eyes and my patching routine. While my former roommate, Melissa, used to burrow deeper under the covers upon hearing her alarm each morning, I woke up early and immediately donned my patch. Rolling out of bed just ten minutes before her first class, as I suspect most of my sleep-deprived peers do, Melissa flew around the room in a whirlwind, grabbing things and stuffing them into her backpack. I dont understand how you can be so disciplined! she exclaimed, yanking a comb through her hair while simultaneously searching for a missing sock. I cant get up any earlier than I have to! Neither can I. The difference is that I have to get up early enough to give my

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eyes time with my patch, time to orient themselves. If I dont, they keep fighting to turn against me and turn inwards. We end up working at cross-purposes. Its a balancing act; there are times when my eyes feel much too strained and one demands to be covered like when I wake up feeling exhausted yet I feel a similar strain if I wear the patch for more than two or three hours. Consequently, I cant drive too far on my own, read for too long, or do anything that requires great focus and coordination without taking a break, or several breaks. These are the considerations I carry with me when I interact with others, often crowding my mind and distracting me from communicating effectively. When meeting people for the first time or going to a social gathering, Im paranoid about my eyes and obsessive about my patching routine. I wear the patch up to the last minute before Im going to meet someone, yanking it off just before they see me in an effort to avoid

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lengthy, awkward explanations. Throughout the entire interaction, I divide my attention between listening to the person Im with and making sure that Im making an appropriate amount of eye contact while also giving myself breaks to move my eyes down or around. A study conducted in 2008 shows that Im not alone. 86% of patients with strabismus (the umbrella term for ocular muscular disorders under which esotropia falls) reported feeling embarrassed and also reported difficulty making eye contact (Nelson et al.). In a study of smaller scale in which patients were interviewed, the most frequently mentioned topics were appearance to others(people notice my eyes) followed by problems with eye contactand interpersonal relationships (Hatt et al. 643). For me, the anxiety of eyestrain and, on a superficial level, the physical appearance of my misaligned eyes, keeps me from participating in social situations as much as I could. I cant stand knowing that when I speak, someone will be staring at me, tracking the movements of my eyes. Most people expect eye contact and, in some ways, depend on it I resent the burden of it. My lifelong eye doctor, Dr. Miller, was the first to notice (or point out to me) that I have to keep looking down every few seconds to relieve my eyes of the strain of fixation. Standing in his office, he turned to my parents and extended his arm parallel to the floor. I can hold my arm straight for only so long. At some point Ill get distracted or tired; I can either strain to hold it up, or itll naturally drop down, he explained, letting his arm droop back to his side. Thats what she goes through with her eyes every day.

4! My parents turned their attention to me and nodded in recognition. Immediately,

my gaze dropped down to my lap, and I felt self-conscious Do other people notice that I look down so often? Are they put off by my fidgeting eyes? Its true that children with esotropia were rated negatively by teachers on ten personality characteristics, including intelligence, trustworthiness, capacity for hard work, and so on, based solely on photographs of their faces (Uretmen et al.). Moreover, its true that adults with strabismus (and women in particular) have a lesser chance of obtaining employment (Mojon-Azzi & Mojon). Clearly, none of this data works in my favor. To ease my fears, Dr. Miller taught me how to fixate on different points on a persons face, the movements subtle enough that they allow me to give the impression of direct eye contact. Undoubtedly this is a useful technique, but it made me wonder: what, truly, is the benefit of this kind of illusion? I personally dont gain any of the supposed satisfaction of looking someone in the eye after all, Im looking them in the forehead, or the nose, or the ear. I could only assume that the importance of eye contact goes far beyond mere convention and expectation. Sure enough, a recent study found that eye contact elicits cortical activity associated with the intensity of attention, interest, and emotion, as evidenced by neuroimaging (Honma et al. 112). This activity excite[s] autonomic activity, consequently enriching and activating social interaction by boosting mutual understanding and trust (Honma et al. 112). Numerous other studies support this, suggesting that increased eye contactindicates an increase in intimacy (Niedenthal et al. 425). Even as someone who hardly enjoys eye contact, I intuited this important relationship between the eyes and intimacy years ago, when I was entertaining the

! thought of a strabismic surgery that could potentially improve my vision as well. Despite all the possible risks, I wrote this journal entry about my then-long-distance boyfriend, Brandon: I dont think people understand that these problems go so far beyond poor vision. I dont care about that. I dont care if I have to wear glasses every day for the rest of my life. I just want to be able to look you in the eye when I tell you I love you. I understood, despite my love for and (perhaps unhealthy) dependence on the written word, that we transmit some kind of information on an instinctual, human level. Unfortunately, strabismic surgery wouldnt be able to help me communicate in this way; the results are often cosmetic, making the eyes appear straight, but not actually fixing the coordination issues. Though this alone would be a true gift to someone who has lived her whole life feeling self-conscious because of the appearance of her eyes, even this limited benefit is often temporary. Many patients who undergo strabismic surgery return for a second, third, or even fourth time (Louwagie et al.; Babar et al.). They find that after a few years, or even a few months, their eye begins to drift again. More important, though, is the fact that while straightened eyes may reduce social anxiety, they cant reduce the physical strain of muscular misalignment, and therefore cant make it any easier to make eye contact. If its true, then, that despite surgical correction and visual tricks I will never be able to look others in the eye, is my ability to connect emotionally irreparably limited?

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Maybe. Niedenthal et al. have found that in gathering meaning from facial expressions, the absence of eye contact detaches any emotional processing that occurs from the perceived [expression] and renders it knowledge-based. Thus, the emotional content is

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determined by simulation of conceptual knowledge in memory, rather than being driven by the experience of eye contact (430). This means that people have to rely on stored cultural beliefs, stereotypes, or other information (Niedenthal et al.) from previous interactions in order to read me or get to know me, which sounds pretty impersonal. However, according to Basso & Oullier, perceptual cues can be embedded in tone of voiceand experiential ones in the words employed. Despite the absence of eye contact, other components of emotional labourare clearly observable in voiceto-voice interactions (436). Indeed, my relationship with Brandon grew out of frequent phone calls and emails. We grew closer and closer, learning about each other through little more than our voices and our written words. After reading one of my emails during our first months together, he called me and said, Your writing, its so elegant and beautiful I laughed and felt embarrassed. Its not like Im writing you poetry. Pretty much! I cant explain it, Neeyati, but I can feel you and hear you. We looked forward to our letters, and I relished these exchanges; I knew his eyes were reading my words, and that in itself was so intimate that when we finally saw each other after spending months apart, it didnt matter that I couldnt hold his gaze. I didnt need that to feel close to him. The importance of eye contact likewise shrinks in the presence of other expressive cues when I tutor students at the university on their writing. A tutoring session is an intimate interpersonal setting in which understanding and trust are essential; students feel vulnerable having their work scrutinized, and eye contact can

! often intensify this feeling. A positive, empathetic voice, on the other hand, does wonders to establish trust. It seems, then, that we use whatever limited amount of sensory information we

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can gather to navigate social interactions. In the absence of physical contact, Brandon and I relied on each others spoken and written voices. In tutorials, I tailor my tone of voice to match what I perceive to be the students needs. According to Dr. Paul Harris, a behavioral optometrist, a person actively obtains information or data from his sensory systems that he uses to build an understanding from which to direct his action (5). He goes on to say that [b]y its very nature, our representation of reality is incompleteBecause of the limits of the system itself, there will always be things going on that, under different circumstances, could have been seen, heard, tasted, felt, or smelled, but were not (Harris 5). From this perspective, it looks like Im not the only one thats missing something in interactions with other people. Maybe human bonding is the process of expressing one personal worldview to another in an attempt to fill in some of the gaps in our perceptions. Or maybe its just the desire to share ones perspective and be understood. In any case, eye contact may be the most direct, and, for many people, most instinctual way to connect with others, but its not the only way. Im never more grateful for this fact than when Im seated next to a student in the Peer Tutoring Center. Believe me, I feel your pain, I say, meeting the students gaze for a second before dropping my eyes back down to the essay. I always struggle with this kind of assignment, too. But really, youre off to a great start! I think if you work on the things we talked about youll have a really strong paper.

! Thats good to hear, because I was really confused. Thank you so much for your help! Smiling, I say, Youre welcome! Good luck! The following week, I arrive at the peer-tutoring staff meeting. Lila, the director of the program, places a folded sheet of paper on the desk in front of me. Nice evaluations, Neeyati!

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Unfolding the paper, my eyes land on the first of the anonymous comments that students had made about my tutoring. She was really nice and attentive to me. It felt good to be able to talk out all of my concerns without worrying to another student. What I mean is I really wanted to know if I successfully conveyed the message I wanted to convey and my tutor helped me express myself better. I smile and place the paper back on the desk. I turn my attention to the meeting, but every few seconds my gaze drops, and my eyes catch hold of encouraging words.

! Works Cited Babar, Sonya, et al. "Eye Dominance and the Mechanisms of Eye Contact." Journal of American Association for Pediatric Ophthalmology and Strabismus 14.1 (2010): 52-57. Basso, Frdric, and Olivier Oullier. "'Smile Down the Phone': Extending the Effects of smiles to Vocal Social Interactions." Behavioral and Brain Sciences 33.6 (2010). Harris, Paul. The Space World. Dr. Paul Harris, Optometrist. Writings. Web. < http://www.paulharrisod.com/sites/default/files/Chapter%202%20Space.pdf> Hatt, Sarah R., et al. "The Effects of Strabismus on quality of life in adults." American journal of ophthalmology 144.5 (2007): 643-647. Honma, Motoyasu, et al. "Perceptual and Not Physical Eye Contact Elicits Pupillary Dilation." Biological psychology 89.1 (2012): 112-116. Louwagie, Curtis R., et al. "Long-term Follow-up of Congenital Esotropia in a Population-based Cohort." Journal of American Association for Pediatric Ophthalmology and Strabismus 13.1 (2009): 8-12. Mojon-Azzi, Stefania M., and Daniel S. Mojon. "Strabismus and Employment: the Opinion of Headhunters." Acta Ophthalmologica 87.7 (2009): 784-788.

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! Mravi!i!, Ivana, et al. "Surgical Treatment of Residual Esotropia." Collegium Antropologicum 35.2 (2011): 299-302. Nelson, Bradley A., et al. "The Psychosocial Aspects of Strabismus in Teenagers and Adults and

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the Impact of Surgical Correction." Journal of American Association for Pediatric Ophthalmology and Strabismus 12.1 (2008): 72-76. Niedenthal, Paula M., et al. "The Simulation of Smiles (SIMS) model: Embodied Simulation and the Meaning of Facial Expression." Behavioral and Brain Sciences 33.6 (2010): 417. Uretmen, Onder, et al. "Negative Social Bias Against Children with Strabismus." Acta ophthalmologica Scandinavica 81.2 (2003): 138-142.