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4 Eye Exercises for Strabismus
Published on August 30th, 2023
Australia
Strabismus, also known as misaligned eyes or crossed eyes, is an eye condition in which the eyes are not in alignment with each other, with one eye turned in a different direction. Strabismus is caused by issues with the eye muscles and can occur due to medical conditions, refractive errors and can also be genetic. Strabismus commonly affects children, but can also occur in adults. Strabismus treatment includes surgery, glasses and vision therapy in the form of eye exercises. Eye exercises for strabismus may not fix crossed eyes naturally but may improve the condition by strengthening eye muscles. There are several eye exercises that may be used in the treatment of strabismus including pencil push-ups, the brock string, barrel cards and near-far focus switching. The exact effectiveness of eye exercises for strabismus will be down to the individual. It is important to check with an eye care professional or healthcare provider before starting any eye exercises as they may not be effective for everyone. Eye exercises should not be performed as an alternative to getting an eye test or seeing an eye care professional for treatment. The types of eye exercises for strabismus are listed below.
- Pencil Push-Ups: Pencil push-ups are an eye exercise that can be used to treat strabismus as it trains the eyes to converge on a single point.
- The Brock String: The Brock string is a type of eye exercise that may be used in vision therapy to improve strabismus as it helps the eyes work together and coordinate.
- Barrel Cards: Barrel cards are an eye exercise that aims to improve how the eyes converge and see a single close-up object, which may be beneficial for those with strabismus.
- Near-Far Focus Switching: Near-far focus switching involves switching the focus of the gaze between a near and far object, to help strengthen the eye muscles and help with controlling the gaze.
1. Pencil Push-Ups
Pencil push-ups are a type of eye exercise that can be used to help treat certain types of strabismus, as they can help train the eyes to focus on a single point. Pencil push-ups are a type of eye exercise that is used to train the eyes to converge on a single point or object close up. According to the Royal Devon University Healthcare, NHS Foundation Trust, pencil push-ups are conducted by holding a pencil at arm's length away from the face, with the top of the pencil at eye level. The arm then moves towards the face, with the eyes focusing on the top of the pencil, trying to keep the pencil as one image. If the pencil becomes two images, the participant should stop and focus until it becomes one. This should be conducted for 30 seconds, 3 times a day. Tromboning exercises are also similar to pencil push-ups, however, they use a finger not a pencil. Pencil push-ups can be done at home, without an optometrist or healthcare professional, however, it is important to consult with your healthcare provider before trying any eye exercise as they may not work for everyone.
2. The Brock String
The brock string is an eye exercise that may be used as part of vision therapy in the treatment of certain types of strabismus, as it can help the eyes work together and coordinate when looking at a nearby object. A brock string is commonly a white string that has three beads, coloured red, yellow and green, placed along the length. According to the Optometrists Network, a brock string exercise will work by securing one end of the brock string to a stationary object and holding the other end of the string up to your nose, looking at the bead closest to you. According to Medical News Today, a person will see two strings in the shape of an X as well as one image of the bead if they have vision without strabismus. For those that have strabismus, there may be two images of the bead, in which case, the bead should be moved back until there is just one image. The aim is to be able to move the bead closer to the eye without the image of the bead separating into two images. The Brock string eye exercise can be done at home, without an optometrist or healthcare professional present, however, it is important to consult with your healthcare providers before trying any eye exercise as they may not be effective for everyone.
3. Barrel Cards
Barrel cards are a type of eye exercise that can be used to help treat certain types of strabismus as barrel cards can help train the eyes to converge, or focus on the same object together. Barrel cards are a card with three barrel shapes drawn on one side in red, that increase in size. On the other side of a barrel card, there will be three barrel shapes increasing in size again, but in green. According to Medical News Today, barrel card eye exercises work by holding the card up to the nose so the largest barrel is furthest away. Focus the eyes on the barrel furthest away until the colours converge and the remaining two barrels have doubled. This should then be repeated with the middle barrel and the barrel closest to the eye. Barrel cards can be used at home, without an optometrist or healthcare professional present, however, it is important to consult with your healthcare providers before trying eye exercises.
4. Near-Far Focus Switching
Near-far focus switching is a type of eye exercise that can help treat certain types of strabismus as it helps to strengthen the eye muscles and can help train the eyes to focus. Near and far focus switching works by holding a finger away from the face at arm's length, looking at the finger and then switching the gaze to something far away. The gaze is then brought back to the finger. Near-far focus switching can help strengthen the eye muscles, help someone control the eyes better and help train the eyes to work in coordination, all skills that can be beneficial for someone with strabismus. Near-far focus switching can be conducted at home, without an optometrist or healthcare professional present, however, it is important to consult with your healthcare providers before trying eye exercises.
What is Strabismus?
Strabismus, also known as crossed eyes or misaligned eyes, is an eye condition in which the eyes are not in alignment with each other. If you have any sudden change to your eye alignment, see an eye care professional as sudden strabismus could be implicated with serious conditions like strokes, brain tumours and brain aneurysms. Strabismus is categorised by what way the eye turns. For example, if a person has esotropia strabismus, the eyes are inward turning. If a person has hypertropia the eye is upward turning. The other two types of strabismus are exotropia; outward turning and hypotropia; downward turning. According to the American Optometric Association, strabismus is caused by an issue with the muscles in the eye, which can be due to medical conditions or refractive errors. Those with a family history of strabismus may also be at a higher risk of developing the eye condition. According to the Boston Children's Hospital, strabismus is one of the most common childhood eye conditions, however, strabismus can also occur in adults. Treatment for strabismus can include surgery, glasses or vision therapy, which includes eye exercises. Eye exercises for strabismus such as pencil push-ups aim to help the eyes work together, in coordination and strengthen the muscles in the eye. Eye exercises should not be performed as an alternative to getting an eye test or seeing an eye care professional for treatment.
What Does Strabismus Look Like?
Strabismus will generally appear as one eye that is not aligned with the other or one eye that is turned. Strabismus will look different depending on the type of strabismus a person has. If a person has esotropia the eyes are inward turning, exotropia is outward turning, hypotropia downward turning and hypertropia upward turning. What strabismus may look like is shown in the image below.
How to Choose a Strabismus Eye Exercise?
The way to choose an eye exercise for strabismus is to consult with your optometrist or eye care professional. The eye exercises that can be done for strabismus are part of vision therapy, which is a type of program that is used to help improve a person’s visual skills and abilities such as eye coordination, according to the Better Health Channel. The eye exercises a person will need to complete for strabismus will be recommended by their optometrist or healthcare provider as part of this vision therapy plan.
What is the Role of Eye Doctors in Choosing a Strabismus Eye Exercise?
An eye doctor, known as an ophthalmologist in Australia, will not commonly play a role in choosing a strabismus eye exercise, this will typically be carried out by an optometrist. In Australia, an eye doctor refers to an ophthalmologist, who is a doctor of medicine with a specialisation in eye care. An ophthalmologist will generally deal with more complex eye conditions such as cataracts and advanced glaucoma. Vision therapy for eye conditions such as strabismus will be directed by an optometrist, specifically a behavioural optometrist, according to the Australasian College of Behavioural Optometrists.
How Effective are Strabismus Eye Exercises?
Eye exercises for strabismus may be an effective way to treat certain types of this eye condition, in a way that is non-invasive. The exact effectiveness of eye exercises for strabismus will be down to the individual and their specific case of strabismus. Eye exercises should not be performed as an alternative to getting an eye test or seeing an eye care professional for treatment.
What is the Success Rate of Strabismus Eye Exercises?
The exact success rate of eye exercises for treating strabismus is unclear, as the effectiveness and success of these eye exercises will be down to each individual and their specific case of strabismus. Eye exercises can be effective in helping to train the eyes to work together and may also be effective in helping strengthen the eye muscles.
What is the Expected Duration for Strabismus to Improve with Eye Exercises?
The expected duration for strabismus to improve with eye exercises, as part of a vision therapy program, is dependent on the individual and their specific case of strabismus. The duration of a vision therapy program will vary depending on the individual and the severity of their vision issues but can take anywhere from a few weeks to several months, according to the Optometrists Network. Eye exercises alone may not correct strabismus but may help as part of a comprehensive vision therapy plan.
Can Eye Exercises for Strabismus Restore Perfect Vision?
No, eye exercises for strabismus will not restore perfect vision, as perfect vision generally refers to visual acuity, something that requires prescription glasses to fix. Strabismus is an eye condition that is caused due to issues with the muscles in the eye. Perfect vision refers to good visual acuity, which is how sharp and clear your vision is. Issues with visual acuity are usually treated with prescription glasses, to help the eyes see clearer, as opposed to eye exercises.
Can Eye Exercise for Strabismus be Used for Lazy Eye (Amblyopia)?
There are certain eye exercises that are used for strabismus, such as pencil push-ups and a brock string, that may be used as part of vision therapy for amblyopia or lazy eye, however, this eye condition also has its own treatments separate from eye exercises. Amblyopia or a lazy eye, is an eye condition where one eye has weaker vision than the other, often due to developmental issues. Amblyopia or lazy eye exercises that are also used for strabismus may include ones such as pencil push-ups. Most treatments for amblyopia focus on improving the vision in the weaker eye by using an eye patch to cover the stronger eye, using certain eye drops or surgery.
What Other Eye Conditions Benefit from Strabismus Eye Exercise?
There are other eye conditions that may benefit from eye exercises for certain types of strabismus, as the aim of these exercises is to strengthen the muscles of the eyes and help train the eyes to work together. Eye exercises such as pencil push-ups can be used for the different types of strabismus such as strabismus exotropia, but may also be of benefit for people who have other eye conditions such as amblyopia. People with amblyopia may benefit from the brock string exercises as this helps with eye coordination and eye teaming.
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