Strabismus / convergence exercises

Convergence theory
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Healthy eyes have a natural ability to converge on an object being viewed in such a way that the image is centered in the macula. You may have noticed that when viewing close objects, your eyes naturally converge, while when viewing distant objects, your eyes align nearly parallel to each other. In both cases, our vision has an extraordinary ability to maintain close and distant objects in sharp focus. Of course, this applies only to healthy vision without convergence disorders.

Proper convergence allows for a deep and accurate perception of depth in the 3D world. The brain automatically combines images from the right and left eyes into a single three-dimensional whole. This ability helps us, among other things, estimate the distance of objects relative to us. Untreated convergence problems can lead to the development of strabismus, either convergent or divergent.

You can find more information about this condition here

Exercise Z1. CONVERGENCE CHARTS EXERCISE

For this exercise, we will use convergence charts. The main goal is to create a virtual image, allowing each eye to work separately, strengthening coordination between the eyes and improving the functionality of eye convergence.

  1. Use any of the convergence charts and place it about 50-70 cm (19-28 inches) away from you at eye level. Then, extend your arm with a straight thumb (or pen) halfway between you and the chart and focus on it while observing the shapes on the chart.
  2. You should see a total of 4 shape images on the chart. While maintaining convergent vision on the thumb, try to bring it closer or further away so that the 2 inner images merge into one, and you see a total of 3 images (2 are real, and one is virtual). As time goes on and you gain experience, you will be able to see 3 images immediately (even without using your thumb).
The further part of the exercise will be available only for Premium Zone members.
Exercise duration in minutes: 1-2
Number of repetitions per day: 3-8
Alternative exercises: Z3, Z4
Eye strain: low
Exercise Z2. DIVERGENCE CHARTS EXERCISE

  1. Use any of the divergence charts and place it about 40-50 cm (16-20 inches) away from you.
  2. Look between the stars or simply over the top of the chart and gaze into the distance. It may be helpful to look at a distant object several meters away. When you succeed, you should see a third (shadow) image, e.g., a star in the middle of the two on the chart. Adjust the distance of the chart from yourself so that the third image is more clearly visible, exactly in the middle of the other two.
  3. Then look at the next row of stars. This will require changing your gaze to a slightly shorter distance than the first row to see three stars again. Look at each of their details. Notice that the white circle comes from a different side this time. If one of your eyes is weaker, you may have difficulty seeing the white circle in one or both rows of stars. If the muscles of such an eye are also weakened, the central image will converge to one side. If you have a problem with this, take a break for a few seconds or blink several times.
  4. Continue the exercise with the following rows down and then back up again.
  5. You can also perform the star exercise in convergent vision mode by moving the chart slightly further away and crossing your eyes in front of the chart.
Exercise duration in minutes: 1-2
Number of repetitions per day: 3-8
Alternative exercises: Z3, Z4
Eye strain: low
Exercise Z3. THUMB EXERCISE
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  1. Choose a distant object, then hold your thumb at the height of the object you're looking at and focus on it. You should see two images of the distant object.
  2. While maintaining convergent vision on your thumb, try to observe the left image of the object and notice as many details as possible. Then return to your thumb and repeat this procedure for the right image of the object. If you have a problem with a "lazy eye", you'll notice that one of the object's images (the one seen by the weaker eye) is less distinct. Spend more time working with this eye.
  3. Now reverse the process. Focus on the distant object. You should see two thumbs. Repeat the process from step two, focusing on the left and right images of your thumb.
Exercise duration in minutes: 1-2
Number of repetitions per day: 3-8
Alternative exercises: Z1, Z2
Eye strain: low
Exercise Z4. MOVING THUMB

  1. Place one of your thumbs at nose level, about 15 cm (6 inches) away from your face. Then place your other thumb about 30 cm (12 inches) away.
  2. Look at the second, farther thumb. You should see two images of the first thumb, with the farther thumb visible between the split images of the closer thumb.
  3. Keep your gaze on the farther thumb and simultaneously start to move it away from you. Always be aware of the two images of the closer thumb, but maintain focus on the moving thumb. After moving the farther thumb to arm's length, move it back towards the closer thumb. Repeat step 3 several times.
  4. During this exercise, you should always see two images of the closer thumb. If you only see one image, it means that one eye "is not seeing". In this case, move the farther thumb back slightly to see two images of the closer thumb again.
The further part of the exercise will be available only for Premium Zone members.
Exercise duration in minutes: 2-4
Number of repetitions per day: 3-8
Alternative exercises: Z1, Z3
Eye strain: low
Exercise Z5. TWO-STRING EXERCISE

  1. Attach the ends of two strings to a chair, for example, and connect their other ends with a bead, so that you can easily slide the point where the strings converge.
  2. Now try to converge your gaze on the two last, distant beads. The easiest way to achieve this is by looking at the bead connecting the strings in front. You should see additional string images between the outer strings. Try to adjust the connecting bead you're looking at so that the additional string images appear most parallel.
  3. Focus on the middle string image, which is the convergent image of the strings on the sides. Try to look at each bead on this image. If you used colored beads, different on each side, your brain will have to choose a dominant eye, which will cause you to see the image seen by that eye.
  4. If you see that one eye is dominant and the image from the weaker eye is missing, try gently shifting your gaze to the right or left to see the missing bead image again. Then perform the string convergence again.
Exercise duration in minutes: 1-2
Number of repetitions per day: 3-8
Alternative exercises: Z1, Z3
Eye strain: low
Exercise Z6. SCANNING NET

  1. Set up the strings the same way as in Exercise Z5, but this time hold their ends about 30 cm (12 inches) in front of you, at chin level.
  2. Move the connecting bead another 30 cm (12 inches) away from the hand holding the strings. Look far into the distance at an object (similar to divergence). You should see a double image of the connecting bead and the strings. Further away from the connecting bead, you should see four strings going into the distance, and at their ends, two sets of end beads.
  3. Check how far you can scan this network; the farther you go, the more difficult it becomes as the strings get closer together. Look at each bead, trying to see it sharply; you can change the type of scanning, from string to string, every other bead, etc.
Exercise duration in minutes: 1-2
Number of repetitions per day: 3-8
Alternative exercises: Z2, Z3
Eye strain: low
Strabismus theory
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Strabismus (squint) is an eye condition characterized by weakened eye muscles, causing a change in the angle of one eye relative to the other. The result of strabismus is a disruption of stereoscopic vision. You can find more information about this condition here

When training the eye with strabismus, we need to correct the "alignment" of the muscles, that is, try to influence the coordination of the eyes and bring it to a natural balance. Strabismus treatment with vision training can be divided into 2 phases:

  1. Strengthening eye coordination through convergence exercises and practicing eye muscle flexibility so that the strabismic eye begins to cooperate with the other eye. For this purpose, we use a string as a reference point. The aim is to see a phantom cross, which will become visible when the correct alignment of both eyes and their convergence on the object we want to see is achieved.
  2. The second stage is training the deviating eye and its main defect (e.g. nearsightedness). This is because the eye affected by strabismus usually has a greater defect than the other eye. Equalizing sharpness between the eyes will therefore result in a greater balance between the eyes and thus complete healing of strabismus
Exercise Z7. SWAYING WITH A MIRROR
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This exercise was developed by Clara Hackett, and its aim is to relax the eyes and make them work together.

  1. Stand with your back to the mirror in a slight straddle so that your feet are about shoulder-width apart.
  2. Cover your healthy eye (let's assume it's the right one) with your hand and look straight ahead with your other eye.
The further part of the exercise will be available only for Premium Zone members.
Exercise duration in minutes: 2-4
Number of repetitions per day: 2-10
Alternative exercises: Z8, Z9
Eye strain: medium
Exercise Z8. BALANCING SWAYING EXERCISE

  1. Stand up straight with your feet slightly apart, about shoulder-width apart, and extend your arms to the sides at shoulder height.
  2. Always turn your head in the opposite direction of the deviated eye. So, for example, if your left eye is turned inward or your right eye is turned outward, turn your head to the left and while moving your head and torso, look at your left hand.
  3. Lean your torso to the right, with your left hand rising up toward the ceiling and your right hand approaching the floor.
  4. Straighten up to the starting position and tilt your torso to the left, with your right hand rising up and your left hand lowering down. Do this 6-8 times.
  5. Now switch sides and repeat the exercise, looking at your right hand this time.
  6. If your right eye is turned inward or your left eye is turned outward, perform the exercise as described above but start by turning your head towards your right hand.
Exercise duration in minutes: 2-4
Number of repetitions per day: 2-10
Alternative exercises: Z7, Z9
Eye strain: medium
Exercise Z9. TROMBONE EXERCISE
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This exercise was recommended by Janet Goodrich, and as the name suggests, in this exercise, you move an object back and forth, mimicking the movements of a musician playing a trombone.

  1. For the exercise, you can use any object the size of a small bottle. It's best to use an object with many interesting elements for your eyes to focus on.
  2. If you have, for example, your left eye turning inward, cover your right eye with your hand and move the object from the midline of your body outward to the left. If your eye turns outward, the object's movement should also start from the outside and continue until the body's midline.
  3. Once you've completed the first phase of the movement, return the object to its starting position and repeat the movement 5-20 times. You can change the speed and range of motion.
The further part of the exercise will be available only for Premium Zone members.
Exercise duration in minutes: 2-4
Number of repetitions per day: 2-10
Alternative exercises: Z7, Z8
Eye strain: medium