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Eye Exercises for Strabismus

Medically Reviewed by Whitney Seltman, OD on July 14, 2020

Strabismus, or crossed eyes, is when both eyes don’t look in the same place at the same time. One eye may look straight ahead while the other looks in another direction. Most often, this happens in infants and young children, but it can happen in adults, too.

There are a few reasons someone may have this condition:

  • Strabismus can be genetic.
  • It’s a sign of severe farsightedness.
  • It may be a sign of disease, such as a tumor.
  • It may mean there’s a problem with the muscles and nerves that control the eye.
  • It may happen after a head injury or stroke.

The eye may be turned in (this is called esotropia), turned out (exotropia), looking upward (hypertropia), or looking down (hypotropia).

Strabismus can be treated, and the earlier the better. Children won’t outgrow it. If you don’t treat it, strabismus can lead to vision damage, including double vision, reduced vision, and amblyopia, also known as lazy eye.

Eye Exercises as Therapy

Treatment is vision therapy. Options range from eyeglasses to eye patches to surgery, and exercises for your eyes. There are six muscles that control your eyes, and they’re supposed to work together to allow both eyes to look in the same place. If you have strabismus, these muscles aren’t working as a team.

Your eye doctor, usually an optometrist or ophthalmologist, may suggest eye exercises to improve muscle control and brain-eye coordination to help your eyes focus correctly. Some of them you can do at home. Others should be done at the doctor’s office because they require special equipment such as lenses, prisms, filters, occluders, or computer programs.

Your doctor might prescribe eye exercises like these:

  • Pencil push-ups. Your doctor will call it a near point of convergence exercise. You can do this easy, cost-free exercise anywhere. Hold a pencil at arm’s length from your face. Slowly move it closer to your nose. Follow the pencil with your eyes and keep it in focus. When you start to see two pencils, move the pencil further away again. Repeat the exercise several times a day. This treatment alone has not been proven to help strabismus.
  • The Brock string. This exercise uses 5 feet of string and three beads of different colors. Space the beads equal lengths apart on the string. Hold one end of the string to your nose. Tie the other end to something that won’t move easily, like a chair or railing. Focus on the bead closest to your nose until you see it as a single object at the X where the strings meet. Shift your focus to the next bead and repeat.
  • Barrel cards. Like the Brock string and pencil push-ups, barrel cards are a convergence technique. Each card has three barrels drawn on it. The barrels are red on one side of the card and green on the other. Also, the barrels are different sizes: small, medium, and large. Hold the card against the bridge of your nose with the smallest barrel closest to you. The card should be vertical, so that one eye can see the red barrels and the other eye can see the green barrels.

Focus on the barrel farthest from your nose. You should see the red and green barrels come together to form one image. Hold your focus for 5 seconds, and then shift it to the middle circle. Once you see the colored barrels overlap to form one image, hold your focus for 5 seconds. Finally, repeat this process for the nearest barrels until you’ve done all three barrel sizes.

  • Computer programs. People with strabismus may have trouble with depth perception and with seeing in three dimensions because their eyes can’t focus on the same object at the same time. Some doctors have specially designed computer programs that use virtual reality and video games to help correct this. These are called divergence techniques, and your doctor can customize them for you. They aren’t usually something you can do at home.

What if Vision Therapy Doesn’t Help?

Most of the time, eye exercises can correct strabismus in adults and children. If they don’t work, your doctor may suggest surgery to adjust the muscles around the eye and bring the eye into correct alignment. Some types of strabismus can be treated with eye drops that temporarily blur your good eye to strengthen the other eye.

Sometimes you can treat strabismus with a drug that weakens your eye muscles for a short time. The doctor injects the drug into your stronger eye muscles, which eases their pull on the eye and strengthens the weaker muscles. It wears off after a few months, and your eyes should be more aligned as a result.

WebMD Medical Reference

Sources

SOURCES:

The University of Illinois College of Medicine: “Crossed Eyes / Amblyopia.”

American Optometric Association: “Strabismus (Crossed Eyes).”

Johns Hopkins Medicine Wilmer Eye Institute: “Strabismus & Amblyopia.”

University of Florida Health: “Strabismus.”

Korean Journal of Ophthalmology: “Effectiveness of Home-Based Pencil Push-ups (HBPP) for Patients with Symptomatic Convergence Insufficiency.”

American Academy of Ophthalmology: “Convergence ability.”

The Ohio State University College of Optometry: “Office-Based Vision Therapy.”

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