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Posted on 10-29-2013

Are Your Eyes Getting Flabby? Do They Need Eye Exercises?

People often ask me about eye exercises. Parents wanting to avoid eye muscle surgery for a child's crossed or lazy eye ask if their child is going to be doing eye exercises instead of surgery. Some want to know whether eye exercises will help their child read better, or to help them focus better when they have ADD or ADHD. Adult patients ask how eye exercises will help them work longer at the computer without getting a headache or fatigue, or to help them stop seeing double or reduce their nearsightedness (myopia). I understand why they would ask these questions and why they might think that since I'm an 'eye doctor' that people do eye exercises in my office.

Of course, I don't think of myself as an eye doctor because I don’t really work with the eyes. I work with people who are having trouble with the visual process and visual development, most of which is neurologically (brain) based. Behavioral optometrists use vision therapy and lenses to help people perform their daily activities with greater efficiency and comfort. The vision therapy I provide is truly not eye exercises. Exercise implies that force and repetition are what cause the changes, that muscles are being worked out.

Vision therapy provides the appropriate conditions for a person to change their approach to solving a problem by stimulating the brain in certain ways. In this case, the problem is how to be more efficient in using both eyes together or how to aim or focus their eyes more accurately. When a person can do these sorts of things better, they will process information and carry out actions more effectively. 

Many people, including eye care professionals and even some behavioral optometrists, describe what goes on in vision therapy as eye exercises. This is particularly true of professionals who neither provide nor accept the kind of treatment of visual problems provided by behavioral optometrists. They often dispute the philosophy underlying behavioral optometry - despite considerable clinical and scientific evidence that supports the philosophy and practice of behavioral optometry. Behavioral optometrists have successfully utilized vision therapy and the therapeutic use of lenses to affect behavior and performance since the 1930s. I guess it's easier to talk about eye exercises since that's how most people think and talk about vision therapy, but I have never been fond of taking the easy way especially when it’s inaccurate.

Vision therapy, which is used to treat many conditions including strabismus (eye turns), amblyopia (lazy eye), many vision related developmental and learning problems and progressive myopia, is better thought of as affecting positive changes in the brain. A good vision therapy program arranges conditions for the person to learn how to more efficiently and more effectively use the visual process for learning, earning a living and engaging in sports and recreational activities. Vision therapy is most effective when it involves real movement, not sitting in front of a computer doing “eye exercises.” Research shows that movement is critical for good visual development and for removing the obstacles to visual development once problems arise. The changes that take place occur in the brain regardless of the style of vision therapy.

There is no change in eye muscles with vision therapy. On a side note: it is rare that there is muscle damage when someone has an eye turn or lazy eye. Even surgeons admit this though they still insist that they must do eye muscle surgery to straighten the eye. This is usually not true. The twelve eye muscles that move the two eyes are many times stronger than their workload would suggest, and also never fatigue. It’s true that vision therapy procedures involve moving the eyes as well as improving one’s ability to use both eyes together. This means using the external muscles that control these movements. This does nothing to strengthen these muscles; it is about training the brain to send more accurate signals to those muscles.

So even though eye exercises might sound like a good idea for your tired eyes, there really is no such thing. Let’s give credit where credit is due. It’s all about the brain.

Next time: When Eye Muscles Go Astray

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