What is strabismus?

Strabismus is often referred to as crossed eyes, but it can present in several different ways. The American Optometric Association defines strabismus as a “condition in which both eyes do not look at the same place at the same time.” It can present as one eye drifting inward (esotropia), outward (exotropia), upward (hypertropia), or downward (hypotropia). This misalignment is often due to incongruities, such as the eye’s inability to focus properly on a point off in the distance.

Strabismus most often occurs in babies and toddlers due to heredity or problems during physical development. Most cases in children are caused by poor communication between the brain, muscles, and nerves of the eye. However, it can also occur in adults who have suffered a stroke, head trauma, or diabetes. The condition can lead to double vision, a lack of depth perception, and even loss of eyesight if left untreated

Treatments range from prescription eyewear to surgery to align the eyes. However, many vision therapy programs now incorporate exercises for the eyes as well. These can help to improve coordination.

Exercises should not be considered a substitute for medical treatment. “Because the causes and manifestations of strabismus vary widely, patient-driven eye exercises alone should not be considered as an exclusive treatment,” says Dr. Jeffrey Anshel, founding president of the nonprofit Ocular Nutrition Society. “An orthoptist or optometrist can properly assess the situation and prescribe a regimen designed to address specific symptoms.”

Bottom line: Be sure to get a thorough eye examination before you start a vision treatment plan.

Pencil pushups are simple ocular workouts that get both eyes aimed on the same fixed point. They are also known as near point of convergence exercises.

Start by holding a pencil out at arm’s length, pointing away from you. Focus your gaze on the eraser or a letter or numeral on the side. Slowly move the pencil toward the bridge of your nose. Keep it in focus for as long as you can, but stop once your vision gets blurry.

Swiss optometrist Frederick Brock developed this exercise to improve eye coordination. You’ll need a string about 5 feet long with three different colored beads.

Secure one end of the string to a stationary point such as a handrail or the back of a chair. Space the beads out at equal distances. Hold the other end of the string tightly to your nose.

You should see a consistent pattern as you shift your focus from bead to bead. The bead you are looking at will appear by itself at the intersection of two identical strings with doubles of the other beads, forming an X. Your eyes are not properly focused on the bead if you see the strings crossing in front of the bead or in back of the bead. Be sure you can get the X at all beads (except the one at the far end, which will just have the two strings coming out toward you in a V).

Reposition the beads along the string and continue the exercise.

This is a handy exercise for exotropia. Draw three barrels of progressive size in red lengthwise on one side of a card. Do the same thing in green on the other side.

Hold the card lengthwise and vertically against your nose so that the largest barrel is furthest away. Stare at the far barrel until it becomes one image with both colors and the other two barrel images have doubled.

Maintain your gaze for about five seconds. Then repeat with the middle and smallest barrel images.