Vision Training

"Eye-Robics" for Tired Eyes

You might have eyes like a hawk, and the only glasses you need are the ones you pour your orange juice into every morning. But visit an optometrist's office who performs vision training (sometimes called vision therapy), and you may discover that your eyes aren't as picture perfect as you thought.

Glance into the cheiroscope, which resembles a microscope with two lenses instead of one. Through the lenses, you see a picture of an elephant you're supposed to trace.

No problem, right? Surprise: As you peer through the binocular lenses, which force each eye to work on its own, you keep losing sight of the elephant's outline. In fact, even the pencil point with which you're trying to draw seems to disappear.

That's because in order for your drawing to line up with the picture, both eyes have to do their thing. But optometrists who practice vision therapy say that often, one eye "shuts down" without you ever knowing it--mainly because the brain sees the information it's receiving as conflicting--and your other eye takes over, resulting in eyestrain and headaches, says Glen Steele, O.D., chief of pediatrics and vision therapy service at Southern College of Optometry in Memphis.

Correcting problems like that--known as suppression--is what vision therapy is all about.

"We're changing the way people go about trying to see," says Dr. Steele. "Not only that but also how they use the information that comes in. If your brain can't use the information, it shuts down."

TRAIN YOUR EYES TO SEE BETTER

Although optometrists often work with children who have problems like crossed eyes or wandering or lazy eye, adults have other, sometimes more subtle, issues to deal with. Optometrists report that a common adult problem is convergence insufficiency, in which the eyes either can't align themselves properly or are unable to sustain that alignment. The result, they say, is often blurry close-up vision or occasional double vision that many people write off as tired eyes.

So how do optometrists remedy these problems? Some use vision therapy, also called visual training, or a series of prescribed visual tasks to help you relearn effective seeing skills, says Stephen Miller, O.D., director of the Clinical Care Center of the American Optometric Association in St. Louis.

You do these tasks for an hour or two a week in the optometrist's office along with some additional eye exercises at home for anywhere from three to nine months--depending on your condition--under the guidance of an optometrist who's skilled in vision therapy.

"It's not a remedy for people who've been wearing glasses all their lives," says Dr. Miller. "But it helps with eye focusing and coordination. A 30-year-old woman may be able to see okay to drive to work in the morning, for example. But any extra stress on the eyes during the day may cause eyestrain, discomfort and blurred vision. Vision training can enhance eye coordination and focusing skills to a point where the eyes work more comfortably and efficiently."

A COMPUTER-AGE PROBLEM

Back in the days when we were hunters and gatherers, survival depended on being able to spot game at great distances. But in this computer age, almost all of our tasks are within 15 inches of our faces, says Arthur Seiderman, O.D., director of the Vision Development Center in Norristown, Pennsylvania, and author of 20/20 Is Not Enough: The New World of Vision.

On top of that, gazing into a computer screen all day is extra-hard on the eyes, says Dr. Seiderman. And it's something that women especially have to worry about, he says. "Your eyes can compensate for vision problems up to a point. But lots of women who've rejoined the work force after taking a few years off to raise their little ones discover that they've lost the ability to compensate for visual problems. In fact, it's hard to imagine anyone putting in four to six hours on the computer who doesn't have a visual problem."

The fact that your eyeglass prescription gets stronger and stronger as you get older has a lot to do with environmental demands, says Mark Greenberg, O.D., chairman of the sports vision section of the American Optometric Association in Pearl River, New York. Working at a computer causes the eye's focusing muscles to lock in, which means they can't relax. So you need stronger and stronger corrective lenses.

"Wearing stronger glasses corrects the symptom and not the problem," says Dr. Greenberg. "What you need to do, and what visual training can help you with, is learn to relax those focusing muscles."

The effect of all that close-up work on your eyes could go unnoticed, Dr. Seiderman notes. "It causes subtle focusing problems that might keep you from being able to concentrate on reading. I'm sure nine out of ten people realize that they're fatigued but don't connect the problem to their eyes."

HOW TRAINING CAN HELP

Many vision skills are actually developed as you grow, in the same way you learn to stand, walk and run, says Dr. Miller. Not everyone's eyes have the same focusing and eye coordination abilities.

To a certain extent, how well you see is determined by genetics. After all, if both your parents were nearsighted, you have a much greater chance of needing glasses yourself, says Dr. Steele. But vision therapy can help you to see better with or without glasses and reduce eyestrain and fatigue, especially in men and women who work at computers.

"The eye muscles are like any other muscles in the body in that they can be enhanced and strengthened," says Dr. Greenberg.

The kind of training you get in vision therapy varies, depending on what's wrong with your eyes, says Dr. Seiderman. But the real focus is on getting both eyes to work as a team. That means doing routines in which each eye works alone in order to equalize their skills, doing routines that work the two eyes at the same time but separately to eliminate the problem of the brain rejecting the messages of one eye, and doing routines in which both eyes work together, he says.

In one session, for example, you might follow moving targets with one or both eyes. Or you might look through an instrument with each eye seeing a different picture to help you relearn to use the eyes together again. By using different power lenses that force the eye to change focus, the eye develops new and more efficient means of focusing or refocusing, says Dr. Miller.

FOCUSING ON SELF-HELP

Although vision training should be done under the direction of an optometrist, you may wish to use the following general vision therapy eye exercises at home.

Do a pencil push-up. A good exercise for dealing with eye coordination (convergence) problems, where the eyes have a hard time working together to look at close objects, is the pencil push-up, notes Dr. Miller. Hold a pencil vertically at arm's length directly in front of your face and slightly below eye level. Gradually bring the pencil closer and closer to your nose.

At some point, you should see two pencils, says Dr. Miller. If the "double vision" doesn't occur until the pencil is almost to the nose, you probably don't have a convergence problem. But some people may see double at five or six inches from their nose. "If that's the case, relax your eyes by looking at something across the room, then look back at the tip of the pencil, which should still be near your nose, and try to be able to see just one. Then move it out to arm's length and bring it in again," he says. Repeat this for about 10 to 15 minutes.

"Over several days or weeks, you should be able to gradually bring the pencil closer each time until it's almost to your nose before you see two," he says.

Practice with an ice cream stick. You can use an ice cream stick (like a Popsicle stick) to work on improving peripheral vision, which is the vision that goes out to each side, notes Dr. Greenberg. "Take an ice cream stick and draw a little letter on it. Move your left arm out as far as you can to the side while still being able to read the letter on the stick without turning your head," he says. Then switch the stick to your right hand and try to hold it as far to the side as you can while still reading the letter. Alternate right and left, for about four minutes total. Practice a couple of times a week, and you should eventually see an improvement in your peripheral vision, says Dr. Greenberg.

Take a thumbnail view of TV. To further stimulate peripheral vision, select an action-filled show like a sporting event on television, suggests Dr. Seiderman. Position your chair so that when your arm is extended, your thumb is 12 inches from the screen. Hold your arm straight out in front of you with your thumb up. Keep your eyes focused on your thumb while trying to be aware of the action on either side of it. Do this for two minutes. Repeat a couple of times a week.

Read the writing on the wall. Instead of staring nonstop into a computer screen, give your eyes a focusing break, suggests Dr. Greenberg. "Take two pieces of paper--one with written material held at a distance of 16 inches and one with newspaper headlines posted about 20 feet away," he says. Then, to help strengthen your focusing abilities, read the paper at a distance of 16 inches and then look over at the paper that is posted 20 feet away. Repeat this exercise, shifting your focus from near to far, for about three minutes using both eyes. Repeat at least once every hour or so while working at a computer screen. When you can do this easily, change the distance of the paper you hold in your hand from 16 inches to 13 inches, then 10 and then 7.

Nose in on the news. Another focusing exercise is to take a newspaper or magazine, hold it at normal reading distance and then gradually move it closer until the print blurs, notes Dr. Miller. Then look at something across the room and back at the newspaper again. Try to see the print clearly. Repeat for about five minutes, two or three times a day.

Stretch your eye muscles. Another convenient way to take a break from the computer is to stand and stare out the window toward something in the distance, notes Dr. Greenberg. Or, if your work station has no windows, look toward each of the four corners of a nearby wall, without moving your head. Do this clockwise first, then counterclockwise. "That really stretches the eyes," he says. "Do it with your eyes open and then closed, to get the feeling of a real stretch while really relaxing the eyes."