What does the treatment involve?
When a patient complains of eyestrain, headache, blurry vision, etc., they are advised to see an ophthalmologist to find the cause of their symptoms.
The specialist will not only carry out a visual acuity examination (to rule out a refractive error, such as myopia, hypermetropia or an astigmatism), and an examination of the eyeball to check that it is healthy, but also an orthoptic screening to confirm that the eyes are aligned in each of their gaze positions, to check the patient's stereopsis (capacity to see in three dimensions), measure the patient's capacity to converge and diverge and, ultimately, evaluate the patient's binocular vision (cooperation of both eyes with the visual brain).
When is this treatment indicated?
Visual rehabilitation is one of the treatments that helps us to solve binocular vision dysfunctions. The efficacy of these treatments will depend on correct indication, which is why it is fundamental that you see a specialist ophthalmologist who evaluates the results and indicates the treatment to follow.
When we detect a binocular cooperation problem giving rise to symptoms, we propose a therapy. Although it depends on each individual case, the age and cooperation of the patient, rehabilitation exercises are generally carried out with a synoptophore.
How is it performed?
A synoptophore is an instrument that enables us to assess if there are fusional convergence or diversion problems and treat them. Rehabilitation through these orthoptic exercises is also a complement to the treatment of certain cases of strabismus, such as intermittent divergent strabismuses and phoria (latent strabismuses) that cause the above described symptoms: headache, eyestrain and even double vision. In these cases, rehabilitation helps us to improve the fusion and, therefore, the cooperation and work of both eyes.
Patients come to do exercises every day for two weeks. Every exercise lasts 20 minutes for children and half an hour for adults.
In the case of children, it is very important that the patient cooperates. These are repetitive exercises and we need the child to concentrate, which is why we do not indicate therapy for very young, unsettled and easily distracted kids who cannot concentrate. We will consider it further down the line.
On the last day after the exercise, we will measure the convergence or divergence capacity again. Then the specialist ophthalmologist will see you once again to explain the result of the therapy and how to do a simple exercise at home to keep up the improvement achieved with the synoptophore.
We usually give the example of going to the gym. If you go, use the machines and work hard but don't go back, over time you will lose the strength gained. For this reason, it is important to do the home exercises that the ophthalmologist explains to you.
All patients who do the exercises get better. Absolutely all of them. However, it will directly depend of the patient's capacity to work hard and concentrate, which is why the ophthalmologist should determine for which patients (in the case of children) the therapy is indicated (or not indicated) based on the child's age, pathology and character.
Professionals who perform this treatment
Frequently asked questions
Can the exercises be done at home straightaway?
It is not advisable. We normally explain them to the patient with this example to make it easier to understand: if you've never gone to a gym or done exercise and start to do weightlifting, for example, it is likely that it will be a waste of time. You need to start with a personal trainer who improves your muscle strength, then you can "go it alone". It is a similar scenario with these exercises: the synoptophore will help us to gain a good level of strength, then we can do them at home. If we start with therapy at home alone, it will not be enough to improve the little muscle strength.
Do the exercises have to repeated each year?
When the convergence improves after the exercises, it is important to keep them up at home. It is likely that the therapy performance time goes down after a few years depending on the symptoms and the ophthalmologist may need to repeat the visual rehabilitation.