Eye exercises part 1 - Introduction and Brock string

If you have been lucky enough to get a diagnosis by a proper specialist and your issues can be linked to heterophoria and its many varieties, you have probably been prescribed prismatic glasses and some eye exercises down the road.

Depending on the type of heterophoria you have and what degree of, these exercises might have to be done every other day or every day and for the next 3 months or even up to a year and more.

In this article, I will describe what exercises I have done for my specific case (esophoria and right eye only sharp at near). You may try these if you wish, as some of them can be made to work for both cases of esophoria/exophoria, however I strongly recommend following a program that your specialist has made for you.

Reason for that is trackable progress, checks to make sure you are doing the exercises correctly and possible adjustments to your glasses and the exercises to get the fastest progress possible.

I have been told by my specialist that there are more factors to the exercises and each takes its own time to improve. You are training the ocular muscles to be more relaxed or stronger where needed and learning to balance them so none overpower the other. You are also building new innervations in order to be able to use those muscles correctly, which takes time. You are also possibly teaching the visual center in your brain to process the new input in new ways.

All of this takes time, some people get very fast progress and some improve very slowly. It is also very common to hit plateaus, where you seem to not be improving at all. I have hit such plateaus for even 2 or 3 months, only to then get a progress that seemed to be overnight or in the matter of a few days. The best approach therefore is to just keep going and making the exercises progressively harder.

It is not uncommon and actually welcome, if you feel eye strain, pain, tiredness, exhaustion or even start having a headache or feeling of a slight migraine during and after these exercises. If the pain you experience is similar to that you feel when exposed to new display technology and lighting, it's a good sign that the exercises are tapping into the problems that the new tech triggers. My approach here actually was that when an exercise stopped being uncomfortable or painful, it was a sign to move to a more difficult version. However I still followed a very specific regimen with an excel spreadsheet where times and repetition were noted every day in order to see the progress and inform adjustment.

I have done all of the exercises with the glasses I got prescribed. These were prismatic in order to help with the esophoria, as well as fixing my nearsightedness and other minor issues. The point is that it is good to have a near perfect vision with the helps of the glasses, so you can focus fully on the exercises instead of trying to compensate for other issues like nearsightedness, which would only hinder your progress. If you have 20/20 vision, you may still have heterophoria. In this case glasses might not even be needed.

The exercises are described in the progression that I followed and may differ in your case. I have to stress again to follow your specialists advice first and foremost. The exercises can't really hurt you in any way, but they can be useless if done improperly and that may discourage you from actually fixing this issue.

Brock string

Brock string is the simplest and most available tool you can use at the start. It is also a good tool to check whether you have esophoria or exophoria. It is a string with few beads on it that can move along the string and that you can either buy or make home yourself. For an easier start, it is good for the string and the beads to not have reflective or too smooth of a surface, as your eyes have an easier time focusing on something with a texture.

Anchor the string at eye level (the string is usually about 1m or a bit more) and put the other end of the string to your nose. Try placing the beads at different distances, but the closest at about 10 cm away from your nose. Looking at the bead, by the nature of binocular vision you should see two strings coming towards it and crossing there (one string being the vision of your left eye, and the other of your right eye, where they cross is where your eyes meet).

If you only see one or the other string, or one string keeps appearing or disappearing, your brain is turning one or the other eye on and off and that is a sign of binocular vision impairment (eye suppression). This can be trained simply by concentrating on always having both strings present at the time. What the brain does in many cases of binocular vision dysfunction is that in difficult situations it turns input from one eye off. You can have both eyes open, but your brain simply decides to register input from one eye only to make things easier.

When looking at one of the beads, pay attention to where the string crosses. Is it right at the bead, in front of it, or behind it? If when you focus on the bead the strings cross in front, you have esophoria. If they cross behind the bead, you have exophoria.

Brock string exercises

I have done several exercises with the brock string for about 3 months as part of my training until there was no pain or discomfort from using it.

• Position the beads evenly on the string. Try looking at one bead in the distance of 30 cm away from your nose while placing the other bead another 20 cm away from the first. Focus with both eyes on the closest bead. What can happen is:
• You see one bead and behing it two beads. Two strings are entering the bead youre looking at and they cross exactly in the center of the bead. You see two strings entering and two exiting the bead. This is optimal perception that is necessary for further exercises.
• You see two strings, but they cross in front or behind the bead. In this case try to make them cross at the bead by following ways:

Touch the bead with your finger from the bottom.

By the help of your finger move the crossing to the center of the bead.

When you can do this, you can follow with regular exercises.

Exercise 1 - refocusing

• Spread the beads evenly on the string.
• Change focus from one bead to the other and always make sure that optimal perception is present - two strings entering and exiting the bead, two beads in front or behind of the bead you are currently focusing on. Keep the focus on the bead for about 10s and then move to another one.
• Do this for 2 minutes a time, then 30s break, then another 2 minutes. Use metronome to keep a steady pace.

Exercise 2 - range of motion

• Place one bead 30 cm away from your nose and another one 60 cm away.
• Focus on the closer bead for 5s, then focus on the farther bead for 5s. Repeat three times and make sure optimal perception is present.
• After three repetitions, move the closer bead 3 cm closer to your nose. Keep repeating until you can't focus on the closest bead. Target distance of optimal perception is 5 cm away from your nose. I did this exercise for 10 min straight.

Exercise 3 - beetle on the string

• Move all beads away to the anchor point so the string is clear.
• Focus at the farthers point away from your nose and make sure you perceive the crossing of the string.
• Very slowly try to move the crossing of the string towards your eyes as if you were following a beetle walking on it towards your nose. Try to get as close as 3 cm to your nose.
• Make sure the movement of the crossing is fluent and not jumpy (it always is jumpy when you start).
• When you reach your nose, keep going in the opposite direction away from your nose and again make sure the movement is as fluent as possible.
• The whole move from end of the string to your nose and back should take 1 minute. Repeat three times.

The target of these exercises is to be able to converge your eyes 3 cm away from your nose, to realize how converging and diverging your eyes actually feels, to be able to consciously converge and diverge and to do it precisely.

Once you can do these things consciously, you will also realize how your eyes work and will be able to follow with more difficult exercises.

These are the exercises that I have done for my esophoria. I have done these while using my glasses. They can be done for exophoria as well, possibly even in the same layout, but I would check with your specialist. The only difference here is that what is easy for people with exophoria will be difficult for people with esophoria and vice versa.

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If you would like to discuss this matter in person, feel free to book a consulting session with me. I will also be grateful for any donation to help me run this blog and my future research in this field.