2. VISION THERAPY
• Is also called vision training,orthoptics,eye training and eye exercises
• Clinical approach for correcting the Eye movement disorders,non strabismic
binocular dysfunction,Accommodative disorder,strabismus,amblyopia,
nystagmus and certain visual perceptual disorder.
3. BROCK STRING
Purpose:-
To develop awareness of physiological diplopia and eliminate suppression.
Objectives:-
•Develop the kinesthetic awareness of converging and diverging
•Develop the ability to voluntarily converge
•Normalize the near point of convergence
Equipment:
Brock string attached to an object at the patient’s eye level on one end.
4. Description and Setup:-
• The Brock string is simply a long white cord with three attached wooden
beads of different colors.
• It is used primarily with convergence insufficiency patients to create the
feeling and awareness of converging and to normalize the near point of
convergence.
7. Endpoint:-
Discontinue this therapy technique when the patient is able to:
• Successfully converge to 1 in. from his or her nose
• Appreciate the feelings of converging and diverging
• Voluntarily converge
• Accurately converge and diverge.
Importance of brock string in vision therapy:-
• The Brock string is a great detection tool to help identify if you may have problems
with convergence (such as Convergence Insufficiency or Convergence Excess) or
suppression.
• The Brock string is also used therapeutically in vision therapy to help patients develop
skills of convergence as well as to disrupt suppression.
8. BARREL CARD/3 DOT CARD
Purpose:-
Develop the ability to voluntarily converge without suppression
Objective:-
The objectives of the Barrel Card/3-Dot Card are identical to those of the Brock
string.
Equipment:-
• Barrel Card
• Albee 3-Dot Card
9. Description and Setup:-
• The Dot Card setup is done with white card with three colored dot-shaped
targets on each side of the card.
• The dot are red on one side and green on the other. It is used primarily with
patients with convergence insufficiency to create the feeling and awareness of
converging and to normalize the near point of convergence.
• The Albee 3-Dot Card is similar to the Barrel Card using circles instead of
barrels.
12. End point:-
Discontinue this therapy technique when the patient is able to:
• Successfully converge to 1 in. from his or her nose
• Appreciate the feelings of converging and diverging
• Voluntarily converge.
Conditions:-
• Convergence insufficiency
• Fusional vergence dysfunction
• Accommodation infacility
13. CHIASCOPIC FUSION
A)Coloured Circles:-
Purpose:-
• The main purpose of the chiastopic fusion technique is to increase fusional
convergence.
Equipment:-
• Keystone coloured circles ( life saver card)
• Pointer
14. Principle:-
• Chiastopic fusion is the crossing of the visual axes (as ¡n the Greek letter chi,
which resembles the letter X) at the plane where the aperture would ordinarily
be. Chiastopic fusion is difficult at first for most patients, especially younger
patients, because there is no aperture to help direct the patient to the crossing
point.
17. Endpoint:-
Discontinue this therapy technique when the patient is able to:
• Successfully achieve clear chiastopic fusion with all of the targets on the Lifesaver
card.
• Switch between chiastopic and orthopic fusion with all of the targets on the Lifesaver
cards.
• Maintain chiastopic and orthopic fusion with all targets on the Lifesaver cards while
moving the cards laterally or in a circular fashion.
18. B)ECCENTRIC CIRCLES:-
Purpose:-
• The main purpose of chiastopic fusion with eccentric circles is to ¡ncrease fusional
convergence and monitor suppression during motor fusión stress.
Equipment:-
• The opaque stock Keystone Eccentric Circles are preferred for chiastopic convergence
(BO) training.
21. Endpoint
Discontinue this therapy technique when the patient is able to:
• Successfully achieve clear chiastopic fusion with a card separation of 12 cm and clear
orthopic fusion witha card separation of 6 cm.
• Switch between chiastopic and orthopic fusion with the cards held 6 cm apart, 20 cpm.
• Maintain chiastopic and orthopic fusion with a card separation of 6 cm, while moving the
cards laterally or in a circular fashion.
22. TRANAGLYPH
Purpose:-
Practice of image fusion and improvement of convergence and divergence skills.
Equipment:-
• Variable tranaglyph
• Red/green glass
• Tranaglyph
Objectives:-
• Increase the amplitude of negative fusional vergence (NFV) and positive fusional
vergence (PFV)
• Decrease the latency of the fusional vergence response
• Increase the velocity of the fusional vergence response
26. VERGENCE ROCK
• Vergence rock training with flipper prisms can be conducted ¡n cases of exo
deviation in a manner similar to that used for eso deviations.
• Step convergence should be emphasized more than step divergence for
patients with XT or XP, but both should be trained. The training goal ¡s to
meetingcriteria for very strong vergence facility (i.e., more than 15 cycles per
minute).
• Vergence rock can be often combined with other training technique like
Vergence Rock-trainer and prisms,vergence rock- bar reader and prisms.
27. 1)Vergence Rock-Television trainer and prisms :-
Purpose:-
• The main purpose of vergence rock using a television trainer and prisms ¡s to
monitor suppression during fusional convergence training. Other important
purposes are to develop a good fusional convergence range and facility at far.
28. 2)Vergence rock –Bar reader with prisms.
Purpose:-
• The main purpose of vergence rock using a bar reader with prisms is to monitor suppression
during convergence training.
