These activities are intended ONLY for the use of our current vision therapy patients under the guidance of one of our licensed developmental optometrists. Please do not attempt to self-prescribe these activities outside of the guidance of a licensed optometrist. Washington Vision Therapy Center is not liable for any adverse affects resulting from these exercises when done without the guidance of a licensed optometrist.

Home Activity Instructions

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Eye Stretches

Materials: Eye Patch

Procedure: 1. Place an eye patch over one eye.

2. Place the hands together with the index fingertips touching. Rub or tap those fingertips together to give your brain feedback on where you are looking. Look right at your fingertips with the unpatched eye.

3. Slowly move the fingers to the right as far as it is possible for you to continue looking at them without turning your head. Continue rubbing the fingertips together to give tactile feedback to your brain. Slowly move the fingers back into the center position.

4. Move the fingers to the left as far as it is possible to continue looking directly at them. You should be looking right at your fingers, and not just noticing them with your peripheral vision. Bring your fingers slowly back to the center position.

Central Peripheral (C/P) Saccades

Purpose: To increase the patient’s awareness of periphery and provide a better ability to gather visual information from the periphery of the visual field.

Materials: Eye patch (if directed by your therapist) White board OR Paper with letters or numbers scattered around a central target

Procedure: 1. If your therapist has directed you to do so, cover one eye with an eye patch.

2. Write letters or numbers scattered around a central target on your white board, or—if you don’t have a white board—write letters or numbers around a central target on a large piece of paper.

3. Stand in front of your paper, approximately 1.5-2 feet back. Keep your eyes fixed on your central target.

4. Have your helper call out letters or numbers for you to reach out and touch. Use your peripheral vision to tell you where the letter or number in question is. Don’t take your eyes off your central target.

5. If you are doing this alone, go through the alphabet or through the numbers in sequential order. Use your periphery to find them, then reach out and touch them while keeping your eyes on your central target.

Bull's Eye

Purpose: To introduce the relaxing and flexing of the lens within the eye that controls accommodation (clearing and blurring).

Materials: Eye patch Transparent bullseye or small transparent Hart chart

Procedure: 1. Cover one eye with your eye patch.

2. Hold the bullseye in front of the unpatched eye, about 4 inches from your face. Stand in front of a window or where you can look far across a room.

3. Look through the transparent bullseye and focus far in the distance. Notice with your peripheral vision how blurry the bullseye is when you are looking far.

4. Pull your focus in and make the close bullseye as clear and crisp as you can. Notice how blurry the distance looks in your peripheral vision when you are focusing close.

5. Practice going from focusing far to focusing close several times.

6. Try this activity with both eyes.

Space Fixator

Purpose: To improve the patient’s fixation on a central target, peripheral awareness, and ability to control visually guided movements.

Materials: White board OR large paper

Procedure: 1. Put your white board or paper on the wall at eye level. Directly in front of your face, draw a central dot. This will be your fixation target.

2. Approximately ten inches above your fixation target, draw another dot. Continue adding dots in a circle around your central target until you have no less than eight evenly spaced dots. These dots should be big enough that you can see them in your peripheral vision when looking at the central target.

3. The four commands (said by you or your helper) for this activity are “Look,” “Ready,” “Touch,” and “Back.” Begin by looking directly at the center target. Be aware of the surrounding dots in your peripheral vision.

4. On “look” your eyes should move quickly and accurately up to the dot at the top of the circle. Try to make this a direct movement and don’t lose track of where the top dot or central dot are.

5. On “ready,” bring your hand from your side to your temple as if you were saluting.

6. On “touch,” your hand should move from your temple to the dot you are looking at (at the top of the circle).

7. On “back,” your eyes should move back to the center dot while you at the same time bring your hand back to your side. Try to make these two motions simultaneous, as if your hand and eyes were linked together.

8. Repeat this process a second time, but instead of moving to the top dot on “look,” move on to the next dot in a clockwise direction.

9. Once you have mastered this moving around the circle in a clockwise direction, reverse and go through the dots counterclockwise.

10. If you are adept at this activity going both clockwise and counterclockwise, try adding this challenge: Go through the “look” and “ready” commands, but on the “touch” command, move your finger to the dot and—at the same time—step forward with the foot on the opposite side of your body. This would mean that if you are touching with your right hand, your left foot steps forward. Move your foot back on the “back” command along with your hand and eyes. For the next dot, touch with your left hand and step forward with your right foot. Continue this way until you finish a complete circle clockwise.

11. Once you have mastered the above levels, have your helper join you for the activity. When your helper claps, finish whichever dot you are on, then switch direction. This will mean that instead of going on to the next dot clockwise, you will instead go counterclockwise to the previous dot. You should continue going counterclockwise until your helper claps again, changing your direction.

Wach’s Mental Minus

Purpose: To allow you to gain more conscious control over your focusing mechanism. Also, to allow an investigation into how plus and minus lenses affect the way you see space and how they affect the way you feel.

Materials: Lens provided by therapist Patch

Procedure, Level I:

1. Patch one eye.

2. Using the minus lens given to you by your therapist, look at some printed material held about 16″ away. The lens should be held directly in front of your eye at the same distance and position it would be in if it were set into a pair of eyeglasses.

3. When you place the lens in front of your eye, you should notice a blur when it is first placed there, then the print should become clearer after the eye adjusts to the lens. Now take the lens away for several seconds and allow the eye to change back to just looking at the print with no lens.

4. Place the lens in front of the eye again, and as the image begins to get clearer, see if you can FEEL the eye doing anything. Repeat the process over and over until you are aware that as the “picture” changes, your eye is physically doing something to make it change. It may take a while, but work until you are able to tune in to the change of feeling in the eye. If you get it, record this fact on your homework sheet.

Procedure, Level II: 5. Next, bring the lens in front of the eye but don’t try to clear it. The eye will naturally want to make the image clear, but by concentrating on how it feels, you can keep your focus where it was before you brought in the lens. Try this several times until you are able to keep the image blurry when you bring the lens in.

Procedure, Level III: 6. Next, look at the print again with the lens. See it blur, then get clearer. Now, keeping the lens in place, see if you can get the print to blur back again to the way it was when you first put the lens in front of your eye. Try looking hard, looking soft, looking close, looking far, etc. until you are able to do it and have a feel of just what you are doing to make it happen. Experiment to see how much of a blur you can produce and then still get it to clear.

Procedure, Level IV: 7. This time, insert the lens and clear the letters. Think about how it feels to have your focus clear inside the lens. Think about keeping your focus where it is, even when the lens is taken out. Take the lens out and try to keep your focus where it was. The print will be blurry if you are able to keep your accommodative position the same. Slide the lens back in and see if it is still clear inside the lens. Repeat this activity until you are able to keep the image blurry outside the lens, but clear inside it.

Procedure, Level V: 8. To clear the image in the lens, you are focusing either in front of or behind the actual print. Practice looking hard and soft, focusing near and far, until you are able to make the print blurry. Bring in the lens and see if the image is instantly clear. Practice adjusting where you are focusing until you are able to have the image instantly clear when you bring in the lens.

Saccadic Strips

Purpose: To improve fixation and smooth, steady eye movements, even when the targets are randomly arranged and require a variety of eye movements.

Materials: Eye patch (if directed by your therapist) Hart chart, cut into vertical strips

Procedure: 1. If your therapist has told you to wear an eye patch for this activity, cover one eye. Take your Hart chart and cut it into vertical strips.

2. Arrange the strips spaced out at eye level, some slightly higher and some slightly lower so that your eyes will have to adjust to track with the letters. Read the top letter of each column, as if you were reading straight across the hart chart. Be sure to stay on beat and keep smooth consistent movements.

3. Continue reading across the columns (all the second letters, all the third letters, etc.) until you have completed the chart.

4. Once you have mastered the previous level, try moving the columns further apart, higher/lower, etc. to make it more challenging.

5. If you have mastered the saccadic strips at a variety of distances and difficulty levels, start challenging your brain by picking a letter and choosing a word to substitute for it. For example, you could say “dog” every time you come to a “d,” “sit” every time you come to an “s,” and “book” every time you come to a “b.”

Pointer Straw

Purpose: To improve eye tracking and accuracy of visually guided fine motor movements.

Materials: Straw Pointer or Stiff Wire Eye patch

Procedure: 1. Cover one eye with a patch. Have your helper hold the straw in front of you.

2. Hold the pointer beside your unpatched eye and guide it into the straw. Try to make the movement into the straw steady and consistant.

3. Practice with the straw in different locations, having your helper move it between each successful stroke.

4. Repeat while having your helper move the straw in a circle or irregular path. Try to maintain smooth motion into the straw with the pointer.

5. Do this procedure with each eye.

Pepper Trampoline Activity

Purpose: To integrate the visual skills of focusing (accommodation), tracking (saccades), and visualization with balanced and rhythmic bilateral movement.

Materials: Trampoline (if none available, jump on floor) Whiteboard

Procedure: As the patient becomes comfortable with each level, move on to the next.

1. Have the patient begin jumping. Ask them to draw circles in the air with their hands (palms down, fingers together) that are about the size of a basketball and are circling out from the center of their body toward each side. The patient should work of keeping these circles smooth and of consistent size as they jump.

2. While maintaining the circles the patient should a. Spell their name forward with one letter per jump. b. Spell their name backward with one letter per jump. c. Spell their name backward with one letter every other jump.

3. Write the sentence “the train went down the track” on the whiteboard. Have the patient a. Spell forward while looking. Seat drop on spaces. b. Turn around and spell again from memory. c. Spell the sentence backward while looking. d. Turn around and spell backward from memory. e. Spell sentence outside in (alternating from first letter to last letter, second letter to second from last, etc.) f. Spell outside in without looking. g. Spell with 90 degree turns or turn on each vowel. h. Substitute vowels for an object (e.g. “dog”) i. Spell with seat drop on spaces and knee drop on vowels. j. Spell sentence outside in with seat drop on spaces and knee drop on vowels.

4. Have the patient spell a word (e.g. “School”) forward and backward while jumping (S-C-H-O-O-L, then L-O-O-H-C-S). Follow this with a. Spelling with 90 degree turns between each letter. b. Self-directed reversal (Patient turns on each letter and decides when to begin turning in the other direction. For example, turning clockwise with S-C-H, then changing to counter-clockwise with H-C-S.)

Peg Touch Localization

Purpose: To improve the patient’s ability to judge distance and depth while making visually guided movements.

Materials: 3 Golf tees Two pointers or pencils Desk or table

Procedure: 1. Place the golf pegs in front of you on a desk or table. Place one close to you, one at a medium range, and one far from you so that they form a straight line stretching away from you. They should all be close enough that you can comfortably reach them with the end of your pointer.

2. Holding your pencils or pointers by one end, reach out and touch the very top of the closest peg with the end of each pointer, touching one at a time.

3. Move to the mid-range peg and touch it very precisely with the tip of each pointer.

4. Move the farthest pointer and touch it with the end of each pointer.

5. Repeat this process, saying one letter each time you have touched each peg with both pointers. Continue cycling through the pointers until you finish the alphabet.

6. If you are able to make consistent, accurate touches and keep track of the alphabet as you touch, try alternating numbers and letters with every two touches. For example, the two touches on the close peg would be “A, B,” then the two on the middle peg would be “1, 2,” the far peg would be “C, D,” and the middle peg again for “3, 4.” Try to keep track of your numbers and letters, while still touching precisely.

Moro Walk (Penguin with a Pizza, Duck on a Motorcycle)

Purpose: To improve the patient’s visual skills by breaking down residual primitive reflexes that remain from the patient’s infancy.

Materials: Tape line Dowel or yardstick

Procedure:

1. Put down a line of easily-removed tape (like masking tape) on the floor so that you can walk on it the length of the room.

2. Stand with the dowel in your hands, palm up so that you can hold it level resting on your palms at arm’s length. Place your hands toward the ends of the dowel so that they several inches farther out than your shoulders on each side.

3. Stand at one end of the tape with your toes on the tape and your heels turned outward to each side. Walk down the tape with your toes turned in as you step, keeping your heels out and the dowel in your hands held level out in front of you. Try to keep your body straight and relaxed.

4. Continue walking this way the length of the tape and back to where you started.

5. For the second part of this activity, hold your hands close together toward the center of the dowel with your palms down, gripping it from the top.

6. Stand with your heels on the tape and your toes pointing outward to each side. Walk down the tape with your heels on the tape as you step, keeping your toes turned out and the dowel in your hands held level out in front of you. Try to keep your body straight and relaxed.

7. Continue walking this way the length of the tape and back to where you started.

8. Practice both parts of this activity several times until you feel you are able to walk with a relaxed posture and keep the dowel in front of you level.

9. Try the above activities again without a dowel, just holding your hands as if you were balancing an invisible dowel. Keep your body straight and relaxed and try to walk as normally with your toes/heels turned.

Red/Green Flipper Reading

Purpose: To improve the eye’s ability to get the text clear easily and comfortably while also making sure that neither eye is suppressing.

Materials: R/G glasses Flipper R/G bar reader Reading material

Procedure: 1. Put on the red and green glasses and open your reading material (or take out the reading material given you by your therapist). Position the red and green bar reader over your reading material so that the stripes are going vertically up and down the page.

2. Hold your flipper in front of your eyes on either the plus (+) or minus (-) side. Read a sentence of your reading material. Notice if any of the bars on the bar reader look like they are getting dark, or if they all look like they are equally dark.

Remember: If every other bar starts going dark that means that one of your eyes is turning off. Try tapping beside that eye, snapping your fingers in your ear on that side of your head, tapping your feet, opening your periphery and focusing on all the space around you, or using any of the other methods that help you get both eyes turned back on.

3. Turn your flipper over to the other side and read the next line of your material. Always be aware of whether the words are clear or not and whether you have both eyes on.

4. Continue flipping back and forth with each sentence as you reading your material. Evaluate whether you are able to keep both eyes on and, if not, pause and try to get them turned back on.

5. If you find that the words or the bars appear to be doubling or moving around (this is often accompanied by dark bars), notice which side of the flipper this tends to happen more on. Most likely, if this occurs on the minus side of the flipper, you are converging (pointing your eyes in front of the paper). Try to remedy this by either tapping a finger on the paper to remind your eyes where they need to be pointing, or if you have practiced fusion cards, you can deliberately try to diverge your eyes to make the paper become single again. Always make the words single before attempting to clear them. If the doubling appears on the plus side of the flipper, you are most likely diverging (pointing your eyes past the paper). Try tapping again to remind your eyes where to point, and you can attempt to converge slightly to bring the paper back into focus.

NOTE: You should either be doing patched flipper reading or red/green flipper reading. Under no circumstance should any patient be doing flipper reading with neither implement. If you are uncertain of which method you were given, double check the home instructions from your therapist or call WAVTC to check.

Patched Flipper Reading

Purpose: To improve the eye’s ability to make text clear when reading quickly and easily.

Materials: Eye patch Flipper (provided in therapy) Reading material

Procedure: 1. Cover one eye with the eye patch. Open your book (or take out the reading material your therapist gave you).

2. Hold the flipper on either the plus (+) or minus (-) side over your eyes and read a sentence from your reading material. Make sure that you are able to get the text completely clear before you read the sentence.

3. Flip the flipper over to the other side so that you are looking through the other lens. Read another sentence. Again, make sure that you get the image all the way clear.

4. Continue flipping back and forth with each sentence, until you have completed half of your time for this activity.

5. Switch your patch to the other eye and repeat this activity with the other eye.

Marsden Ball

Marsden Ball Vision Therapy in Yakima

At Washington Vision Therapy Center, our team works closely with our patients to provide the best possible care and support for all of their vision and eye care needs. One of the ways we do this is by providing the latest technologies and treatment options. The Marsden ball is one of the tools that we use that could help improve your vision.

Friends waiting for the Marsden Ball technique in Yakima, WA

What Is the Marsden Ball?

This is a basic type of vision therapy. These balls may not seem like much of anything but they can provide a great deal of support for users. The goal of using these tools is to make vision therapy a bit more enjoyable. The activities performed with the ball are designed to help improve spatial awareness. It works so well because it is a bright ball, it is interesting, and it can grab and hold the attention of even young toddlers who may not otherwise respond well to therapies to improve vision.

It works to improve vision as well as a tool to provide information. It can help the child to focus on the ball even while moving, balancing, or performing other tasks. This aids in improvement and development of vision quality.

How Vision Therapy in Yakima Can Help

Vision therapy in Yakima at our practice can help you and your children with a variety of treatment options. When you come in to see us, we’ll provide you with a comprehensive exam to discuss what areas of concern may be present. After diagnosis, a treatment plan is created that fits your symptoms and needs. For many individuals, the Marsden ball is an excellent component to a vision therapy program.

Call Us for an Appointment for Vision Therapy Today

When you call our offices to schedule your appointment, mention your interest in this type of tool. You can also just come in and let us determine the technology that is going to provide you with the best possible results. Call Washington Vision Therapy Center today at 509-654-9256 for a Yakima area appointment that fits your needs.

Maples Double Pursuits

Purpose: To improve tracking and fixation of the eyes, even when mental loading is added.

Materials: Eye patch (if your therapist has recommended it) Two pencils

Procedure: 1. Cover one eye with the eye patch if your therapist has asked you to wear the patch for this activity.

2. Have your helper hold pencil #1 in front of your unpatched eye at a comfortable distance. Focus on looking at that pencil.

3. Have your helper move pencil #2 around #1 in a random pattern. Try to be aware of the second pencil, using your peripheral vision to tell you where it is, while still keeping your attention fixed on #1.

4. Have your helper tell you to switch and try to move your eye quickly and accurately to #2. Continue switching back and forth from pencil #1 to pencil #2 as directed by your helper until you can make accurate movements from one to the other without letting your eye get “lost” on the way.

5. Once you get good at step 4, have your helper ask you questions, and see if you can still make quick and accurate movements while thinking about their questions.

6. Try this activity while having your helper move both pencils, rather than holding one still.

7. Point to pencil #1 with one hand, while still keeping your eyes on pencil #2. Try to use your peripheral vision to guide your hand without losing fixation on #2. Switch your hand to #2 and your eyes to #1 when your helper tells you.

8. Try to do step 7 while answering questions asked by your helper.

Infinity Walk

Purpose: To solidify the eyes’ ability to track with a detailed task while moving the body and reading from different gazes.

Materials: Hart Chart Two obstacles (buckets, pillows, etc.) Metronome

Procedure: 1. Position the two obstacles so that they are 3-5 feet apart. You will be walking around these obstacles in a figure-eight pattern.

2. Put up the hart chart on the wall at eye level. The hart chart should be centered in front of the two obstacles.

3. Start the first level by standing between the two obstacles and facing away from the chart. Walk to your right behind the first obstacle and coming around to the front of it. Complete a figure eight around the buckets as you read the Hart chart. Be sure to step right on the beat. This level will look like the following diagram, where X is you, the circles are the obstacles, and the line is the Hart chart.

4. Once you have mastered this level and are able to read the chart without getting lost or losing track of the beat, try the second level. This time start with your body centered between the obstacles, facing toward the Hart chart and come in front of the bucket to your right. This will mean you will have to turn your head to keep your eyes fixed on the Hart chart. Again, be sure that you are reading smoothly and stepping right on the beat. This level will look like this:

5. For the third level walk the same way as you did on the second, only this time lead with your heels (walking backward). You should not have to turn your head to keep your eyes on the Hart chart for this level. It is especially important that you listen to the rhythm on this level, as it is much harder to keep the beat when walking backward than when walking forward.

6. For the fourth level walk the same direction that you did for the first level, only lead with your heels (walking backward). You will have to turn your head to keep your eyes on the Hart chart for this level.

7. For the fifth level start back walking the way you were walking on the first level, walking forward without having to turn your head. As you walk, step on the beat, and slap your opposite knee on the offbeat (halfway between beats). Practice keeping this rhythm (stomp, slap, stomp, slap) as you walk around the figure eight pattern. Once you have mastered this, start reading the Hart chart as you walk.

8. For the sixth, seventh, and eighth levels, simply repeat the second, third, and fourth, but add knee taps to the procedure. Always make sure that you are staying on beat and reading smoothly and consistently without skipping letters or lines on the Hart chart.

Hart Chart Fixations

Purpose: To improve ability to organize and visually track while maintaining peripheral awareness.

Materials: Hart Chart Eye patch Metronome

Procedure: Level I – Straight Across

1. The patient stands in a relaxed an balanced posture. One eye is patched.

2. The Hart Chart is placed at eye level. The patient should be a comfortable distance (2-3 feet) from the chart. Set the metronome at sixty beats per minute.

3. The patient is asked to read the letters out loud in a rhythmic fashion without moving their head – one letter per beat of the metronome. The patient reads the entire chart proceeding from left to right, top to bottom. The patient should be encouraged to maintain peripheral awareness of the whole chart and of other objects in the room.

4. Repeat for the other eye. As this becomes easier, take several steps back from the chart.

5. If there are significant differences between the eyes, practice the poorer eye more frequently.

Level II – Outside In

1. Have the patient start with the first line of letters and read in the following order: first letter, last letter, second letter, second from last letter, and so on.

2. The patient should read each line from the ends to the middle in this fashion.

Level III – Columns 1. The patient reads the first and last letter of each line. When they get to the bottom of the chart, they should proceed to the second and second-to-last letter of each row. When these two columns are completed, the patient should move to the next two columns in and so on. Level IV – Obliques

1. When the above activities have been mastered, the patient begins reading the first letter of the first column, last letter of the last column, second letter in the first column and next to last letter in the last column. (He reads the first column top to bottom alternating with the last column bottom to top.)

2. When this has been achieved, the patient should progress to the second and second to last column. Repeat with the remaining columns.

Fusion Cards with Accommodation

Purpose: To improve the ability to coordinate the converging, diverging, and focusing of the eyes. Improvement in this skill will enhance the patient’s ability to control where their eyes are pointing and where they are focusing.

Materials: Fusion cards (provided) Flipper (provided)

NOTE: Fusion cards used for this activity include your See 3 Coins card, Lifesaver card, Picture Fusion cards, and Text Fusion Card. Use whichever of these have been indicated by your therapist.

Procedure: You will have learned how to converge and diverge your eyes during previous activities with fusion cards. Your therapist will indicate to you whether they want you to work on converging, diverging, or both.

Converging: 1. Converge your fusion card (by looking in front of the paper, causing the two targets in the background to each double, then overlap to create three) until you can see the center target clearly and keep it from splitting without too much difficulty.

2. Bring the plus (+) side of your flipper over your eyes and try to keep the central image clear. If it splits, keep the flipper over your eyes and regain your fusion of the middle target. Wait a while to allow your eyes to adjust to the flipper and get the target clear.

3. If you are using the Text Fusion Card, clear the text and then read it aloud, trying to maintain clarity the entire time.

4. If you master the flipper you are working with, try converging your target and bringing the flipper back and forth in front of your eyes and back off, keeping the fusion card converged and getting it clear each time. You may also try holding the plus flipper over your eyes and blurring and clearing the text without letting the image split.

5. If you are very comfortable clearing the text while converging with the plus flipper, try getting up and walking around the room while you read it aloud, keep it clear, and maintain convergence.

Diverging: 1. Diverge your fusion card (by looking beyond the paper, causing the two targets in the foreground to each double, then overlap to create three) until you can see the center target clearly and keep it from splitting without too much difficulty.

2. Bring the minus (-) side of your flipper over your eyes and try to keep the central image clear. If it splits, keep the flipper over your eyes and regain your fusion of the middle target. Wait a while to allow your eyes to adjust to the flipper and get the target clear.

3. If you are using the Text Fusion Card, clear the text and then read it aloud, trying to maintain clarity the entire time.

4. If you master the flipper you are working with, try diverging your target and bringing the flipper back and forth in front of your eyes and back off, keeping the fusion card converged and getting it clear each time. You may also try holding the minus flipper over your eyes and blurring and clearing the text without letting the image split.

5. If you are very comfortable clearing the text while diverging with the minus flipper, try getting up and walking around the room while you read it aloud, keep it clear, and maintain divergence.

Fusion Cards

Purpose: The goal of this procedure is to call out the letters in a regular and consistent tempo and in the proper order. You must develop the ability to “see ahead” to the next section of letters so your timing will be at the expected speed.

Materials: Hart chart Eye patch if indicated by therapist Red/green filters and red/green glasses if indicated Metronome or other means of keeping rhythm

Procedure:

1. Cut the chart into four equal pieces.

2. Place the four charts on the wall spaced as directed by your therapist.

3. Patch one eye if instructed to do so by your therapist. Start the metronome.

4. Call out the first letter of the first chart, then the first letter of the second chart, the first letter of the third chart, and the first letter of the fourth chart.

5. Repeat this process with the second letter of each chart, the third letter, etc. until all letters are completed.

6. Notice your speed, timing, and accuracy. If there is difficulty keeping pace with the tempo, try a slower speed with a goal of increasing the tempo as ability improves.

7. Change the order of the charts regularly to prevent memorization.

NOTE: Consistency is important in this activity. Perform the activity daily or as instructed by your therapist. Work to make your reading more smooth and consistently accurate.

Four Chart Fixations

Materials: Hart chart Eye patch if indicated by therapist Red/green filters and red/green glasses if indicated Metronome or other means of keeping rhythm

Procedure: 1. Cut the chart into four equal pieces.

2. Place the four charts on the wall spaced as directed by your therapist.

3. Patch one eye if instructed to do so by your therapist. Start the metronome.

4. Call out the first letter of the first chart, then the first letter of the second chart, the first letter of the third chart, and the first letter of the fourth chart.

5. Repeat this process with the second letter of each chart, the third letter, etc. until all letters are completed.

6. Notice your speed, timing, and accuracy. If there is difficulty keeping pace with the tempo, try a slower speed with a goal of increasing the tempo as ability improves.

7. Change the order of the charts regularly to prevent memorization.

NOTE: Consistency is important in this activity. Perform the activity daily or as instructed by your therapist. Work to make your reading more smooth and consistently accurate.

Bug Walk Jump String

Purpose: To provide immediate feedback as to whether both eyes are turned on, whether they are pointed to the same place in space, and whether perception of where a target is matches its real location. Also, to increase familiarity with the feeling of converging and diverging, aiding conscious control of the process.

Materials: Brock String Doorknob or other Fixture

Procedure: 1. Tie one end of string to doorknob, screw eye, etc. Hold the string taut and with the other end on the bridge of the nose, directly between the eyes.

2. The helper should move the beads to the far end of the string.

3. As the helper slides one bead up the string slowly, count aloud (about a count of 10 to go the length of the string). The patient should focus on the bead, but be aware of the room and its surroundings. The patient should try to keep the “X” at the bead all the way up. Bring the bead close to the nose, hold it about 5 seconds, then move down slowly, still counting to 10 as the eyes follow the bead.

4. Repeat 2 or 3 times. Slower speeds are more difficult, but are most desirable as this shows more control.

5. Have the patient try to replicate this eye motion independently, moving the eyes slowly down the string and slowly back. This should be a smooth motion of the eyes, not jumps.

6. Continue practicing with the bead and independently.

Bead Jump Brock String

Materials: Brock String Doorknob or other Fixture

Procedure: 1. Tie one end of string to doorknob, screw eye, etc. Hold the string taut and with the other end on the bridge of the nose, directly between the eyes.

2. The helper should space the beads out along the string with a greater distance between the beads at the far end of the string than the nearer beads.

3. Give the patient the color of a bead to which they are to “jump” their eyes. Before jumping, while looking at another bead, the patient should use peripheral vision to see where the bead is that they are jumping to, plan the move in their mind first, then make the jump on the command “GO”.

4. Select a series of beads to which to “jump” the eyes. For example, red to green to yellow. Think about the pattern and plan ahead to know exactly where and which way the eyes will be moving.

5. On the command of the helper to “GO,” make the planned jump. Try to notice if the strings cross directly at each bead and make their “X.” The helper should watch the patient’s eyes to see if they move together and go to the proper places. Repeat several times using different sequences of beads.

Basic Brock String

Materials: Brock String Doorknob or other Fixture

Procedure: 1. Tie one end of string to doorknob, screw eye, etc. Hold the string taut and with the other end on the bridge of the nose, directly between the eyes.

2. The helper should space the beads out along the string with a greater distance between the beads at the far end of the string than the nearer beads.

3. The patient should choose a bead to fixate on, and notice if two apparent strings are going into that bead. The “X” formed by the two strings should be right on the bead the patient has chosen.

4. The patient should look at each bead carefully. If both eyes are exactly on the bead, they will see an X. If they see the strings crossing in front of the bead or in back of the bead, this means their eyes are not really looking at the bead. Be sure you can get the X at all beads (except the one at the far end, which will just have the 2 strings coming out toward you in a “V.”)

5. When the patient can do this, have them turn their head so their right eye is looking straight down the string & the left eye has to pull inward to see the beads. Have them try to get the X at each bead. Then have them turn so the left eye is looking straight down the string and the right eye has to pull inward to see the bead. Again, see if they can get the X at each bead. NOTE: If one string is disappearing or getting shadowy, try anti-suppression strategies.

If you are interested in learning more about this technique, call our Yakima and Richland Optometrist today at 509-654-9256.

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