Strabismus Therapy (Crossed Eyes) in Atlanta

3D Vision

How a child looks does not necessarily reflect how the child sees. Often, surgery creates a false sense of security: the eyes are cosmetically aligned, but 3D Vision is still poor or absent. For this reason, we recommend a 3D evaluation for all patients who have had strabismus surgery in the past, even if the eyes now appear normal.

The brain should combine the information from the two eyes. We call this process fusion. Fusion is the glue that holds the eyes in alignment. The better the 3D vision is, the stronger the fusion is. Without fusion, strabismus surgery is merely cosmetic, and the need for multiple surgeries increases.

When successful, the latest technologies in 3D strabismus treatment allow drivers to drive, golfers to golf, hitters to hit, and learners to learn: all in a more stable, predictable 3D world.

Non-Surgical Treatment

Our treatments may include glasses and vision therapy: a kind of biofeedback that uses 3D vision to increase eye-brain coordination and align the eyes. If surgery is necessary as part of the treatment, then we refer. Our goal is to decrease the number of surgeries to a minimum and to increase two-eyed coordination and depth perception for easier learning, driving, and sports.

Treatment Age

We work with adults and school-age children. Because vision therapy requires a degree of cooperation and understanding, we typically do not see children under the age of five for in-office vision therapy. Depending on the circumstances, we may see younger children and suggest home activities, but only if the child has already been examined by a pediatric ophthalmologist and the parents are fully committed to working with the child at home.

Understanding Strabismus and Its Impact

Strabismus occurs when one eye turns inward, outward, upward, or downward, disrupting the brain’s ability to merge images from both eyes. This misalignment can cause:

• Double or blurred vision

• Chronic eye strain and headaches

• Amblyopia (lazy eye) in children if untreated

While congenital cases are common, strabismus can also stem from trauma, neurological disorders, or uncorrected refractive errors. Early intervention is critical to prevent permanent vision loss.

Vision Therapy: A Non-Surgical Treatment for Strabismus

Vision therapy is a customized program combining eye exercises, prism lenses, and digital tools to strengthen communication between the eyes and brain. Unlike surgery, which adjusts eye muscles physically, vision therapy addresses the root cause by enhancing neurological control over eye alignment. Studies, including a 2022 trial in Optometry and Vision Science, report over 70% success rates in improving eye coordination through structured therapy.

Key benefits include:

• No downtime or surgical complications

• Personalized plans for children and adults

• Sustainable improvements in binocular vision

For lasting results, consult a board-certified vision therapy specialist to explore whether this non-surgical approach aligns with your needs.

How Vision Therapy Corrects Strabismus: 4 Key Mechanisms

Vision therapy addresses strabismus by targeting eye-brain coordination, muscle strength, and neural adaptability. Here’s how it works:

1. Strengthening Eye Muscles
   Targeted exercises like pencil push-ups (focusing on a slowly moving object) improve ocular muscle control, enabling better alignment of misaligned eyes.

2. Enhancing Binocular Vision
   Activities such as 3D stereogram training teach both eyes to work in sync, resolving double vision and restoring depth perception for daily tasks like driving or reading.

3. Rewiring Neural Pathways
   By leveraging neuroplasticity, therapy retrains the brain to process signals from both eyes simultaneously, critical for merging images into a single, clear view.

4. Gradual Skill Progression
   Programs start with simple tracking exercises and advance to complex tasks (e.g., shifting focus between near/far objects), ensuring sustainable improvements in visual function.

Who Benefits Most from Vision Therapy?

Vision therapy is effective for children and adults, with outcomes tailored to age and condition severity:

• Children: Early intervention (ages 3-8) capitalizes on developing neural pathways, often achieving permanent corrections for issues like accommodative esotropia.

• Adults: While progress may take longer, adults benefit from improved alignment and reduced symptoms in conditions like intermittent exotropia, thanks to disciplined adherence to therapy.

Best for: Intermittent exotropia (outward-turning eyes), accommodative esotropia (inward-turning due to focusing strain), and convergence insufficiency.

How Effective Is Vision Therapy for Strabismus?

Vision therapy is clinically proven to improve eye alignment, binocular vision, and daily visual function. Studies, including a 2023 Journal of Vision Development meta-analysis, show 65-80% success rates for strabismus patients, especially when paired with glasses or patching. Key benefits include:

• ✅ Improved eye coordination: Reduces double vision and enhances focus accuracy.

• ✅ Stronger depth perception: Critical for tasks like driving or sports.

• ✅ Reduced surgical reliance: Prevents or complements surgery by addressing neuromuscular root causes.

However, success requires consistent effort: results often take 6-12 weeks to manifest, with full improvements seen after 6-12 months of structured therapy.

What Does a Vision Therapy Program Involve?

1. Initial Evaluation

A comprehensive eye exam by a board-certified optometrist assesses:

• Eye alignment and tracking ability

• Binocular vision deficits (e.g., suppression)

• Medical history (e.g., trauma, neurological issues)

A personalized plan is then created, targeting specific weaknesses like convergence insufficiency or gaze instability.

2. Therapy Exercises

Core activities focus on:

• Eye teaming: Using tools like stereoscopes to merge images from both eyes.

• Convergence/divergence training: Brock String exercises to control inward/outward eye movements.

• Focus shifting: Alternating focus between near/far objects to improve flexibility.

• Anti-suppression techniques: Red-filter glasses to strengthen the weaker eye’s input.

3. Duration and Frequency

• Office visits: Weekly 30-60 minute sessions with a therapist.

• Home exercises: Daily 15-20 minute drills (e.g., pencil push-ups, computer-based tasks).

• Progress checks: Monthly assessments to adjust difficulty and goals.

Actionable Tips for Success

• Start Early: Children under 8 see 3x faster progress due to neuroplasticity.

• Stay Consistent: Skipping exercises delays results—use apps or calendars to track routines.

• Combine Treatments: Pair therapy with prescribed prism glasses or patching for amplified effects.

• Monitor Closely: Report headaches or regression immediately to your therapist.

• Celebrate Milestones: Small improvements (e.g., longer focus endurance) signal progress.