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EUGENE M. HELVESTON, MD
E
METHOD: A perspective and analysis of current prac- YE EXERCISES HAVE BEEN USED SINCE BEFORE THE
tices that include a review of the literature and personal Middle Ages. These included a wide variety of
experiences of the author. strabismus masks that were used to encourage eyes to
RESULTS: Visual training of some sort has been used for point in the proper direction and presumably work to-
centuries. In the first half of the twentieth century, in gether. Other visual training was used in children with
cooperation with ophthalmologists, orthoptists introduced a squint by placing them strategically in a room lying in
wide variety of training techniques that were designed their crib, placed at a specific angle to a window or other
primarily to improve binocular function. In the second half source of light. Ribbons or strings were also placed around
of the twentieth century, visual training activities were the crib to induce the infant to look in a healthier
taken up by optometrists and paramedical personnel to direction. A totally different scheme was used by those
treat conditions that ranged from uncomfortable vision to cultures who considered crossed eyes a mark of beauty.
poor reading or academic performance. Other visual Exercises were devised for children by placing a spot on
training has been aimed at the elimination of a wide their forehead or in some other near area to induce the
variety of systemic symptoms and for the specific im- child to assume a state of spastic convergence and accord-
provement of sight and even for the improvement of ing to the plans of doting parents to develop beautifully
athletic performance. At present, ophthalmologists and crossed eyes.1 For reasons that seem obvious today, none of
orthoptists use visual training to a very limited degree. these methods have prevailed.
Most visual training is now done by optometrists and Physical training makes up an important part of the lives
others who say it works. Based on an assessment of of many. Exercise is clearly effective for the betterment of
claims and a study of published data, the consensus of the human condition. Aerobic exercises rid the vascular
ophthalmologists regarding visual training is that, except system of debris that can clog arteries and cause premature
for near point of convergence exercises, visual training death.2 Weight training increases muscle volume, promotes
lacks documented evidence of effectiveness. strength, and even enhances musculotendinous union for
CONCLUSION: Although visual training has been used
improved proprioception and better balance. Exercise may
for several centuries, it plays a minor and actually decreas- be used by older individuals primarily for health reasons
ing role in eye therapy used by the ophthalmologist. At the and by motivated youth for athletics or esthetics. Most
beginning of the twenty-first century, most visual training is healthy younger individuals can obtain sufficient exercise
carried out by non-ophthalmologists and is neither practiced for good health by simply being young and exuberant. The
nor endorsed in its broadest sense by ophthalmology. lure of exercise as a lifestyle needs no further validation
than the media blitz that extols the virtues of wonder
working equipment and guaranteed techniques.
Accepted for publication Jun 1, 2005.
From the Department of Ophthalmology, Indiana University School of Most of us are realistic regarding our own physical
Medicine, Indianapolis, Indiana. capabilities. How close are we to perfection? The ultimate?
Inquiries to Eugene M. Helveston, MD, Emeritus Professor of Oph- As good as it gets? No! Perfection is attained by just a few.
thalmology, Indiana University School of Medicine, Ophthalmologist in
Chief, ORBIS International, 702 Rotary Circle, #213, Indianapolis, IN In most cases, we accept who we are and use exercises to
46202-5175; fax: 317-274-5247; e-mail: ehelveston@msn.com build on that.