Vision Therapy – Marsden Balls

A Marsden ball might not look very impressive, but this little ball offers big benefits for athletes and children affected by strabismus, ambylopia and other conditions. Marsden ball exercises are just one of the techniques that vision therapists use to help patients make better use of their vision.

What Is a Marsden Ball?

Marsden balls are used in used for a variety of vision therapy exercises. The hollow rubber balls are about four inches in diameter and dangle from the ceiling on a string attached to an i-hook. Depending on the exercise, the ball may feature letters, numbers, colors or a combination of letters and colors.

Why Are Marsden Balls Used?

Every initial visit to a vision therapist involves a thorough examination to identify issues that may prevent you from using your vision fully. Once your therapist identifies the source of your problem, he or she creates a treatment plan that includes both low-tech and high-tech therapies, including computer software, prisms, lenses, filters, games and exercises. The Marsden ball, one of the low-tech options, is often used if you or your child has one of these problems or conditions:

  • Difficulty using both eyes together
  • Hand-eye coordination problems
  • Poor visual tracking skills
  • Amblyopia (lazy eye)
  • Strabismus (crossed eyes)
  • Problems with visual spatial processing
  • Traumatic brain injuries
  • Autism spectrum disorders

Marsden ball exercises can also help an athlete improve his or her performance. Hand-eye coordination and tracking are essential skills for many types of sports. For example, poor tracking skills may make it difficult to tell where a baseball or softball will land. The exercises also improve peripheral vision, allowing an athlete to see action on the sides of the field or court without turning his or her head.

How Does the Marsden Ball Work?

Sometimes the simplest solutions are the most effective. During Marsden ball exercises, the vision therapist sets the ball in motion and asks the patient to perform a variety of tasks, such as calling out the letters they see on the ball. While performing the exercises, patients are asked to keep their heads still and move their eyes to identify letters or colors. Marsden ball exercises are sometimes performed on wobble boards or other devices that help improve balance. Depending on the exercises, patients are asked to sit, stand, walk or lie down while keeping their focus on the balls. The balls can be raised or lowered as needed.

Marsden ball exercises are just one vision therapy technique that can help improve common vision disorders, make reading easier and improve sports performance. Would you like to find out if vision therapy can help you? Call us to schedule an appointment.

Sources:

Optometry Times: Vision Therapy: A Top 10 Must-Have List

http://optometrytimes.modernmedicine.com/optometrytimes/content/tags/brock-string/vision-therapy-top-10-must-have-list?page=full

Vision Care Institute: Be the Best You Can Be

http://www.thevisioncareinstitute.co.uk/sites/default/files/private/uk/pdf/07%20PerformanceVisionSportModule3.pdf

Review of Optometry: Treating Patients on the Autism Spectrum, 4/5/11

https://www.reviewofoptometry.com/article/treating-patients-on-the-autism-spectrum

Vision Therapy – Balance Board

The brain and the eyes work together to create a visual experience. On one hand, the eyes send signals to the brain, which allows it to translate that data into visuals; on the other, the brain sends signals to the muscles attached to each eye, controlling their movements. If anything disrupts these signals and the brain, there may be problems with eye teaming, eye tracking, motor skills and learning. Balancing boards, or teetering boards, help with these components by retraining motor patterns and neurological links.

What to Expect In Treatment

During a vision therapy session that includes a balancing board, the patient stands—feet shoulder length apart—on the wobbly board that is able to move backwards, forwards and from side to side. Often, during the first session, the person is asked to start by balancing themselves forwards, backwards, right and left. This exercise allows the individual to learn how to adjust their balance and control their body. Coordinating the body is important because the coordination of the eyes rely on the body and brain’s ability to balance the entire body, thus learning to balance the body helps the eyes.

Once the patient has mastered adjusting their body on the board, they can then move on to other activities like using the board with a saccadic fixator, which is a wall-mounted square board with a starburst design. Along the various striations of the starburst are lighted buttons. As the buttons light up, the individual works quickly to see how many buttons they can push before the lights go out. The key in doing this activity is to keep the head still and the body steady while on the balancing board. Saccadic fixators and balance boards are used together to test, evaluate and develop eye-hand coordination, reaction times and spatial integration.

Additional Treatment Options

Another addition that may be used with a balancing board is a chart that is pinned to a wall. The patient is then required to track and locate letters and numbers in columns and rows while they are balancing at the same time.

Marsden balls may also be incorporated. Here, a ball with letters, numbers, colors, pictures, or a combination is hung from the ceiling. In activities used to help the patient focus their visual attention, they may be asked to focus on a figure while knocking the ball with a rod, or hitting or catching it with their palms, fists or thumbs. Again, in this vein, these activities are done while the patient is using a balancing board.

Over time, using balancing boards with other vision therapy programs can help in the following areas:

Cognitive

  • Learning fresh material
  • Sequencing information and data
  • Integrating sensory information

Visual

  • Eye tracking
  • Eye teaming

Motor

  • Rhythm
  • Handwriting
  • Speech
  • Coordination
  • Posture and gait

Having patients stand on a teetering board, or balancing board, as they look at objects and perform visual tasks helps the brain and eyes work better together so that they can do their jobs. Doing so helps the patient move better and adjust to performing tasks in their “real-world” environment, which is constantly moving or having them move while they think and use both their eyes and brain to assess and make sense of the things around them.

Vision Therapy Programs

Vision therapy programs are designed to correct complications like astigmatism, wandering eyes, lazy eye or crossed eyes – all of which can affect eye focus, eye movement, visual perception and coordination. With visual therapy, a combination of vision exercises and specialized equipment are used to train the visual system to repair itself, or strengthen itself, so that eye problems can be rectified or diminished enough to improve how the patient views the world and functions in it.

Executed under the supervision of an optometrist, visual therapy is implemented in an office once to twice a week for up to an hour. Exercises and equipment will be personalized to meet the patient’s needs based on the severity of the problem and related symptoms. These components will also be considered when determining how many sessions the patient requires. To accompany in-office visits, the optometrist may also educate the patient on how to perform specific vision exercises at home.

When visual therapy is complete, and all necessary sessions have ended, the patient’s visual skills and capabilities should have improved and any symptoms associated with their eye condition should have reduced significantly. In addition, visual efficiency should have enhanced and the patient should be more efficient when it comes to processing and understanding visual information.

Patches

Eye patches are used to strengthen muscle control in weak eyes. By placing a patch over the strong eye, the weaker eye is forced to do the heavy lifting. While it may be uncomfortable for the patient at first, the muscle controlling the weaker eye will become tougher and more resilient. This will allow the individual to control its movement. When removed after therapy, the person should be able to move both eyes in an organized fashion so that they work together and not against one another.

Corrective Lenses

Corrective lenses are used to correct deviations, adjust focal points or neutralize other anomalies that impact the eyes’ ability to focus an image on the retina. To do this, the lenses must be the correct type and of the right power. Strength – which is expressed as diopeters – relies on the material of the lens, as well as the slope of the curve that is grounded into the lens. For instance, if the person is nearsighted and has trouble viewing objects far away, the lens will be concave, or thicker at the edges than in the middle, to allow for distant objects to come closer to the eyes. On the other hand, if the individual is farsighted and has a problem seeing objects up close, the lens will be convex, or thinner at the edges and thicker in the center. Convex lenses, unlike concave ones, bend toward the focal point, which makes the image appear larger than the object actually being seen.

Balance Board

The brain and the eyes work together to create a visual experience. On one hand, the eyes send signals to the brain, which allows it to translate that data into visuals; on the other, the brain sends signals to the muscles attached to each eye, controlling their movements. If anything disrupts these signals and the brain, there may be problems with eye teaming, eye tracking, motor skills and learning. Balancing boards, or teetering boards, help with these components by retraining motor patterns and neurological links.

Training Devices

Visual-motor-sensory integration training uses various devices to appeal to a person’s senses, including touch, sound and smell. This type of therapy is particularly useful in children with autism. Devices may include play dough, rubber toys, weighted bells and blankets, water, rice, sand, beans, musical instruments, computer games, talking toys and other items. All of these are used to stimulate the senses as a way of strengthening visual, motor and sensory skills.

Cawthorne-Cooksey Exercises

These exercises are mainly used at home and range from simple head and eye movements to performing more complex activities like throwing a ball or focusing on a stationary object while the head is moving. While moving one’s head and tossing a ball sounds easy enough, they are not simple tasks for persons with sensory system disorders that affect movement and sense of balance.

Electronic Targets

Automated targets with timing mechanisms not only show the optometrist how the eyes move in the beginning of treatment – when eye problems have yet to be fully addressed – by strategically positioning the targets, but they give weak eyes a necessary workout. By moving the eyes around to focus on different targets at different times, the weak eye’s muscles are strengthened so that they can learn to move in harmony with the stronger eye.

Computer Software

Computer aided vision therapy consists of a software package designed to enhance eye tracking skills, visual thinking, processing skills and binocular vision skills. Eye teaming, focusing and tracking are not optical in nature, and problems in these areas are the result of poor eye muscles. Specialized software not only trains the eyes to work together, but strengthens the muscles that control their movement.

Therapeutic Lenses

Contact lenses, or therapeutic lenses, are thin lenses that are placed on the surface of the eye. While some wear them for cosmetic reasons, their primary function is to correct and improve vision problems related to refractive errors, act as a protective layer in patients with eye injuries, reduce discomfort or pain associated with refractive and non-refractive errors, and minimize light sensitivity in patients with eyes disorders or injuries to the eye.

Prisms

A prism has the same cross-section across the entire length of its shape. When used in eyeglasses, they often correct abnormalities associated with nearsightedness, farsightedness and double vision. Eyeglasses, or corrective lenses, reduce or increase the size of the image based on the eyes’ ability to see and focus, while prisms fool the brain into believing the eyes are working collectively by moving the image somewhat down, up, right or left. The geometric configuration permits light to be bent or mirrored in particular ways. Prisms are pounded into the lenses to show the image outside the span of sight and bring it into view so that it can be observed more closely.

Filters

Optical filters carefully transfer light in a specific range of wavelengths or colors while obstructing what remains. These dyed plastic or glass devices are placed in the optical path. They are described by their frequency response, and this identifies how the scale and stage of each frequency component of an incoming signal is altered by the filter.

Rotation Trainers

Rotation trainers consist of a disk – with various designs – that is attached to a rod-like base. As the disk rotates, the patient is asked to perform tasks that are designed to test and enhance eye-hand coordination, space awareness, perceptual awareness and visual acuity.

Saccadic Fixators

This entails a wall-mounted square board with a starburst design. Along the various striations of the starburst are lighted buttons. As the buttons light up, the patient works quickly to see how many of these lit buttons they can push before they go out. The key is to keep the head still. Peripheral vision can be enhanced by having the individual look at the center of the board and use only their peripheral vision to locate the lights. Saccadic fixators are employed by optometrists to test, evaluate and develop eye-hand coordination, reaction times and spatial integration. This works best for patients who have problems with eye movements, hand-eye coordination and peripheral vision.

Directional Sequencers

This device integrates all of the senses used for learning. It is one of the basic instruments used for visual-motor training, and helps with direction, rhythm, eye-hand coordination, and work and shape recognition. It consists of an aluminum case with illuminated membrane switches organized along a grid. When the user hits one of the membrane switches, it lights up. The device offers an audio feedback tone and the display panel indicates the number of switches that have been pressed. Often the individual will be required to coordinate pressing the switches with the metronome beat, or pattern templates can be put over the membrane switches to help guide the user. If the person presses a switch too early or too late it will not light up and will not be calculated once the timed activity is over.

Marsden Balls

Here, a ball with letters, numbers, colors, pictures, or a combination is hung from the ceiling. In activities used to help focus visual attention, the individual may be asked to concentrate on a figure while bunting the ball with a rod, or hitting or catching it with their thumbs, palms or fists.

Syntonics

Known also as optometric phototherapy, syntonics deal with the application of selected visible-light frequencies and are used to treat lazy eye and problems with peripheral vision and depth perception. By applying particular visible-light frequencies through the eyes, syntonics can improve vision. This is because when light enters the eye, retinal nerves connected to some of the brain’s center are stimulated. The hypothalamus and pineal gland are regions of the brain that affect electrical, hormonal and chemical balances – all of which impact body function, including vision and the nervous system.

How Vision Therapy Works

Vision therapy, also referred to as vision training, neuro-vision therapy, or vision rehabilitation, is an optometry subspecialty. Vision therapy is prescribed to develop, improve and/or enhance visual function so an individual’s vision system functions more smoothly. Vision therapy can be beneficial for individuals of all ages. The goal of treatment is to help ameliorate vision problems and improve a patient’s quality of life by maximizing vision performance and comfort.

How Vision Therapy Works

In order to understand how vision therapy can improve your vision, it is important to understand exactly how the brain creates an image. At the most basic level, a nerve cell sends and receives electrical signals from sensory neurons. This input and output is used to process visual images. Throughout their life, neural networks continually reinforce themselves in response to new experiences. Body-mind interaction is an important part of this learning process. While the quantity of neurons does not increase, new connections between these neurons can be built at any age. The more frequently a pathway is stimulated, the stronger the pathway becomes and the faster the transmission along this pathway will be. The goal of vision therapy is to reinforce and strengthen these new pathways.

There are several similarities between occupational therapy and vision therapy, especially when it comes to improving hand-eye coordination and visual motor integration. However, vision therapists have completed more in-depth training in the field of visual motor integration, as well as the use of lenses, prisms, and filters.

Who Benefits from Vision Therapy?

Vision therapy is especially beneficial for individuals with ocular motor dysfunctions, binocular dysfunctions, accommodative dysfunctions, visual motor and visual perception disorders, learning-related vision problems, traumatic brain injuries, myopia control, amblyopia, and strabismus. Vision therapy may also be prescribed for patients seeking sports vision enhancement.

Vision therapy is customized to meet the needs of an individual. For example, if you are seeking sports performance enhancement, you will receive therapy designed to improve visual processing speeds, reaction times, visual endurance, accuracy, and eye teaming. Individuals with vision-related learning difficulties will receive therapy that focuses specifically on improving the visual input skills and visual processing skills required for efficient reading, writing, spelling and mathematics.

Depending on a patient’s needs, vision therapy may last anywhere between six weeks to one year. Most problems can be improved with bi-weekly sessions over two to three months, as determined by an eye care professional.

How Vision Therapy Helps

The goal of vision therapy is to treat vision problems that cannot be fully addressed through eyeglasses, contact lenses or surgery. For example, studies show that vision therapy may be beneficial for addressing eyestrain and other issues that can affect a child’s reading abilities. The human brain has significant neuroplasticity, which means it can change its structure and function in response to external stimuli. This neuroplasticity is present not only in childhood, but also into adulthood. As a result, custom vision therapy programs can help bring about neurological changes that correct vision problems for improved visual perception and performance.

What It Treats

Vision therapy addresses vision problems that include amblyopia (“lazy eye”), strabismus, binocular vision problems, eye movement disorders, and accommodative (focusing) disorders. For example, if one eye fails to attain normal visual acuity due to eye teaming problems, vision therapy can help improve this teaming and reduce an eye’s perceived “laziness”. Studies show that vision therapy can improve the accuracy of eye movements required for close-up work and reading, as well as minimizing eyestrain and eye fatigue.

Vision therapy is not a “cure all” for vision issues and it is not a replacement for glasses, contact lenses or eye surgery for certain conditions. For example, do not expect to “throw away your glasses” after attending a few vision therapy sessions or practicing eye exercises at home. Vision therapy cannot “cure” refractive disorders or reverse nearsightedness. However, it may play an important role in addressing visual anomalies associated with vision development, perception and function.

Unlike other forms of exercise, the goal of vision therapy is not to strengthen the eye muscles. Instead, this progressive program of vision exercises is designed to help individuals develop or improve fundamental visual skills and abilities. Vision therapy helps individuals improve visual ease, efficiency and comfort while changing how they interpret or process information. Vision therapy can be beneficial for individuals of all ages, including children and older adults.

Vision Therapy – Signs and Symptoms Checklist

Vision therapy, which is also known as vision training or visual training, is an individualized treatment program that can help identify and correct perceptual-cognitive deficiencies that are impacting visual learning, focus, and concentration.

Vision Therapy for Children: Checklist

While individuals of all ages can benefit from vision therapy, it may be especially helpful for young children with learning disabilities. Vision deficits can cause eyestrain, blurred or double vision, and headaches that make it difficult to stay focused while reading, maintain attention in the classroom or focus on close work. Vision therapy can help correct these visual deficits. With vision therapy, children are better positioned to achieve their full academic potential in the classroom.

Could your child benefit from vision therapy? Use this checklist as a guide.

  • Your child turns or tilts his head to see
  • Your child’s head is frequently tilted to one side or one shoulder is noticeably higher
  • Your child has poor hand-eye coordination, which may be evident in poor handwriting, motor coordination, etc.
  • Your child has problems moving through space and frequently drops objects or bumps into things
  • Your child holds a book or object unusually close
  • Your child closes one eye or covers the eye with his/her hand
  • Your child omits or confuses small words when reading
  • Your child reverses words when reading (e.g., “no” for “on”) or transposes numbers (e.g., “21” for “12”)
  • Your child complains frequently of headaches, eyestrain, nausea, dizziness and/or motion sickness

If your child exhibits one or more of these behaviors, schedule them for a comprehensive vision exam.

Vision Therapy for Adults: Checklist

Vision therapy is beneficial for adults who may have difficult focusing on work or reading due to untreated vision disorders. Vision therapy addresses vision problems that include amblyopia (“lazy eye”), strabismus, binocular vision problems, eye movement disorders, and accommodative (focusing) disorders.

Could you or a loved one benefit from vision therapy?

  • One eye drifts or aims in a different direction than the other
  • You frequently experience headaches or eyestrain while reading, writing or typing
  • You skip lines or words when reading or copying
  • You substitute words when reading or copying
  • You need to use a finger or marker to keep place while reading or writing
  • You squint, close or cover one eye while reading
  • You tilt your head in an unusual posture while reading or writing
  • Your eyes “hurt” or feel especially tired at the end of the work day
  • You experience vision blurs at a distance when looking up from near work
  • One eye sees more clearly, even with glasses on
  • You struggle with hand-eye coordination activities, like playing softball

If you or an adult under your care exhibits one of more of the symptoms, schedule a comprehensive vision exam.