Focusing in on Eye Exercises

For the vast majority of us who don't have perfect vision, glasses, contacts, surgery, or just putting up with bad eyes are an annoying fact of life. And anytime you have an annoying fact of life, people seek magically easy solutions; and anytime people seek magically easy solutions, someone pops up and offers it for sale. Maybe it works, maybe it doesn't; but the demand is always there, and so the solution will always be available to those who have their payment cards at the ready. In the case of imperfect vision, one of these solutions is eye exercises. These are some simple movement and focusing exercises that you can do a few minutes every day, and that promise to improve (or even completely fix) your bad eyes. Today we're going to find out if the science agrees with the anecdotes we hear from the people who use them, and the people who sell them.

It's pretty easy to find online stores selling everything related to eye exercises. One called Rebuild Your Vision offers a few exercise instructions for free, but everything is really designed to funnel customers into their supplement product called Ocu-Plus with alleged customer testimonials like:

I no longer have any need for my eyeglasses or need them to drive.

and

My young daughter was nearsighted. Thanks to your eye product, that's the past!

Another called Good-Lite sells a dizzying array of products to help you do various eye exercises, including red and green 3D glasses, charts of every description (some going for hundreds of dollars), diagnostic sets, wands, lights, prisms, games, even a special Starter Kit with a bunch of these — yours for only $920.95.

Or just search Amazon.com for "eye exercises" to find thousands of books for sale, teaching you magical ways to heal your vision naturally with exercises, yoga, Tibetan rites, qigong, and even more charts, games, and electronic gizmos. Some of the books claim to teach what they call the Bates Method.

This goes back to 1920, with the publication of Perfect Sight Without Glasses, by an ophthalmologist named William Bates. Bates believed — wrongly — that the eyes focus by physically elongating in the sockets via the actions of extraocular oblique muscles, which could be exercised. He also believed that mental strain could cause these muscles to malfunction, as could variations in blood circulation. He taught relaxation and visualization techniques to reduce the mental strain, and eye movements to strengthen the hypothetical muscles. The Bates Method also includes staring directly at the sun — although modern publishers often edit this out of Bates' books, which are now in the public domain and so are sold willy nilly as Amazon print-on-demand by numerous individuals and publishers. It probably goes without saying that none of Bates' notions were ever accepted by the ophthalmology profession, particularly his pseudoscientific (and provably false) ideas about the physiology of the eye. Bates even drew a warning from the Federal Trade Commission in 1929 for making false and misleading claims.

Trying to find the science-based answer to the question of eye exercises turns out to be a non-trivial task. The vast majority of less authoritative websites and articles favor them, but this is common whether a product works or not. When you go to the higher end, you start to see a 50/50 split. For example, WebMD has articles that go both ways. And every source, no matter how authoritative, says that exercises do work for some conditions. And this is where the dividing line really lies. Because there are some things that eye exercises are good for, but they're not the magical easy solution to improving your vision that most of us are hoping for. Among authoritative sources, the verdict is clear that you cannot improve blurry vision — either close up or far away — using this method.

My favorite source for authoritative visual information is the website of the American Academy of Ophthalmology. It's a source regular Skeptoid listeners might remember from episode #740 about blue-blocking glasses for people who work at computer screens, their data was very clear that all such products are completely worthless scams, and computer screens do not harm your eyes in any way unless you give yourself eye strain — which blue blocking glasses don't help with. Their finding on the use of eye exercises to improve vision is just as clear. From one article:

There is no irrefutable evidence that eye exercises can affect uncorrected visual acuity (sharpness of vision).

From another article, answering a question about eye exercises for myopia:

Many people, understandably, want to find "natural" cures for ditching their eyeglass needs. But none of the suggested methods — like herbal supplements or eye exercises — have been shown to have any effect.

In fact, in 2014, the AAO issued a joint position paper with the American Academy of Pediatrics, the American Association for Pediatric Ophthalmology and Strabismus, and the American Association of Certified Orthoptists. The paper was addressing the claim that learning disabilities are caused largely by visual problems, and that eye exercises (aka "vision training" or "vision therapy") could improve this. It concluded in part:

Currently, there is no adequate scientific evidence to support the view that subtle eye or visual problems cause learning disabilities. Furthermore, the evidence does not support the concept that vision therapy or tinted lenses or filters are effective, directly or indirectly, in the treatment of learning disabilities. Thus, the claim that vision therapy improves visual efficiency cannot be substantiated.

So in summary — and you can take this to the bank — eye exercises do not improve your vision, if your problem is nearsightedness, farsightedness, presbyopia, or astigmatism — exactly the set of eye problems that most of us wish we could magically solve. There is no scientific evidence that any eye exercise program will reduce or eliminate the need for glasses.

The conspiracy-minded among us might well counter "Oh, course ophthalmologists would say this; they just want to sell you glasses and contact lenses!" This "follow the money" argument is as silly here as it is nearly everywhere else conspiracy theorists try to use it. If profits-over-results was truly what motivated the eye health industry, ophthalmologists could just as easily sell eye exercise books, videos, classes, and checkups — and at a higher profit margin than glasses or contacts.

And as a matter of fact, ophthalmologists do recommend eye exercises that are proven to be beneficial; just not for the conditions most of us are facing. Let's run down the short list of things eye exercises actually do treat and put the "follow the money" conspiracy theory to bed:

• Convergence problems: Including amblyopia and convergence insufficiency, these are conditions where one or both eyes don't work well together. There are exercises and other interventions that can improve the socket muscles' ability to help the eyeballs work together. A related condition called exophoria can also benefit.
  
  
• Adult strabismus: Some people's eyes naturally point in different directions, and this can also be caused by a variety of things including injuries and other health problems. In some cases, there are exercises your ophthalmologist can teach you to improve your specific condition.
  
  
• Glaucoma: Caused by high intraocular pressure, glaucoma can sometimes be reduced not by any eye exercise, but by general cardiovascular exercise, like walking a few times a week. The mechanism is not fully understood, but the correlation is clear.

And… that's it.

At the beginning of this episode, I may have given the impression that everyone who advocates for eye exercises is simply looking to get into your wallet. If I did, allow me to clarify. That is most definitely not the case; the majority are more likely honestly misinformed. You can find countless YouTube videos and blogs and other free resources teaching all the exact same exercises available from the people selling them. Wait, you might ask; in our commercial world, why would anyone give away useful, helpful information for free? Well, one reason might be that most people are basically good and generally want to help others. So if they're going to the trouble to make a YouTube video, it's usually because they want to put good information out there. Now — as we know so well from 900 episodes of Skeptoid — all the information on the Internet is not necessarily correct. Please take a moment to recover from that shock. But in my experience, the creators generally think it's correct. For this to be the case, a lot of these people must have tried eye exercises themselves, found that they worked, and then chose to share that great news with the world. Could there be a circumstance under which eye exercises which do not actually do any good, seem to do some good, enough to fool the person?

It turns out that yes, confirmation bias applies here just as much as it does to so many other aspects of navigating life. It's not unusual for people to put off wearing glasses as their vision declines; many people dread the inconvenience, the change to their physical appearance by becoming a "glasses person", the psychological barrier of accepting that you're getting older or losing your acuity. And so they tend to tolerate pretty bad vision, without necessarily realizing that it's as bad as it is. And then, when they finally do get glasses, the effect is so dramatic that they suddenly tighten their tolerance for what's an acceptable amount of blur. The moment they remove their glasses, they're shocked at how bad their vision gets. This is one powerful driver of the false belief that wearing glasses weakens your vision.

And then when they try eye exercises, they may have their glasses off for an extended period, during which they may recover their previous tolerance to the blurred vision, noticing "Hey, this isn't that bad after all." This contributes to the perception that the eye exercises worked. "I took my glasses off for 5 seconds and I couldn't believe how bad my vision was, but I did 20 minutes of eye exercises and now I'm getting along all right." It is a textbook example of pure confirmation bias. That can be a powerful motivator — powerful enough to convince some people that the eye exercises improved their vision. And so they go to YouTube and they shared the exercises that worked so well for them, hoping to help others. Not everyone who's wrong is a scammer or a charlatan. Sometimes good people are just wrong.

And sometimes others sell you eye vitamins.

By Brian Dunning
Follow @BrianDunning