Purpose: The purpose of these activities is to help the patient develop understanding of how the eyes move, the ability to control these movements in a coordinated and effortless manner, and the ability to visually anticipate movement or change. Precise and predictable eye movements direct the purposeful movement of the body.
In all eye movement control activities the patient is encouraged to a) feel the eyes moving, and b) to maintain awareness of the peripheral surroundings (“side vision”). Moving the eyes to extreme positions of gaze can be uncomfortable, so watch for signs of fatigue and take a break if necessary. Repeat this exercise over no more than two or three training sessions.
Materials: Marsden Ball or Equivalent (you can make a ‘Marsden’ Ball by piercing a tennis ball with an eyelet screw, then attach a string to it. See instructions to make a Marsden Ball).
Activity 1 – Circle
1. The patient stands in good balance directly under the ball.
2. The home assistant pulls the ball down and away from the patient’s head, down to nose level. Allow at least 18 inches clearance between the ball and surface of the child’s head.
3. The ball is swung in a large circle around the patient’s head; the circle should be wide enough that it clears a path around the child’s head of at least 18 inches.
4. The patient is asked to track the ball smoothly with the eyes alone as far as possible while keeping the head still.
5. When the ball moves out of view, the patient moves his/her eyes to the opposite side in one big, smooth movement, ready to pick up tracking when the ball re-appears.
6. The ball should be swung in both a clockwise and counterclockwise direction. Large diameter circles should be tried first, then work down to smaller diameter circles (at least 18 inches).
Activity 2 – Visual Anticipation/Prediction
1. The above procedure is repeated.
2. The patient is to predict, by calling out “now” when he/she believes the ball will re-appear.
Activity 3 – Bunting
1. The patient keeps the ball moving smoothly by hitting it gently as it starts to slow down. A small stick or paper towel tube is a good tool to use to hit the ball. Remember, the point here is to keep the ball moving in an even circle without increasing or decreasing its radius. The head should remain steady/still, but the eyes should be moving and guiding the action.
Activity 4 – Teeter Board/Balance Board
1. The above procedures are done on teeter/balance board. If one is not available, the child can try standing on one foot, or on a throw pillow.