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Some cases of convergence insufficiency are successfully managed by prescription of eyeglasses, sometimes with therapeutic prisms. Pencil push-ups therapy is performed at home. The patient brings a pencil slowly to within 2–3 cm (0.79–1.18 in) of the eye just above the nose about fifteen minutes per day five times per week.
Although glasses and/or patching therapy, exercises, or prisms may reduce or help control the outward-turning eye in some children, surgery is often required. A common form of exotropia is known as " convergence insufficiency " that responds well to orthoptic vision therapy including exercises.
Prisms or "field expanders" that bend light have been prescribed for decades in patients with hemianopsia. Higher power Fresnel ("stick-on") prisms are commonly employed because they are thin and lightweight, and can be cut and placed in different positions on a spectacle lens.
Treatment options for esotropia include glasses to correct refractive errors (see accommodative esotropia below), the use of prisms, orthoptic exercises, or eye muscle surgery. The term is from Greek eso meaning "inward" and trope meaning "a turning".
The most common strabismus finding is large angle exotropia which can be treated by maximal bilateral eye surgery, but due to the progressive nature of the disease, strabismus may recur. Those that have diplopia as a result of asymmetric ophthalmoplegia may be corrected with prisms or with surgery to create a better alignment of the eyes.
Orthoptists are trained professionals who specialize in orthoptic treatment, such as eye patches, eye exercises, prisms or glasses. They commonly work with paediatric patients and also adult patients with neurological conditions such as stroke, brain tumours or multiple sclerosis.
Suppression of an eye is a subconscious adaptation by a person's brain to eliminate the symptoms of disorders of binocular vision such as strabismus, convergence insufficiency and aniseikonia. The brain can eliminate double vision by ignoring all or part of the image of one of the eyes.
Other options for strabismus management are vision therapy and occlusion therapy, corrective glasses (or contact lenses) and prism glasses, and strabismus surgery. The effects that are due only to the toxin itself (including the side effects) generally wear off within 3 to 4 months.
Vision therapy is a subset of behavioral optometry. In general, vision therapists attempt to improve the vision, and therefore day-to-day well-being, of patients using "eye exercises," prism, and lenses, with more emphasis on the patient's visual function.
Prism lenses (here unusually thick) are used for pre-operative prism adaptation. Health insurances always review therapies in terms of clinical effectiveness in view of existing scientific literature, benefit, risk and cost.