What Are Oculomotor Skills? The Types, Red Flags, and Exercises To Help

Oculomotor skills are the ability to use the eyes in a systematic manner to efficiently scan and locate an object in the field of vision. There are 6 muscles in each eye that controls the movement of the eye. These muscles allow us to efficiently scan the environment, hold our gaze on an object of interest, track objects as they come closer to our body, and quickly jump our eyes from target to target.

What Types Of Oculomotor Skills Do We Develop?

Fixation: The ability to hold your gaze directly at an object in view. An example of this would be looking at the teacher instructing at the front of the room.

Saccadic Motions: The ability to jump the eyes to a different target without overshooting or undershooting the target. When we read, we use saccadic motions to jump and fixate our eyes to the next word or line.

Visual Tracking: The ability to systematically use the eyes to smoothly follow a target in space. An example of this would be when the doctor tells you to follow their pen. In a more functional manner it could be watching a child move forward and backward on a swing.

Convergence: The ability to move the eyes inward in order to maintain fixation on an object that is coming closer to the body. An example of this would be reading signs when driving. As the sign gets closer, you are able to keep your eyes on the sign.

Accommodation: The ability to adjust the eyes as the distance between the object and person changes. An example of this would be a student reading text from the board, then looking down at their paper to copy the text.

How Do Oculomotor Skills Develop, And What Are The Red Flags Of Abnormal Development?

Oculomotor skills begin developing in the womb. When a baby is 2 months old, accommodation and convergence is established. The oculomotor system continues to refine until a child reaches Kindergarten. At this time, a child should be able to control their eyes and smoothly track a target, without head motions. These skills are critical for development since we use our vision to complete most daily activities. For a student,  think about school-related tasks, such as gazing at the teacher that is standing near the board or using saccadic motions and convergence skills during reading and writing tasks. They also use visual tracking skills during games in physical education class. If these skills do not correctly develop, you might see a child have difficulty with one (or more) of the following tasks.

• Skipping lines and words when reading
• Reading the same lines/words over and over
• Writes letters floating above or through the line
• Writes letters with inconsistent sizing
• Writes letters and words with inconsistent spacing
• Catching a ball
• Throwing a ball at a target
• Avoids reading and writing tasks
• Overshooting and undershooting targets (i.e. difficulty aligning marker to place a lid on it aligning scissors to a line, stringing beads)
• Copying from the board or from a book
• Navigating their environment

What Exercises Can Help Oculomotor Difficulties?

As a school-based occupational therapist, I often see students have difficulty completing the above tasks.  When I take a closer look at their eyes, I am able to determine which oculomotor skill(s) is hard for them to complete. From there, I can target oculomotor activities that promote the development of these skills or determine if a more comprehensive vision exam is needed. Below are some of my favorite oculomotor activities. To make them more effective, add in movement activities, such as sitting on a stability ball, standing on a wobble board, or swinging forward and backward or side-to-side.

• Eye jumps – Target: saccadic motions of the eyes. Have the child extend their arms in front of their body and lift their hands about shoulder height. Have them make a fist with a thumb-up position. From there, have the child gaze at the left thumb and then jump their eyes to the right thumb, repeating multiple times. The goal is to smoothly jump the eyes to and from each thumb without overshooting or undershooting the target.
• Rubber bands on a straw – Target: convergence of the eyes. Have the child hold a straw perpendicular to their nose. Have them place the rubber bands on the straw. When the rubber band is moving over the straw, have the child visually track the rubber band. You should be able to see the eyes move inward as the rubber band moves closer to the eyes. After the rubber bands are on, have the child remove the rubber bands. This time, you should see the eyes turn away from each other.
• Ball bounce and read – Target: visual accommodation. On a board, write out different colors, vocabulary words, sentences, or numbers. Have the child stand about 8-10 feet from a board holding a ball in their hands. Tell the child to look at the board and read the first word. After they read the word, the child will then look down at the ball, bounce the ball and then look up to read the next word. Repeat through all of the words on the board.
• Balloon volleyball – Target: visual tracking. Balloons move slower through the air than a ball, so it’s easier to track. Start by having the child watch you toss the balloon up and down. Then have the child toss the balloon up and down. From there, take turns and bop the balloon back and forth. The goal is to have the eyes smoothly track the balloon through the air.

If you notice your child has difficulty with oculomotor skills, then it may be beneficial to talk with their occupational therapist. The occupational therapist can determine if it would be beneficial to incorporate oculomotor interventions into their treatment sessions or if a more comprehensive evaluation is necessary.

Brittany Stout, OTR