Extraocular myofascial release: introduction of a new method for treatment of esodeviations and assessment of its effectiveness on patients with convergence spasm: a clinical trial Original research study

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Published: Mar 19, 2026
DOI: https://doi.org/10.24292/01.OT.120326
Keywords:
extraocular muscles, strabismus, esodeviation, connective tissue, myofascial release

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Alireza Mohammadi
Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
https://orcid.org/0000-0001-7593-2505
Hassan Hashemi
Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
https://orcid.org/0000-0002-6086-1537
Morad Amir Ahmad
Department of Optometry, Department of Physiotherapy, Erbil Technical & Medical Health Collage, Erbil Polytechnic University, Erbil, Kurdistan Region, Iraq
http://orcid.org/0009-0003-3587-1164
Behnoosh Vasaghi-Gharamaleki
Rehabilitation Research Center, Department of Basic Sciences in Rehabilitation, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
https://orcid.org/0000-0003-3101-9313
Ali Mirzajani
Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
https://orcid.org/0000-0003-1520-0470
Ebrahim Jafarzadehpur
Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
https://orcid.org/0000-0002-4451-800X
Abbasali Yekta
Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
https://orcid.org/0000-0003-4356-9064
Mehdi Khabazkhoob
Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
https://orcid.org/0000-0003-0801-8793

Abstract

Purpose: We examined the effect of Extraocular Myofascial Release (EOMR) on the amount of esodeviation in patients with convergence spasms to evaluate its efficacy, maintenance, and effect size.


Methods: 29 patients with esodeviations due to convergence spasm participated in this study. After the initial measurement of the deviation, we conducted 2 treatment sessions the following week. Then, we stopped treatment for 2 weeks to assess the maintenance of the treatment. To perform the EOMR technique, we apply extremely gentle and continuous pressure to the medial rectus and its associated connective tissue with the index finger pulp for 300 s per eye.


Results: According to repeated-measures analysis of variance, the amount of esodeviation significantly decreased at far 1.22Δ, 95% CI: 0.64–1.81 and near 4.9, 95% CI: 4.13–5.67 immediately after the first session of EOMR. More decrease occurred after the second session of therapy for far 1.83Δ, 95% CI: 1.02–2.63, which was 44.6% of the total pre-treatment amount of esodeviation, and at near 5.52Δ, 95% CI: 4.41–6.63, which was 71.6% of the pre-treatment amount of esodeviation. The amounts of far and near esodeviation were still significantly lower than pre-treatment measurements even 2 weeks after the termination of the treatment at far 1.52Δ, 95% CI: 0.74–2.29 and near 5.4Δ, 95% CI: 4.05–6.74.


Conclusions: The EOMR technique reduces the amount of esodeviation in patients with convergence spasm non-invasively by decreasing the force derived by the medial rectus tonus, its passive characteristics, and smooth muscle contraction. It can be a reliable therapeutic technique for esodeviations with non-accommodative and non-paretic etiologies.

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How to Cite
1.
Mohammadi A, Hashemi H, Ahmad MA, Vasaghi-Gharamaleki B, Mirzajani A, Jafarzadehpur E, Yekta A, Khabazkhoob M. Extraocular myofascial release: introduction of a new method for treatment of esodeviations and assessment of its effectiveness on patients with convergence spasm: a clinical trial. Ophthatherapy [Internet]. 2026Mar.19 [cited 2026May30];13(1):A0001. Available from: https://www.journalsmededu.pl/index.php/ophthatherapy/article/view/3207
Issue
Vol 13 No 1 (2026)
Section
Surgery and laser therapy
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Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)

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