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Definition

What is convergence insufficiency?

Convergence insufficiency is a condition in which your eyes are unable to work together when looking at nearby objects. This condition causes one eye to turn outward instead of inward with the other eye creating double or blurred vision.

How common is convergence insufficiency?

Convergence insufficiency is usually diagnosed in school-age children and adolescents. It can cause difficulty reading, for which parents or teachers might suspect the child has learning difficulties rather than an eye disorder. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of convergence insufficiency?

The common symptoms of convergence insufficiency are:

  • Tired, sore or uncomfortable eyes (eyestrain)
  • Headaches
  • Difficulty reading — words seem to float on the page, you lose your place or you read slowly — which might cause you to avoid reading or not complete schoolwork
  • Double vision (diplopia)
  • Difficulty concentrating
  • Squinting, rubbing or closing one eye

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes convergence insufficiency?

The cause of convergence insufficiency isn’t known, but it involves a misalignment of the eyes when focusing on nearby objects. The misalignment involves the muscles that move the eye. Typically, one eye drifts outward when you’re focusing on a word or object at close range.

Risk factors

What increases my risk for convergence insufficiency?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is convergence insufficiency diagnosed?

People with convergence insufficiency might have otherwise normal vision, so it’s important to mention reading or learning concerns to your eye care provider. To diagnose convergence insufficiency, your eye doctor might:

  • Take a medical history. This might include questions about problems you have with focusing, blurred or double vision, headaches, and symptoms.
  • Measure the near point of convergence (NPC). This test measures the distance from your eyes to where both eyes can focus without double vision. The examiner holds a small target, such as a printed card or penlight, in front of you and slowly moves it closer to you until either you have double vision or the examiner sees an eye drift outward.
  • Assess positive fusional vergence (PFV). During this test, you’re asked to read letters on an eye chart while looking through prism lenses. The examiner will note when you begin to have double vision.
  • Perform a routine eye exam. If you have any other vision problems, such as nearsightedness, your eye doctor might conduct tests to assess the degree of the problem.

How is convergence insufficiency treated?

Convergence insufficiency can often be treated by practicing convergence through exercises. These exercises may be prescribed by an orthoptist (a medical technician who is specifically trained in ocular muscle function and binocular vision) or by an ophthalmologist. There is also a computer program available which may be used on a home computer to increase convergence ability. The results of the computer program are often followed by your eye care professional with print outs that can be brought in to the office visit.

Which method of treatment will be used for an individual patient depends on the age of the patient requiring treatment, the proximity to an orthoptist or vision therapist and the preference of the patient. Important aspects to consider in choosing a treatment regimen are the convenience and expense of treatment as any method chosen tends to be successful if the prescribed regimen in followed. Most studies show that a short course of treatment is usually successful. Prolonged therapy does not show significant advantages and is usually unnecessary.

One method of therapy to resolve convergence insufficiency is the use of base-out prisms which force the system to work harder to converge. They are used only during short periods of time while performing therapy as they are very tiring to the eyes.

Base-in prisms can be used to artificially align the eyes for reading; however, their use will make it unlikely that the patient will develop stronger convergence on their own.

Patching is not an option to strengthen convergence because wearing a patch will disrupt any ability to exercise binocular function (use the two eyes together). Occasionally, patients will patch one eye temporarily in order to relieve double vision during times when a large amount of near work is required.

Occasionally, a patient will not respond to therapy. In these cases, prism glasses may be used for reading in order to artificially align the eyes and allow for more comfortable binocular vision. In rare cases, surgical intervention may be suggested.

Patients with convergence insufficiency are often permanently cured after exercises to strengthen their convergence. Continued near work following convergence therapy tends to help maintain adequate convergence once treatment is discontinued. At times, convergence insufficiency symptoms will resurface after illness, lack of sleep or increased near work demands. If treatment had been successful previously, an additional course of treatment tends be successful at resolving recurrent symptoms.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage convergence insufficiency?

Please discuss with your doctor for further information.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: September 28, 2017 | Last Modified: September 28, 2017

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