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What is a Convergence Insufficiency?

Convergence is the ability of the eyes to turn inward to focus on objects at a very close distance.
An insufficiency of convergence occurs when the eyes are unable to adequately converge at
near distances, especially during long periods of reading or studying.

What might a patient with convergence insufficiency notice?

  • Double vision
  • Blurry vision when doing near work
  • Eye strain or eye fatigue
  • Headaches or brow aches after prolonged reading
  • Inability to “cross the eyes” normally
A child getting her eyes checked

What are some other details about Convergence Insufficiency?

  • It occurs frequently in high school, college-aged students, or people who have justbegun a new job which requires more reading.
  • Even young children, if experiencing difficulty during reading in school or while doinghomework, may have convergence insufficiency.
  • One eye may actually turn outward when the person looks at near objects.
  • The eyestrain, fatigue, and brow aches may be caused by the unusual strain needed to keep the eyes focused.

How is Convergence Insufficiency treated?

Vision therapy: eye exercises may be taught to the patient and/or the patient’s parents. In this way, the therapy can be carried out at home. The patient usually returns every 2-3 months for a progress evaluation to learn the next step of therapy. Treatment may consist of the following types of exercises:

Eye check up

Near point training

Patients with Convergence Insufficiency cannot align their eyes at all when looking up close. Every time they look at something up close, one eye turns out. This can be treated with a simple therapy called near point training. In effect, the eye muscles are “doing push-ups”. The patient is instructed on how to hold an object at an intermediate distance from the eyes, then move it closer to the bridge of the nose while carefully watching it approach. The patient is instructed in how to be aware of one eye turning out or ignoring an image. The ultimate goal is to be able to move the object all the way to the bridge of the nose and keep both eyes aligned on it.

Prism Therapy

Once the eyes are able to turn in up close, it is necessary to prolong the time that they can be held in this position comfortably. This may be achieved utilizing prism therapy. Various exercises may be given which usually involve reading through a prism for different lengths of time. Prism therapy may also involve looking at something normally and then replacing the prism again quickly; this teaches the eyes to respond quickly to near demands.

HTS, home computer convergence software

To be done for about 25 minutes, 5days a week. A progress evaluation every 2-3 months.

Surgical Treatment

Surgery is rarely necessary in cases of Convergence Insufficiency. However, in an occasional patient, when routine therapy has not helped, surgery on the ocular muscles may be necessary.

Most people have a very strong convergence mechanism. Fortunately, convergence insufficiency is treatable with eye therapy with resolution of symptoms. The symptoms may recur, but patients who have undergone successful convergence therapy are usually able to correct the problem on their own with additional exercises.