Convergence insufficiency occurs when your eyes don't turn inward properly while you're focusing on a nearby object. When you read or look at a close object, your eyes should converge — turn inward together to focus — so that they provide binocular vision and you see a single image. But if you have convergence insufficiency, you won't be able to move your eyes inward to focus normally.
Convergence insufficiency is usually diagnosed in school-age children and adolescents. Convergence insufficiency can cause difficulty with reading, which may make parents or teachers suspect that the child has a learning disability, instead of an eye disorder. Treatments are usually effective for convergence insufficiency.
Not everyone with convergence insufficiency experiences symptoms. Signs and symptoms occur while you're reading or doing other close work and may include:
When to see a doctor
Convergence insufficiency results from misalignment of the eyes when focusing on nearby objects. The exact cause isn't known, but 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.
Difficulties with reading and concentrating can adversely affect a child's learning. Convergence insufficiency typically isn't detected in routine eye exams or school-based vision screenings. A child with the condition may be evaluated for learning disabilities because of his or her reading troubles.
Tests and diagnosis
People with convergence insufficiency may have otherwise normal or "20-20" vision, and the condition may not be detected during a routine eye exam. To diagnose convergence insufficiency, your eye doctor may do the following, including special eye-focusing tests:
Treatments and drugs
If convergence insufficiency isn't causing symptoms, you generally don't need treatment. But for people with symptoms, treatment with eye-focusing exercises can increase the eyes' convergence ability. Treatment may take place in the office of a trained therapist or at your home. Treatments may include:
A study sponsored by the National Eye Institute of the National Institutes of Health compared home-based treatment with doctor office-based treatment for convergence insufficiency in children ages 9 to 17. Study results showed that the most effective therapy was a weekly hourlong session of in-office vision therapy with at-home reinforcement exercises. Other studies have also found that office-based treatment is effective about 75 percent of the time.
Home-based treatment with pencil pushups or computer programs hasn't been shown to be as effective — in some studies, it works only about one-third of the time. But home treatment costs less and is more convenient. Only a small percentage of eye care providers offer in-office therapy for convergence insufficiency. Many people who can't find or can't afford in-office therapy opt for home-based treatment.
If you choose home treatment, many experts recommend using computer software programs along with pencil pushups. The combined approach may be more effective, and the computer therapy is more engaging for children.
Treatment for convergence insufficiency may take three months or longer, though you'll likely start to see improvement in your symptoms after four weeks. After your convergence ability has improved, you can help maintain your improved vision by continuing to read and do other near tasks. Treatment can permanently cure convergence insufficiency, but symptoms may come back after an illness, lack of sleep or when you're doing a lot of reading or other close work. In rare cases, eye-focusing exercises don't work and your doctor may recommend surgery.
Last Updated: 2011-07-16
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