Convergence Insufficiency

Convergence InsufficiencyTo see clearly, your eyes need to work together. Convergence of the eyes occurs when your eyes come together when they need to focus on a single or close object simultaneously, such as a book or smartphone. When this does not happen, it is known as convergence insufficiency. At Family Eye Care Center of Atlanta, we specialize in treating convergence insufficiency for patients in Buckhead, Atlanta, Georgia, and the surrounding areas. Our team of dedicated professionals works together with you to correct your vision and offer personalized treatment plans for your unique needs to improve your quality of life. 

What Is Convergence Insufficiency?

Convergence insufficiency is a vision disorder that occurs when your eyes have difficulty converging your eyes together when looking at close or nearby objects. It affects your ability to move your eyes inward and outward when focusing, comprehending, and paying attention. 

Typically, both eyes work together to converge an object or image, such as when glancing at your tablet or driving your car. When this does not happen, it may lead to double or blurry vision, persistent headaches, reading problems, or other problems when focusing on a nearby target, such as a book. 

The condition starts during childhood but can also occur at any age. Early treatment is vital to help your eyes usually function and work together. Left untreated, convergence insufficiency may lead to an outward eye turn that comes and goes, a condition known as intermittent exotropia.

Causes of Convergence Insufficiency

Convergence insufficiency is caused by problems with coordinating your eye muscles and movements. The condition causes one or both eyes to drift outwards when looking at something nearby instead of coming together to focus on the object. The brain controls eye movements. The eye muscles of people with convergence insufficiency work normally. The brain or nerves that send signals to the eye muscles can cause the condition. Additionally, a brain injury or conditions that affect the brain can lead to convergence insufficiency, which may include: 

  • Parkinson’s disease
  • Graves’ disease
  • Traumatic brain injury
  • Concussion
  • Myasthenia gravis
  • Alzheimer’s disease 

It is not precisely known why or how the condition occurs, although it runs in families. You may get convergence insufficiency if you have a family member with the condition. The condition is often misdiagnosed and goes undetected because testing is not included in a basic eye exam or school screening. You may pass the 20/20 eye test and still have convergence insufficiency. Using the computer for long periods also puts you at high risk of acquiring the condition. 

Symptoms of Convergence Insufficiency

Convergence insufficiency can cause several symptoms when you read, do close work, or look at objects up close. Symptoms vary for every person. Some people may not experience any symptoms at all.  When your eyes are not able to converge easily and efficiently, you may develop the following symptoms: 

  • Eye strain (especially with or after reading)
  • Blurred vision
  • Difficulty reading and concentrating
  • Headaches or muscle tension
  • Poor sports performance
  • Diplopia (double vision)
  • Short attention span
  • Discomfort in your eyes
  • A “pulling feeling” around your eyes
  • Rubbing, Squinting, closing, or covering an eye
  • Reading slowly
  • Frequenting losing your place while reading
  • Trouble remembering what you read
  • Your eyes might hurt or feel fatigued after doing close work or reading
  • Words blurring, coming in and out of focus, or they appear to swim, jump, move or float on the page
  • Avoidance of near work
  • Sleepiness during near work
  • Dizziness (vertigo) or motion sickness
  • Repeatedly reading the same line 
  • Excessive blinking or rapid eye movements
  • Squinting 
  • Using a finger or ruler when reading

Additionally, you may cover or close one eye to relieve double or blurred vision. Your symptoms may also worsen due to lack of sleep, illness, anxiety, or doing close work for long periods. Your brain might ignore one of your eyes to compensate for vision problems (vision suppression). This may help you stop seeing double; however, it does not address the issue. It may also decrease distance judgment and coordination. 

Convergence Insufficiency Diagnosis

Since convergence insufficiency is often misdiagnosed, it is best to have a comprehensive eye exam. If your child is having problems with school work, they should also have their eyesight tested.

During your appointment, your doctor will ask you to describe your symptoms, and extra testing will be required to rule out or diagnose convergence insufficiency. It is essential to explain in detail the symptoms you are experiencing. Your eye doctor will also take your medical history to better understand your symptoms. The following painless tests may also be conducted during your appointment: 

  • A complete eye exam to check how the nerves and muscles work to move your eyes inwards toward the nose, including how close to your face you can focus before your eye moves outward. 
  • Your doctor may ask you to look through a prism lens and read letters on a chart to check if you see double. This helps determine positive fusional vergence.
  • You will be tested on how quickly you can switch your focus from distant to close objects and how much you can drift outward when looking at near and far things.

Convergence Insufficiency Treatment

Convergence insufficiency usually responds well to treatment. It is best to seek treatment for convergence insufficiency during childhood since the brain is more efficient in making permanent changes as it develops when young. Treatment for adults is also effective and necessary and may take a while; therefore, patience is required. Your doctor will determine the best treatment plan depending on your age and preferences based on the severity of your convergence insufficiency. At Family Eye Care Center of Atlanta, we customize treatment programs and guide and monitor your progress throughout your program, making any necessary changes or adaptions that might be necessary.

Convergence insufficiency is mainly treated with special eye movement exercises (vision therapy) performed by an eye care professional and practice sessions that can conveniently be done at home. Convergence insufficiency treatment exercises may include:

  • Depth perception practice
  • Catching exercises
  • Physical distance judgment activities
  • Posture improvement
  • Training with computerized technology, including automated games to stimulate the brain and eye muscles of each eye simultaneously 
  • Computerized vision training glasses (also called synoptophore)

Treatment may also include prism glasses or lenses, which can be incorporated into reading glasses to reduce symptoms. Prisms redirect the light entering your eyes by bending the light and helping you focus on a single image to relieve double vision. Base in prism glasses may occasionally be prescribed. They do not correct convergence insufficiency and are a temporary solution to align your eyes for reading. Base-out prism glasses can also be prescribed to increase the difficulty of convergence activities. Prism lenses are also used when you don’t respond to therapy.

Convergence insufficiency treatment generally works well. If you are not responding to vision therapy, your eye doctor might recommend surgery focusing on your eye muscles. Surgery is rare and is considered the last option. 

 

If you or your child has difficulty reading and concentrating or experiencing any other symptoms, call the Family Eye Care Center of Atlanta for an accurate diagnosis and personalized treatment plan. Contact us today for more information, or schedule an appointment online. We are glad to help.

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