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Convergence Insufficiency

When we look at objects far away, most people have straight eyes. When we look at something up close our eyes have to converge (move inward) to allow both eyes to focus on the same object. When the muscles that cause our eyes to converge are weak it can cause strain and difficulty focusing and even learning disabilities. 

What are the symptoms of convergence insufficiency?

  • Eyestrain
  • Headaches
  • Difficulty reading
  • Blurry vision to read
  • Double vision
  • Difficulty concentrating
  • Squinting or closing one eye
  • Fatigue

What causes convergence insufficiency?

There is not always an identifiable cause of convergence insufficiency. Some patients may suddenly develop convergence insufficiency if they have had a concussion, a viral illness, Lyme disease, Parkinson’s disease, or migraine.

How is convergence insufficiency diagnosed?

Testing can be done in the office to measure your eyes ability to convergence. A patient may have poor ability to converge the eyes but if there are no symptoms, treatment may not be necessary; thus, it is very important to assess a patient’s symptoms by our trained staff. It is also important that a full, dilated eye exam be performed to ensure there are no other ocular findings, such as swollen optic nerves which could be a sign of high pressure in the brain.

How is convergence insufficiency treated?

In our office, we treat symptomatic convergence insufficiency with home-based computer exercises. Based on scientifically published studies we know this treatment works effectively on symptoms. Once symptoms are improved, most patients will remain symptom free simply by using their eyes for near work, such as reading. In some extreme cases patients may benefit from glasses with prism to alleviate their symptoms, or eye muscle surgery if the symptoms are also present at a distance.

Convergence insufficiency and attention deficit hyperactivity disorder (ADD or ADHD).

Nearly 10% of children with ADHD also have convergence insufficiency. The symptoms of convergence insufficiency can make it difficult for a patient to concentrate. Per DSM-IV criteria for ADHD includes symptoms listed below; some of these overlap with symptoms of convergence insufficiency.

  • Often does not give close attention to details or makes careless mistakes in schoolwork, work or other activities.
  • Often has trouble keeping attention on tasks or play activities.
  • Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
  • Often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
  • Is often easily distracted. 

Vision therapy. double vision. students not focusing. trouble reading.