Convergence insufficiency (CI) is an eye coordination problem where the eyes move outward when doing close work like reading.  Convergence insufficiency is the most common eye coordination problem, but is frequently undiagnosed as it is not tested for at vision screenings.  It commonly affects children, but people of all ages can have it.  It is also the most common vision problem that develops after a concussion.  Read on to learn more.

 

Causes of Convergence Insufficiency

The lack of efficient communication between the muscles controlling eye movements and brain causes CI. There are six strong muscles surrounding your eye. However, the nerves controlling these muscles do not send the proper signals to enable the appropriate aiming at a target like a screen or a page.

 

Symptoms of Convergence Insufficiency

Convergence insufficiency symptoms vary from one person to another. Some children with convergence insufficiency may not report any visual symptoms because they do not know how they are supposed to see.  The majority of symptoms will occur when doing up-close tasks like reading. You may notice the following:

 

• Headaches that are associated with near work, or seem to occur at the end of the school or workday

• Eyestrain - Convergence insufficiency may make your eyes tired, sore, or irritated

• Difficulty concentrating - Paying attention or focusing can be challenging if you have CI. If your eyes have trouble working together up close, a child may avoid near tasks and look around the room instead

• Trouble reading - Convergence insufficiency can make words look like they are moving, doubled, or blurry. Hence, children with this condition can struggle to learn reading, or take a long time to get through their homework

• One eye squinting - Closing one eye helps people with convergence insufficiency see one image

• Double vision - You may experience double vision when your eyes fail to move together. You may also experience blurry vision

• Avoidance of near work – kids with convergence insufficiency may avoid reading and writing, or prefer to read graphic novels rather than chapter books

• Motion sickness or dizziness- eye coordination problems can contribute to motion sickness by affecting how the visual and vestibular systems work together

• Poor depth perception – Sometimes the brain suppresses, or turns off an eye, to avoid double vision.  This leads to difficulty with depth perception.  This can reduce sports performance, coordination, and spatial judgments

Diagnosis

CI is underdiagnosed because you can still have an eye coordination problem even if you can see clearly on an eye chart.  School screenings do not test for this condition.

 

A comprehensive eye exam by a developmental optometrist is the best way to diagnose CI. Visit your optometrist if you or your child have any of the symptoms discussed above.

 

Your appointment will entail your eye doctor doing various tests. They will begin by asking about your medical history to help them understand the symptoms you have. They will then examine your eyes and carefully evaluate how your eyes work together.

Your eye specialist will measure the distance you use both eyes without double vision, called near-point convergence. They will do so by moving a letter or a penlight towards your nose until your eye moves away or you begin seeing double. Your eye doctor will do additional tests with prisms to evaluate how well your eyes line up and work together.

Treatment

Convergence insufficiency can be effectively treated by a program of optometric vision therapy.  Vision therapy is a series of doctor-designed eye exercises that teach the eyes and brain to work together correctly.  Our office’s vision therapy program involves both in-office therapy sessions and supporting home exercises. Convergence insufficiency can be effectively treated with about 12 sessions of in-office therapy, however, treatment may be longer if additional tracking or vision processing problems are identified at the initial evaluation.  

 

Special prism glasses can help with up-close tasks like reading or computer work if vision therapy does not improve your symptoms.



 

For more information about convergence insufficiency, contact Vision Rehabilitation Associates at our office in Northfield, Illinois. Call (847) 716-2340 to book an appointment today.