Convergence Insufficiency

Convergence insufficiency is an inability to focus both of your eyes while reading or looking at a close object. Your eyes converge to focus at a nearby object so that you can see the object as a single image. It is difficult to read if you have convergence insufficiency. This can lead to misconception that your child has learning disability. Treatments usually provide relief from the signs of convergence insufficiency.

You may not experience symptoms even though you have convergence insufficiency. Signs and symptoms of convergence insufficiency are:

• Pain in your eyes or eyestrain 
• Headaches 
• Problem reading, seeing blurred or moving words 
• Double vision 
• Inability to concentrate 
• Peeping or closing one eye 

When to see a doctor? 

Schedule an appointment with an ophthalmologist or an optometrist if you or your child has difficulty reading or signs and symptoms of convergence insufficiency. 

The exact cause of convergence insufficiency has not been identified. It is believed that convergence insufficiency occurs when the muscles that move your eyes can't align properly while trying to read or look at close nearby objects. Usually, one eye instead of moving inward, turn outward while focusing on a close word or object.

A routine eye exam is usually not useful for diagnosis of convergence insufficiency. Following tests are performed:

• Medical history review: Your doctor may ask your signs and symptoms that you are experiencing which could be helpful while diagnosing convergence insufficiency. 
• Tests to detect your eyes' ability to focus: Usually simple tests are performed to detect whether you have convergence insufficiency. For instance, you may be asked to focus on an object which is slowly moved towards you. Or, you may have to read eye chart through prism lens.
• Routine eye exam: Routine eye exam may be performed to detect any other vision problems, such as nearsightedness. 

Following treatments are available for convergence insufficiency: 

• Pencil pushups: In this exercise, you bring the pencil closer to your nose while focusing on small letter on the pencil. Stop the movement if you have double vision. This is usually recommended for 15 minutes a day for five days or more in a week. 
• Office or home-based vision therapy: Vision therapy is found to be superior to other eye exercises. You perform exercises for focusing your eyes with the help of computer software program. The results can be printed and your progress is assessed by your doctor. This is either performed in your home or doctor's office. According to recent studies, vision therapy at doctor's office has proved to be more effective than at home.
• Combined therapy: Combination of pencil pushups and vision therapy is believed to be more effective and engaging for children. 
• Reading glasses: This is opted if vision therapy or exercise proves to be ineffective. Your doctor suggests glasses with prisms for reading. This treatment option is found to be more effective in children. 
• Continued observation: You may be diagnosed with convergence insufficiency even if you are not experiencing signs and symptoms. Your doctor recommends you to observe your symptoms while reading or looking at a close object. Your doctor may schedule tests to assess your condition. 
• Surgery: Surgery is rarely opted if neither exercises nor computer-assisted therapy works. 

Cost and your convenience are also considered while choosing treatment options. Nearly after four weeks of treatment your condition will probably improve. Treatment can provide relief from the symptoms of convergence insufficiency for long period of time. 

But symptoms are likely to return: 

• After being ill 
• If you do not sleep enough
• If you are reading a lot or doing close work for a longer period. 

In this case you will be recommended another round of treatment.

Because convergence insufficiency causes difficulties while reading as well as difficulties in concentrating,there is a risk that child's learning can be affected.

Hence, your child's convergence insufficiency may be mistaken with his/her learning disability.

Routine eye exams or school based vision screenings are not able to detect convergence insufficiency.