Convergence Insufficiency

Convergence Insufficiency is a common binocular vision condition impacting both children and adults.  It occurs when the eyes have a strong tendency to turn out during reading and close work. As the eyes aim inaccurately, it frequently results in blurry vision, double vision, eye strain, headaches, or more. The tests required to diagnose convergence insufficiency are often not included in traditional vision screenings.

A person who has convergence insufficiency generally experiences symptoms while doing close work like working on a computer or reading, however, when the eyes are tired symptoms may occur while viewing any distance. Children with convergence insufficiency may prefer looking at pictures in a book or playing video games rather than reading. That is because images are easier to understand than words on a page that appear blurry or double to them.

It is common for individuals with convergence insufficiency to avoid near work based on experiencing any combination of the following symptoms, which often worsen at the end of the day:

• Eye strain
• Headaches
• Blurred vision
• Double vision
• Difficulty reading
• Difficulty concentrating
• Difficulty with reading comprehension
• Words moving on the page
• Tendency to cover or squint one eye
• Feeling tired while reading
• Slow reading
• Burning eyes
• Tearing eyes

If you or a loved one experience any of the above symptoms, a Neuro-Vision Evaluation conducted by a Neuro Optometrist is the only means of getting a clear and accurate diagnosis. If you’re interested in better understanding the seriousness and severity of the symptoms you or a loved one are experiencing, we encourage you to take our Vision Symptom Quiz.

Convergence insufficiency is typically a developed binocular vision deficit that may have a genetic component to it, but not always. A common misconception is that convergence insufficiency is caused by muscle weakness in the eyes. It is actually a difficulty within the brain’s ability to control muscle function through the neuro-vision system. Concussions and brain injuries can lead to convergence insufficiency as well.

According to well-established research, the best treatment approach is an individualized neuro-vision therapy program which improves the ability for the eyes to aim more accurately and automatically. Treatment includes repetitively converging and focusing on objects to train proper neuro-vision function. Treatment is often done with advanced equipment that also tracks the alignment of the eyes.

The success rate for treatment of convergence insufficiency with vision therapy is extremely high. After your Neuro-Vision Evaluation, Dr. Talaber will estimate the number of Vision Therapy sessions needed to treat convergence insufficiency based on the severity of the convergence problem.

Convergence Insufficiency Treatment Trial Study Group. Randomized Clinical Trial of Treatments for Symptomatic Convergence Insufficiency in Children. Arch Ophthalmol. 2008;126(10):1336-1349.

Conclusion: Twelve weeks of vision therapy results in a significantly greater improvement in symptoms and clinical measures.

Alvarez T, Vicci V, Alkan Y, et al. Vision Therapy in Adults with Convergence Insufficiency: Clinical and Functional Magnetic Resonance Imaging Measures. Optom Vis Sci. 2010;87(12):E985-1002.

Conclusion: Vision therapy was associated with and may have evoked clinical and cortical activity changes as observed by the fMRI scans.

Ciuffreda K. The scientific basis for and efficacy of optometric vision therapy in nonstrabismic accommodative and vergence disorders. Optometry. 2002;73(12):735-762.

Conclusion: For nearly 75 years, optometric vision therapy has been an important mode of therapy for both children and adults who manifested a range of accommodative and vergence disorders.The findings clearly support the validity of optometric vision therapy. Furthermore, the results are consistent with the tenets of general motor learning.