What is Convergence Insufficiency?

Convergence insufficiency is a condition in which eyes are unable to function together when looking at nearby objects. Our brain combines information it receives from both eyes to see objects clearly and in a single image. The eyes must converge and focus on the same point. To preserve convergence and eye alignment when objects become closer to the face, the eyes must bend inward. Individuals with CI have difficulty converging and keeping eye alignment. Their eyes tend to drift away instead of staying properly aligned when attempting to focus on close-up tasks.

Convergence Insufficiency

How common is convergence insufficiency?

Convergence insufficiency is one of the most common vision conditions, as it affects as many as up to 17% of individuals (children and adults). The condition is more commonly found in children and young adults, and it may be underdiagnosed or misdiagnosed, as some individuals may not realize they have the condition or attribute their symptoms to other factors.

Different symptoms

The symptoms of CI can vary from person to person, and they may not always be immediately apparent. Some of the common signs and symptoms include:

  1. Eye Strain: Feeling tired or uncomfortable after short periods of reading or screen time.
  2. Double Vision: Seeing multiple images or text overlapping when looking at close objects. Double or blurred vision occurs because one eye is incapable of turning inward to the required level.
  3. Blurred Vision: Experiencing difficulty in maintaining clear vision, especially during near tasks.
  4. Headaches: Frequently experiencing headaches, often centered around the eyes or forehead.
  5. Eyestrain in Specific Situations: Symptoms worsen during activities that require sustained focus, like reading or using digital devices. When reading or conducting near work activities for lengthy periods of time, people with CI frequently experience hazy or double vision, eye strain, and pain.
  6. Eye Fatigue: Sensation of tired, achy, or heavy eyes, especially after engaging in close-up work for extended periods.
  7. Motion Sickness: Feeling nauseous, dizzy, or unwell when exposed to motion or movement, particularly during activities like reading or driving.
  8. Reduced Reading Efficiency: Struggling with reading speed and comprehension, and needing to re-read things due to visual discomfort. Individuals have trouble concentrating on what they are reading, words seem to move, jump, or float on the page, motion sickness or vertigo.

Causes of convergence insufficiency

The specific cause of convergence insufficiency is unknown. However, it is believed to be related to a combination of factors, including:

  1. Eye Muscle Imbalance: Weakness or poor coordination of the muscles responsible for eye convergence.
  2. Genetics: There may be a genetic predisposition to developing CI.
  3. Prolonged Near Work: Excessive use of digital devices, reading, or other close-up tasks can contribute to the development of CI.
  4. Trauma or Neurological Factors: In some cases, head injuries or neurological conditions may be associated withCi. Infection, traumatic brain injury, certain drugs, neurodegenerative illnesses, myasthenia gravis, or Graves ophthalmopathy can all cause convergence insufficiency.

How is convergence insufficiency diagnosed?

Diagnosis is set based on a full eye examination. Tests will include visual sharpness assessment. An eye care provider will assess convergence ability by examining how your eyes converge when you’re supposed to look at things from a close distance.

It’s possible that you’ll need to repeat this test with each eye independently, and then together. An optometrist or ophthalmologist will assess eye your eye teaming. With just a health history and eye examination, your practitioner should be able to diagnose the issue.

To be able to precisely diagnose CI, a doctor should take at least the measurements of the near point of convergence, exodeviation, accommodation, and positive fusional vergence.

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Convergence insufficiency treatment

The good news is that Convergence Insufficiency can be treated effectively. The main treatment for convergence insufficiency is vision therapy. This is a personalized program of eye exercises and activities designed to strengthen the eye muscles and improve eye teaming skills. Vision therapy aims to retrain the brain-eye connection, allowing the eyes to work together more efficiently.

Nowadays, there exist computer programs, such as AmblyoPlay, that can help enhance convergence ability and track progress over time. Symptoms usually go away once you’ve done the exercises on a regular basis for a short amount of time.

According to the findings of a study conducted by the Convergence Insufficiency Treatment Trial Group, vision therapy is the most effective method for improving both convergence and patient symptoms.

Furthermore, eye doctors frequently recommend certain eye exercises.  Looking through prisms could be one of these exercises. However, the prism lens approach is only used when a person is unable or unsuccessful in undergoing vision therapy.

Covering one eye with eye patch does not help with CI correction because it does not allow you to practice working with both eyes simultaneously. However, it may temporarily alleviate symptoms.

Due to the effectiveness of vision therapy, surgery is rarely considered.

Adults

As convergence insufficiency is not a condition that people could out-grow, it is present both in children and adults. According to research conducted by the Convergence Insufficiency Treatment Trial group, adults showed significant improvement after receiving office-based vision therapy. According to the study, 50 percent of the adults claimed they had “improved vision” or had been “cured” after 12 weeks of treatment. The study concluded that with continued sessions, there may have been an increase in the number of adults with CI that showed improvement from vision therapy.

Based on these findings, research suggests that with a vision therapy program, adults with CI can still learn how to use their fusional convergence skills for clear, single vision. Vision therapy helps to improve eye muscle coordination and trains the brain to use the appropriate skills for precise and comfortable binocular vision. Convergence insufficiency can be successfully treated in adults as well.

Frequently Asked Questions

What is convergence insufficiency?

Convergence insufficiency is a condition in which eyes are unable to function together when looking at nearby objects.

How do I know I have convergence insufficiency?

You may suspect you have it if you experience any of the symptoms, such as eye strain, double vision, blurred vision, headache, eye fatigue, motion sickness, reduced reading efficiency, etc. Consulting with an eye care professional is recommended for proper evaluation and diagnosis.

What causes convergence insufficiency?

The exact cause of convergence insufficiency is not fully understood, but it is believed to be related to a combination of factors, including eye muscle imbalance, genetics, prolonged near work, trauma, and neurological factors.

Is there treatment for convergence insufficiency?

Convergence Insufficiency can be treated effectively. The most common and successful treatment for convergence insufficiency is vision therapy.

Can convergence insufficiency be treated with vision therapy?

Yes, vision therapy is the most common and effective treatment for convergence insufficiency.

What is AmblyoPlay?

AmblyoPlay is a vision therapy solution that is performed through playing therapeutic games and exercises on your tablet or computer for 30 minutes per day. With exercises that adapt to each patient and their specific needs, it is an ideal solution for problems such as lazy eye, strabismus, convergence insufficiency, double vision, or other binocular problems.

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