Convergence Insufficiency (CI) is a common vision disorder diagnosed in optometrist and ophthalmologists offices across the country. In fact, nearly 1 in 10 school-age children in the U.S. suffer from this eye-coordination problem. Chances are you found this blog post searching for information after you or more likely, your child, received a diagnosis.
The two questions people ask once upon diagnosis are:
1) What is Convergence Insufficiency?
2) How is it treated?
Let me answer those questions in order.
Convergence Insufficiency occurs when a person’s eyes do not coordinate well at near distances. For instance, in order to perform close-vision functions such as reading a book, working on a computer, doing a sheet of math problems for homework, or even coloring/doing artistic crafts, both eyes need to turn inward (converge) to focus on the item. Most people’s eyes converge easily, but those with CI do not. And in some cases, their eyes will actually pull outward. The person with convergence insufficiency will develop a set of symptoms during the effort to force their eyes inward. Since children in school spend a good deal of their learning day engaged in close-vision activities, those symptoms will appear during and after those learning activities. When you read the symptoms below, you can see that these symptoms can be more than bothersome, not to mention, hinder the process of reading and/or learning to read.
The most common symptoms of convergence insufficiency are:
eyestrain (especially with or after reading)
blurred or double vision
squinting, rubbing, closing or covering an eye
sleepiness during and after reading or close-distance activity
Other symptoms include:
words appear to move, jump, swim or float
frequent loss of place when reading
inability to concentrate
dizziness or vertigo (especially during or after reading)
On many occasions I have seen children for initial exams who complained that the words were moving around or jumping around on the page and their parents found this hard to believe until I explain exactly what convergence insufficiency is and how it impacts their child’s eyes.
A person with 20/20 distance vision can still suffer from convergence insufficiency. This is why a routine and cursory vision screening in school or the pediatrician’s office will NOT detect the disorder. It will only be diagnosed by an eye care professional measuring you or your child’s eyes as they function at near vision as opposed to distance.
So once the diagnosis of convergence insufficiency is made, what then? How is it treated?
Developmental optometrists like myself will prescribe an in-office program of vision therapy designed to re-train the eyes to converge easily and appropriately. Some eye care professionals not board certified in developmental optometry may prescribe simple “pencil push-ups” or home-based therapy, but a 2008 National Eye Institute study in the treatment of convergence insufficiency concluded office-based treatment was by far the most effective treatment. Certainly, I’ve seen this in my own practice, where my therapists and I can correct inappropriate procedures and motivate patients when necessary.
Convergence insufficiency can be missed for years, but it can be treated at any time. My suggestion is if you or your child has symptoms of convergence insufficiency OR have been diagnosed with CI, find a board certified developmental optometrist and begin a program of office-based vision therapy.
I hope you have found this explanation helpful.
Dennis R. Cantwell