People with convergence insufficiency might have otherwise normal vision, so it's important to mention reading or learning concerns to your eye care provider. To diagnose convergence insufficiency, your eye doctor might:
- Take a medical history. This might include a health history as well as questions about problems you have with focusing, blurred or double vision, headaches, or other symptoms.
- Measure the near point of convergence (NPC). This test measures the distance from your eyes to where both eyes can focus without double vision. The examiner holds a small target, such as a printed card or penlight, in front of you and slowly moves it closer to you until either you have double vision or the examiner sees an eye drift outward.
- Assess positive fusional vergence (PFV). During this test, you're asked to read letters on an eye chart while looking through prism lenses. The examiner will note when you begin to have double vision.
- Perform a routine eye exam. If you have any other vision problems, such as nearsightedness, your eye doctor might conduct tests to assess the degree of the problem.
If convergence insufficiency isn't causing symptoms, you generally don't need treatment. But for people with symptoms, treatment with eye-focusing exercises can increase the eyes' convergence ability.
Treatment, which can take place in the office with a trained therapist or at your home, might include:
- Pencil pushups. In this exercise, you focus on a small letter on the side of a pencil as you move it closer to the bridge of your nose, stopping as soon as you see double. The exercise is often done for 15 minutes a day, five or more days a week.
- Computer vision therapy. Eye-focusing exercises are done on a computer using software designed to improve convergence. You can print the results to share with your eye doctor.
- Reading glasses. Glasses with built-in prisms generally haven't proved effective. If you have another focusing or vision problem, such as not seeing well at close range (farsightedness), reading glasses might help.
Recent studies indicate that office-based therapy with home reinforcement is the most effective treatment for convergence insufficiency. Home-based treatment with pencil pushups or computer programs hasn't been shown to be as effective. But home treatment costs less and is more convenient and more readily available.
Treatment for convergence insufficiency might take three months or longer. Treatment can resolve convergence insufficiency, but symptoms might recur after illness, after lack of sleep, or when you're doing a lot of reading or other close work. Discuss treatment options with your eye care professional.
July 16, 2020
- Friedman N, et al. Massachusetts Eye and Ear Infirmary Illustrated Manual of Ophthalmology. 5th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed May 5, 2020.
- Coats DK, et al. Causes of horizontal strabismus in children. https://www.uptodate.com/contents/search. Accessed May 5, 2020.
- Yanoff M, et al., eds. Disorders of supranuclear control of ocular motility. In: Ophthalmology. 5th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed May 5, 2020.
- Convergence insufficiency. National Eye Institute. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/convergence-insufficiency. Accessed May 5, 2020.
- Convergence insufficiency. American Association for Pediatric Ophthalmology and Strabismus. https://aapos.org/glossary/convergence-insufficiency. Accessed May 5, 2020.
- Softing Hataye AL (expert opinion). Mayo Clinic. June 28, 2020.
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