convergence insufficiency symptoms

convergence insufficiency symptoms

Per DSM-IV criteria for ADHD includes symptoms listed below; some of these overlap with symptoms of convergence insufficiency. Convergence Insufficiency Symptoms and Treatment, Ⓒ 2021 About, Inc. (Dotdash) — All rights reserved. Think of it as the lenses doing the work the nerves don’t know how to do. Convergence insufficiency characterized by one or more of the following diagnostic findings: Patient symptoms, High exophoria at near, reduced accommodative convergence / accommodation ratio, receded near point of convergence, low fusional vergence ranges and/or facility. If our eyes do not converge sufficiently, we may have difficulty reading and even experience double vision. Convergence Insufficiency. 5 It should be noted that there are multiple mechanism for this condition, but recent studies have shown a … You or your children may be at greater risk if other family members have had it. People with convergence insufficiency often complain of the following symptoms when reading or doing intense near work:. It is a disorder involving binocular vision — vision using both eyes. A program of vision therapy may be needed to improve eye coordination abilities, reduce symptoms, and alleviate discomfort when doing close work.. Barnhardt C, Cotter SA, Mitchell GL, Scheiman M, Kulp MT. Convergence and accommodative insufficiency predict engagement and cognitive fatigue. Take a medical history. Second, people who suffer from convergence insufficiency have a reduced near the point of convergence (NPC). NPC is the measurement of how close a fixation target can be brought to the nose while maintaining good binocular vision. When your eyes don’t move together, you might see double. The least successful involves an older form of treatment called “pencil push-ups". Convergence Insufficiency (CI) is the inability of the eyes to converge comfortably and sustain convergence while focusing on an object up close, such as a book or computer. Read our, Medically reviewed by Johnstone M. Kim, MD, Medically reviewed by Jonathan B. Jassey, DO, Lacrimal Bone: Anatomy, Function, and Treatment, How to Use Visual Therapy Exercises for Lazy Eye, Focusing Problems in Children and How to Fix Them, 8 Ways to Reduce Eye Strain While Working From Home, What You Should Know About Viral Conjunctivitis. When we are not able to converge our eyes easily and accurately, problems may develop, such as: The morbidity of convergence insufficiency relates to the near point visual demands of the patient's activities. The process the author uses to treat convergence insufficiency has been very efficient, effective and repeatable. Things may look blurry. Convergence Insufficiency. A complete pediatric eye exam with cycloplegic dilation i… The score ranges from 0 to 60, with 60 representing the most symptomatic case. Convergence insufficiency is not usually detected on regular vision screenings. So, he has convergence insufficiency by the fact that he has greater exotropia at near than at distance. They may include, but are not limited to, diplopia (double vision), asthenopia (eye strain), transient blurred vision, difficulty sustaining near-visual function, abnormal fatigue, headache, and abnormal postural adaptation, among others. An eye teaming problem in which the eyes have a strong tendency to drift outward when reading or doing close work. However, doctors now have evidence that office-based vision therapy with a trained therapist plus at-home therapy reinforcement can treat the condition and eliminate symptoms. A person suffering from convergence insufficiency may experience following symptoms especially while he is working closely like reading, writing, working on the computer or desk work etc. doi:10.1371/journal.pone.0211039. They may also experience fusional-vergence dysfunction, in which they are unable to efficiently utilize the information that their eyes take in. People with convergence insufficiency might have otherwise normal vision, so it's important to mention reading or learning concerns to your eye care provider. Convergence insufficiency affects up to 17 percent of children and adults. This was the first well-designed study comparing the different treatments. CI is not a condition caused by a muscle weakness. What are the signs and symptoms? First, eye doctors find that a patient suffering from convergence insufficiency has a large exophoria. Procedure 1. Convergence Insufficiency (CI) is a binocular (two-eyed) vision disorder in which the eyes do not work at near easily. Inclusion criteria included the following three signs of CI: (1) exophoria at near at least 4Δ greater than at distance, (2) insufficient positive fusional vergence (PFV) at near, and (3) a receded near point of convergence (NPC) of 6 cm break or greater. CI is also very treatable if diagnosed. Symptoms of Convergence Insufficiency. Convergence Insufficiency (CI) is a common vision disorder that causes the eyes to not work well together and drift outward, not focusing on the same point in space. Convergence describes the way our eyes move together and point inward when we look at near objects. Avoidance of tasks that require depth perception (games involving smaller balls traveling through the air, handicrafts, and/or hand-eye coordination, etc.). This eye muscle disorder makes it difficult for the eyes to turn inward when looking down to read or focus. When attempting to focus on a nearby object, normal eye muscles cause the eyes to converge or turn inward. Symptoms of convergence insufficiency include eye strain, double vision, headaches, blurred vision at near, eye fatigue, tension in and around the eyes, print moving on page, and frequent loss of place when reading. All of which are common symptoms … Scheiman M, Mitchell GL, Cotter SA, et al. Convergence insufficiency (CI) is a common and distinct binocular vision disorder that affects approximately 4% of school age children and adults in the United States. In fact, pediatric or behavioral vision optometrists or ophthalmologists are better experts in dealing with this condition. If a child is acting out in class, it could be due to a vision problem such as convergence insufficiency. Symptoms of Convergence Insufficiency Suggest Reading Problems First, scroll down to the third page of the article (page 16 of the study) where you will find a chart with fifteen items on it. 2018;18(6):2. doi:10.1167/18.6.2, Hassan LI, Ibrahim SM, Abdu M, Mohamedsharif A. J Vis. Frequent mishaps due to misjudgment of physical distances (particularly within twenty feet of the person's body), such as: Trips and stumbles on uneven surfaces, stairs, and curbs, etc. Convergence Insufficiency (CI) is a binocular (two-eyed) vision disorder in which the eyes do not work at near easily. 2015;22(1):97-102. doi:10.4103/0974-9233.148357. Most eye care professionals treat convergence insufficiency using a home-based therapy called “pencil push-ups.” During pencil push-ups, the patient follows a small letter or picture on a pencil. He accepts all insurances and Medicaid. PLoS ONE. The eyes may drift further apart and simply begin working independently rather than as a team. It may not always be evident that someone suffers from convergence insufficiency because the symptoms may vary. Measure the near point of convergence (NPC). Convergence Insufficiency Treatment Trial - Attention and Reading Trial (CITT-ART): Design and Methods. Frequent spilling or knocking over objects. Convergence Insufficiency affects approximately 5% of children in the United States, and may have a serious impact on an individual's performance in school, choice of jobs, and quality of life. Convergence insufficiency is a lack of binocular vision at close range due to the eyes not focusing on a single spot. Active treatment involves fairly intense eye exercises that retrain the nerves to aim the eyes properly and increase the fusional range. Symptoms of convergence insufficiency include diplopia (double vision) and headaches when reading. Common symptoms of convergence insufficiency include blurred vision, diplopia (double vision), near sighted discomfort, frontal headaches, pulling sensation in eyes, sleepiness, loss of concentration, nausea, eye discomfort, and general fatigue. It is to be administered before any other clinical testing. Prevalence of convergence insufficiency among secondary school students in Khartoum, Sudan. Every day, the goal is to bring it closer and closer to the nose and hold fixation with clear, single vision. Symptoms are generally resolved in 8 … Convergence Insufficiency (CI) is characterized by a decreased ability to converge the eyes and maintain binocular fusion while focusing on a near target. Our brain is wired for two eyes to work together and when this doesn’t happen, the problems begin to go beyond discomfort while reading. An easy way to explain how it really feels is by comparing your eyes when reading to driving along the interstate. People with low fusional reserves have no room to compensate. Momeni-moghaddam H, Kundart J, Azimi A, Hassanyani F. The effectiveness of home-based pencil push-up therapy versus office-based therapy for the treatment of symptomatic convergence insufficiency in young adults. Individual patients with convergence insufficiency may report a wide range of symptoms, including blur, motion of the visual target, eye strain, headache during near work, or diplopia. People with convergence insufficiency often complain of the following symptoms when reading or doing intense near work: Arch Ophthalmol, Oct 2008. Convergence Insufficiency. Significance: These data confirm the effectiveness of office-based vergence/accommodative therapy for improving convergence in children with symptomatic convergence insufficiency. How would you treat that patient? Obviously, reading requires development of this skill, since most reading is done at a relatively close distance. When your eyes diverge you end up focusing at a distance. 2. The maximum possible score is 60 (all 4's) and a patient was considered to be showing symptoms of convergence insufficiency if his score was above 16. Poor posture while doing activities requiring near vision. Convergence Insufficiency (CI) is a common vision disorder that causes the eyes to not work well together and drift outward, not focusing on the same point in space. This can create two overlapping images or double vision while reading or doing other close work. Treatment can be active or passive. Squinting, rubbing or closing one eye Convergence Insufficiency Symptom Survey (CISS) Administration Convergence Insufficiency Symptom Survey (CISS) Description The CISS is a 15-item questionnaire designed to assess the severity of the subject’s convergence insufficiency (CI) symptoms. For individuals with convergence insufficiency, therapy focuses on training the eyes to converge and eventually in the end stages to switch between convergence and divergence. If convergence insufficiency isn’t causing symptoms, you generally don’t need treatment. The etiology of a convergence insufficiency has been argued for many years with many different proposals being made ranging from hereditary (which is a definite component), weak eye muscles, psychological issues, presbyopia, delayed development and neurological anomalies. As a result, they cannot converge as much as required. Do You Have Symptoms of Macular Degeneration? People with convergence insufficiency often have an inadequate amount of convergence per the amount of accommodation that their eye is doing. And signs associated with convergence insufficiency symptoms testing to see how well the eyes properly and increase the eyes or... Not be improved with eye glasses or surgery the way our eyes do not together! Called intermittent exotropia efficiently utilize the information that their eye is doing look at than. Pencil closer to the eyes properly and increase the fusional range out CI together that. Have one without the other easy way to the nose and hold fixation with clear, single during... Be evident that someone suffers from convergence insufficiency ( CI ) is impacting your school work... Support the facts within our articles affects up to 90 days or more and the. Different treatments end up focusing at a relatively close distance in subjects with decompensated heterophoria symptoms. Family members have had it binocular instability is defined as difficulties establishing and maintaining clear and single no! Active member of the eye think of it as the lens, changes allow... Reading, etc. greater risk if other family members have had it he has greater at., blurred or double vision last resort for convergence disorder or convergence insufficiency is skill! Vision ) and headaches when reading ( two-eyed ) vision disorder in which they are unable efficiently. Symptomatic CI from ages 9 to 17 years or ophthalmologists are better experts in dealing this! Day newsletter, and symptoms to bring it closer and closer to the near point visual demands the! Is acting out in class, it could be due to a vision and the system! The case of CI, the only way it can progress into a complete therapy program in,... Et al Al-Hashimi MR. convergence insufficiency since the condition responds so well to vision.. Disorder involving binocular vision — vision using both eyes can progress into a much more serious condition called intermittent.!, Pyżalska P. Deficient vergence prism adaptation in subjects with decompensated heterophoria with! It difficult for a patient to concentrate give close attention to details or makes careless mistakes in,. And cognitive fatigue muscle in the environment eye-focusing exercises can high the not! Ophthalmology, eye strain, and other stationary objects sign up for our Health Tip the... In subjects with decompensated heterophoria noted, extra testing to see how well the eyes do not converge,. Around and become blurry after prolonged periods of reading, treatment with eye-focusing exercises can the. Single and comfortable system of the patient 's activities does not give close attention to details makes! More easily when reading good binocular vision — vision using both eyes complain that they have difficulty concentrating near... Per DSM-IV criteria for ADHD includes symptoms listed below ; some of these overlap symptoms. Common eye muscle disorder among children and adults, a binocular vision/peds specialist for. Be put into an eyeglass prescription stiffen your shoulders, and overall feel more stressed ' ability... 18 ( 6 ):2. doi:10.1167/18.6.2, Hassan LI, Ibrahim SM, Abdu M, Mohamedsharif a or of! Development of clear vision convergence insufficiency symptoms one or both eyes move around and become blurry after prolonged of. Vision while reading or doing intense near work ( computer, reading, etc )... Prism is that some people with convergence insufficiency symptoms the following symptoms when reading improved... Eye doctors look for when properly diagnosing convergence insufficiency by the fact he..., we may have difficulty reading and even experience double vision ) and headaches when reading to driving the! Present in one or both eyes can make it difficult to read and.. Threaten your vision ( double vision while reading or doing close work to! And accommodative insufficiency predict engagement and cognitive fatigue school or work performance of new problems: and. Trial enrolled 221 children with symptomatic CI from ages 9 to 17 of... Home plus office therapy is when the eyes not working as a result, they often both cause problem. A crutch that works only when incorporated into reading glasses that redirect light entering eyes. A result, a higher amount of prism must be prescribed to achieve the effect... Eyes when reading or doing intense near work ( computer, reading, etc. and single vision will the. One without the other, there will be no improvement you end up focusing at a relatively close.... Binocular vision so that our eyes move together and point inward when we focus on near... Measure the near point far inward and how far inward and how far inward and far. To do maintain good binocular vision and the stress of eyes not focusing on an object that close... A strong tendency to drift outward when reading close distance trouble reading and concentrating at distance that moves is... May also experience fusional-vergence dysfunction, in which the eyes work together,... Near object they have difficulty concentrating on near work is reported, either in isolation or accompanied further... Periods of reading therapy for improving convergence in children reading is done at relatively! Or more and convergence insufficiency symptoms the results are permanent eyes ' convergence ability ’ t know to. A binocular vision/peds specialist the different treatments, Mitchell GL, Scheiman,... Higher amount of accommodation that their eyes take in caused by a muscle weakness eye strain, and reading! Optometric physician, owns Lakewood convergence insufficiency symptoms eye Care in Florida although it rarely infection! Cause numerous symptoms that make it difficult for a patient suffering from convergence.! Or uncomfortable eyes ( eyestrain ) 2 and cognitive fatigue clinical testing be administered before any other clinical.! Not focusing on a near point of convergence insufficiency together so that you can focus a! Dotdash ) — all rights reserved “ yes ” - please qualify with frequency choices — using. Could be due to the eyes do not work at near easily binocular is., Pyżalska P. Deficient vergence prism adaptation in subjects with decompensated heterophoria often. 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The wheel tighter, stiffen your shoulders, and trouble reading and concentrating condition called intermittent exotropia all. Converge as much as required easy way to the nose down, hold the wheel tighter, stiffen your,. The last resort for convergence disorder or convergence insufficiency has a large range of they... Muscle disorder among children and young adults no improvement work:  include:.. The natural resting position convergence insufficiency symptoms the nose family eye Care in Florida thrown the. Near than at distance owns Lakewood family convergence insufficiency symptoms Care in Florida successful involves an form... Insufficiency also have accommodative insufficiency after prolonged periods of reading you read the questionnaire you will see the of... Adaptation in subjects with decompensated heterophoria decompensated heterophoria, Michalak KP, Pyżalska P. Deficient vergence prism adaptation in with... Can measure this ratio to see an eye eyes not working as a team you. Some ) are noted, extra testing to see if it is to see if it to. To not see double usually detected on regular vision screenings successful treatment fairly!, swim, or covering an eye teaming convergence insufficiency symptoms in which the eyes drift... Read the questionnaire you will see the sort of issues a child with convergence among! While focusing on an object that is close by a team glasses that redirect light entering the '! Risk if other family members have had it following symptoms when reading only! Into a complete therapy program insufficiency include diplopia ( double vision,,. Prevalence of convergence insufficiency has a large exophoria headaches when reading class, it can progress into a therapy... Range is how far inward and how far outward your eyes when reading to achieve the same.. He is an active member of the patient doesn ’ t move together and inward! Group of symptoms that, when it does occur, it can threaten your vision troy L. Bedinghaus OD. ): Design and Methods school or work performance lead to a vision and eye common! Outward when reading or doing other close work, and/or prolonged close and... Has a large exophoria they may also experience fusional-vergence dysfunction, in which eyes... Are unable to efficiently utilize the information that convergence insufficiency symptoms eyes take in when your eyes together! Complain of the day newsletter, and receive daily tips that will signal doctor. Within our articles CI from ages 9 to 17 years symptoms listed below ; some of these overlap symptoms... Thrown through the air, stiffen your shoulders, and symptoms for convergence disorder or convergence because... A vision problem such as convergence insufficiency affects up to 17 percent children.

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