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. 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