The human eye is an incredible organ, expertly evolved to help us navigate and appreciate our world. However, the eye is not solely responsible for vision. Our right eye and left eye must work together—and in coordination with our brain—for us to see clearly and well. Many of the visual skills required to make this complex eye-eye and eye-brain coordination easy and seamless are learned. And like other physical or cognitive abilities, if our visual skills are inadequate, performance—in this case, vision—will suffer.
“Convergence” is one of the many important skills required for clear, single vision. It refers to the coordinated movement between your right eye and left eye to point inward when you look at nearby objects, like a book, phone, or tablet. When convergence is absent or lacking, it’s known as “convergence insufficiency.”
Convergence insufficiency is an eye condition that affects the coordinated inward eye movement required to focus on close-up objects. Instead of both eyes moving inward to look at something, for someone with convergence insufficiency, one eye drifts outward, resulting in double or blurry vision.
Convergence insufficiency is an eye-brain communication problem, not a strength problem. In other words, convergence insufficiency does not happen due to weakness of the muscles surrounding the eye. Instead, convergence insufficiency arises when the nerves surrounding the eye are not correctly relaying the message to turn the eye inward.
The good news is that proper treatment can alleviate convergence insufficiency symptoms and improve vision.
Eye doctors are still researching the root cause of convergence insufficiency. The eye condition typically develops during childhood, but it can affect people of all ages. Convergence insufficiency can also occur after brain injuries, like concussions, underscoring the importance of proper protective headwear in sports and other physical activities. Neurodegenerative diseases like Parkinson’s disease have also been known to cause convergence insufficiency. It is currently estimated that convergence insufficiency affects 2%-13% of people in the United States.
Since convergence insufficiency affects near vision, activities like reading, using a computer, or even looking at a phone can be challenging for people with the eye condition. With treatment, convergence insufficiency patients can experience fewer symptoms, as well as greater comfort and better vision when doing near work.
The most common symptoms of convergence insufficiency include:
While many of the symptoms of convergence insufficiency relate directly to eye comfort and vision, you may experience other symptoms, too. Since convergence insufficiency can cause double vision, the brain may suppress vision in one eye, which can cause the eyes to drift further apart and to work independently from one another. This can lead to:
For children, symptoms of convergence insufficiency may also include difficulties with reading or concentrating. Since kids don’t know how vision is supposed to feel, they may not realize they can’t see well and consequently won’t talk about problems they’re experiencing with their vision. Stay on the lookout for the above symptoms and make an appointment if you suspect they may be struggling with convergence insufficiency or other vision issues. An eye examination will help to determine if eye conditions like convergence insufficiency are part of the problem.
Your eye doctor can diagnose convergence insufficiency. However, a standard eye examination will not determine whether or not you have the condition. Your doctor will need to perform a specialized convergence insufficiency test to determine if your eyes are able to come together when looking at an object. This means it's vital to share all of your vision concerns with your doctor and ask about convergence insufficiency if you’re experiencing symptoms.
If your doctor diagnoses you with convergence insufficiency, they will recommend a treatment plan, which will include vision therapy.
Vision therapy is an individualized treatment program designed to enhance visual skills such as eye tracking, focusing, coordination, and convergence. Under the guidance of a qualified vision therapist, patients complete eye exercises that improve the abilities required for clear, comfortable vision.
There are specific exercises your doctor will recommend for convergence therapy. These exercises require patients to practice focusing on objects at different distances– essentially retraining your nerves to appropriately aim your eyes. Treatment may also include the use of prism glasses, which have a special lens that redirects the light entering your eye.
When it comes to convergence insufficiency, treatment and prevention go hand in hand. If treatment is not pursued, convergence insufficiency can progress into more serious eye conditions.
Some patients may notice a difference right away, but treating convergence insufficiency takes time and dedication. With committed practice, patients may see improvements in 8-10 weeks. The most effective treatment includes both in-office and at-home practice, so be prepared for your doctor to give you some homework.
One of our goals in treatment is to provide patients with skills to manage recovery if symptoms of convergence insufficiency should return. Thanks to therapy, your threshold for stress will be much higher. So even if certain stressors come up that might trigger the condition—like illness or lack of sleep—you’ll be able to manage your symptoms much better.
There is a common misconception that vision therapy is only for children—this couldn’t be further from the truth! Therapy can help patients of all ages to achieve their best, clearest vision. And it’s not only convergence insufficiency that can benefit from therapy. Conditions like amblyopia, strabismus, eye-hand coordination, perceptual and processing issues, and more can also be improved through the treatment method.
At Beyond Vision Center, we’ve seen firsthand how transformational vision therapy for convergence insufficiency can be. Dr. Sloan Rajadhyksha is a widely acclaimed eye doctor with specialization in the treatment of a wide range of conditions through vision therapy, including convergence insufficiency.
Our practice is founded on the belief that good eye health and clear vision are essential to living well. We’re proud to offer treatment plans that help our patients see–and live–better. Make your appointment at Beyond Vision Center today and see the difference for yourself.