Convergence Insufficiency And Its Exercise

What Is Convergence Insufficiency (CI)?

Convergence insufficiency (CI) is a condition in which your eyes are unable to focus on nearby objects, together. You may face such a condition when you are reading a book, tying your shoes, or sending a text message. To put it simply, CI causes one eye to turn at a different angle than the other eye. It limits a person’s ability to work with visual information at close distances and creates double or blurred vision. However, a few simple convergence exercises, done regularly, are usually effective to treat this insufficiency.

It may even limit activities. Because the insufficiency, in severe conditions prevents people from seeing three-dimensional CI is quite normally found in school-going children and adolescents. At this age, when the child has to spend a long-time reading text on paper, it leads to weakness of eye muscles and discomfort in the eyes. While the parents or teachers might suspect the child has learning difficulties and not an eye disorder.

However, nowadays it is not limited to children only. Even as adults, when we spend a prolonged time in front of our computer screens and androids’ phone, which has become an unavoidable part of our lives. It causes visual strain and convergence weakness. To strengthen your eye muscles, the best cure is doing regular eye convergence exercises. Except in critical conditions, when you must consult the best Eye Hospital.

Symptoms of Convergence Insufficiency

You are most likely to notice symptoms of CI at the time of doing some close visual work such as reading. Symptoms are even more visible if you have been reading for long durations. Fatigue and extreme tiredness can also be some of the symptoms. But remember, not everyone with this insufficiency has signs and symptoms.

Possible symptoms include:

• Eyestrain,
• Tired, sore, or uncomfortable eyes,
• Headaches,
• Difficulty in reading — words blur together or seem to float on the page,
• You lose the spot where you are reading or you read slowly,
• Needing to re-read things a few times,
• Sleepiness when reading,
• Double vision (diplopia),
• Trouble concentrating,
• Squinting, rubbing, or closing one eye,
• Motion sickness or vertigo.

Others may notice that one of your eyes, sometimes turns at different angles, as you read. This might also happen at the same time you are facing blurred vision. They may, also, notice you squinting or closing one of your eyes while you read. (This might make it easier for you to have a focused, single image)

Causes of Convergence Insufficiency

CI occurs from misalignment of the eyes when focusing on nearby things. The exact cause isn’t known yet by the medical professional, but it is said that misalignment is seen in the muscles that move the eye. And the problems develop in coordinating the eye muscles and eye movements. At the time of moving, focusing on nearby objects becomes difficult, sometimes one or both eyes tend to drift away from that object.

Eye movements are controlled by the brain. Some types of neurologic impairment may cause this insufficiency. The condition is quite common in children with some forms of neurologic impairment. In some cases, a brain injury or neurodegenerative disease, such as Parkinson’s disease, can also become one of the causes.

But there’s no change in the eye muscles. The vast majority of children with CI are completely normal otherwise. Therefore, the experts are not yet sure what causes CI.

There may be problems in the complex series of operations that the brain and eyes perform.

Genes may also be the culprit at times. You or your children may be at higher risk for CI if some family members ever had it. In some instances, a health condition can lead to CI. These include:

• Head injury and concussion
• Graves’ disease
• Myasthenia gravis
• Parkinson disease
• Alzheimer disease

Convergence Exercise

These exercises are aimed to reduce and treat convergence insufficiency. Convergence insufficiency is generally observed in the young population especially school-going children and adolescence. It may lead to difficulty in reading and writing. Convergence exercises are recommended for treatment of the convergence insufficiency. Therefore, to understand the requirement of convergence therapy ewe first need to understand the convergence insufficiency.

How To Perform Convergence Exercises To Strengthen Your Eyes?

If convergence exercises are performed regularly then improvement in the condition can be seen within a few weeks. The time for recovery however varies on the seriousness of the condition. Generally, at the initial stages, the convergence exercises are supervised by an orthoptist. An orthoptist explains the technique, frequency, and duration of the convergence exercises. Follow-up appointments are scheduled to evaluate the progress. Convergence exercises are adequate to treat this condition. But in case the symptoms of convergence insufficiency persist, it is recommended to visit an ophthalmologist and undergo a thorough eye check-up.  

Pen/Pencil Push-Ups

This exercise includes converging your vision to a pen or pencil. This method is known as smooth convergence since it includes smooth movement of your eyes.

Smooth Convergence Exercise Steps-

• Keep your head in a straight position, sitting or standing.
• Hold a pen/pencil in a straight-ahead at an arm’s length at or slightly below the arm level.
• Focus on the tip of the pen/pencil
• Move the pen/pencil, maintaining the straight line towards yourself.
• Stop where you see blurred image/ feel a little strain/ see a double image
• Hold the position and try to form a single image by pulling your eye muscle. This will help to strengthen the eye muscles. Hold the position for 10 seconds.
• Then take back the pen/pencil to the previous position at the arm’s length and hold for 10 seconds.
• Again, move it close to a point where there is a difficulty in vision.
• In case you are unable to form a single image, you can pull back the pen/pencil slightly for 2-3 cms.
• Repeat this 10 times and then give your eyes a little rest by looking at a distant small object for 20-25 seconds and repeat the entire cycle.

Smooth Convergence Exercise Schedule

• Initially, this convergence exercise can be practiced once in the morning and once in the evening for 5 minutes each.
• Over a period of two months increase the timing of each session to 15 minutes.
• Post two months, practicing the exercise once daily is sufficient.
• Visit your ophthalmologist for tracking your progress.

Jump Convergence Exercise

This exercise is aimed to control and strengthen your eye muscle between two distances. For performing this convergence exercise, you will need two objects-

• One object which is at a distance of 3-4 meters away
• Another object which is in a close range of 20cms may be a pen or pencil or any other such object of your choice.

Jump Convergence Exercise Steps

• First look at the distant object which is 3-4 meters away.
• then quickly jump your focus back to the close-range object and try to form a single image.
• Once you are able to form a single image jump your focus back to the distant object and hold it for 10 seconds.
• Every time you can form a single image with the close object easily move the object a little close towards you and continue doing this convergence exercise in repetition.
• Again, focus back on the distant object.
• Continue the repetition until the close object touches your nose.

Jump Convergence Exercise Schedule

This exercise can be performed after a smooth convergence exercise. There is no time limit since you need to repeat it until the close object touches your nose.

Perform this exercise twice daily once in the morning and evening for two months. Post which can be done once daily.

Dot Card Eye Convergence Exercise

Dot cards are double-sided dot or lettered cards use to measure the near point of convergence. They are more effective in treating the convergence insufficiency rather than a pen or pencil pushups since it ensures correct ocular alignment.

The dots in the dot card are 3 cms apart from each other. You need to hold the card length-wise with the end of the nose touching it. This ensures that the dots are 6 cm and 2 cm away from the nose.

Dot Card Convergence Exercise Steps

• The head needs to be kept straight while holding one end of the dot card against the nose tip. Hold the dot card straight or at a mild angle so that you can see the dots clearly.  
• Focus on the farthest dot and try to form a single dot. You need to pull in your eye muscles to form a single image.
• Hold that position for 10 seconds.
• Now try to focus on the next dot in the line closer to you. Now again try to form a single image. While you focus on this dot the other dots should appear double and form an X pattern. Stay in this position for 10 seconds.
• Repeat the same exercise with other dots each time moving closer to your nose and holding for 10 seconds.  

Computer Vision Convergence Exercise

Certain software is designed for performing convergence exercises on the computer. The exercises can be done on the computer to improve the symptoms of convergence insufficiency. The results can be printed for sharing with your ophthalmologist for evaluating your progress.

Relaxation After Convergence Exercises

Relaxation of the eye muscles is of utmost importance after completing convergence exercises. In some rare cases, convergence spasms might occur if eye muscles are not relaxed properly following convergence exercises. Certain uncomfortable symptoms are expected after performing the exercises but not relaxing the muscles can intensify the degree of discomfort.

Do not overdo the exercises. Avoid performing convergence exercises when your eyes are tired or you are unwell. Your eyes need to be fresh before you start the convergence exercises. This ensures less uncomfortable symptoms.

Close your eyes for one minute after the convergence exercises and relaxation and then start doing other activities. Disclaimer While Performing Convergence Exercise You may feel a slight strain, headache, or pain for the first few days. It is completely normal. Gradually the symptoms will disappear and you will feel less strain.

Go for follow-up appointments to track your progress and consult your ophthalmologist before you stop doing the exercise. Generally, the symptoms of eye convergence insufficiency disappear after three months of regular exercise. In case there is no improvement in condition your ophthalmologist may perform additional eye examinations to determine any underlying condition.   You can also consult your eye doctor if you are having excessive persistent eye discomfort after performing convergence exercises.

For consulting him for your difficulties, please visit Eyemantra.

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