Convergence Insufficiency: Symptoms, Causes, And Convergence Exercises

Convergence Insufficiency

Convergence Insufficiency

convergence insufficiency 1
convergence insufficiency 2

Convergence Insufficiency defined as the incapacity of a person’s eyes to maintain binocular function while working at a close range. In most cases, when a person tries to focus his vision on a particular object, then one of his eyes will revolve on the outside. This form of medical condition has been the most common occurrence in school children and adolescents.A person who has recently suffered from a concussion or severe brain injury is likely to develop this medical condition.

Convergence is the non-synchronized movement of eyes, for example, when a person focuses his vision on a close-by object, then his eyes rotate inwards. In certain instances, this particular form of movement stops happening in a person’s eye, which results in the medical condition known as “convergence insufficiency”. This condition has a generational aspect associated with it. So, if a family member of a person has been diagnosed with this condition. Then, this person may have the same condition.

Symptoms of Convergence Insufficiency

  • A person can start seeing words in a blurry manner after extensive periods of reading and also feel incapable of completely focusing on a computer screen.
  • Diplopia (double vision):- This condition causes a person to see two images of a single object.
  • If a person faces a recurring eye strain problem. Then, Severe forms of eye-ailments, other than convergence insufficiency can also occur.
  • A person can start having headaches, which further results in tiredness and loss of will to perform daily chores.
  • The constant need to read a particular text, more than one time because of non-clarity in the vision during the initial session of reading.
  • A person can also start feeling motion sickness. This condition causes the sensory organs of the body to send mixed responses to the brain, which further leads to dizziness or nausea.

Causes of Convergence Insufficiency

This medical condition’s determinant cause is still unknown. But according to a certain stratum of an eye specialist, some particular factors can contribute towards its occurrence. The list of probable factors are-

  • Genes may cause this medical condition if this deficiency runs in family. You are more likely to acquire it if somebody in your family has it already.
  • Graves’ disease: – This medical condition is a form of autoimmune disorder, which results in an overactive thyroid. The probability of Convergence insufficiency diagnosis is high in a person suffering from Graves’ disease.
  • Parkinson’s disease: – It is a distinct form of brain disorder that has a severe effect on the central nervous system. Its symptoms are tremors, stiffness, and a severely depleted sense of coordination. According to experts, “Parkinson’s disease”, may have a role in the origination of convergence insufficiency in the eyes of a person.
  • Alzheimer’s disease: – It’s a perilous disease, which leads to the annihilation of memory and other significant mental functions. Its early symptoms can also lead to convergence insufficiency.
  • Traumatic brain injury:– people who have gone through any traumatic accident are likely to develop this disease.

Convergence Insufficiency Preventions

The first description of this medical condition was in the year 1885. Since then, most orthoptist have preferred certain orthoptic exercises as the primary method of treatment. But in the present times, the data obtained from the research of several eye laboratories has raised questions on the basic nature and dynamics of convergence. This form of medical condition occurs when a person does not take proper care of his eyes. As eyes are the most sensitive organ of a person’s body.

A person should ensure that he is not putting too much strain on his eyes by subsequently sitting in front of a computer screen. If a person does adhere to certain precautionary measures, then he can develop “Computer vision syndrome“. A person should also wash his eyes with water at least thrice a day. So, that any foreign particle which has entered into the eye can come out. Proper care of the eyes will ensure a clear and enhanced vision. If the early diagnosis of symptoms of convergence insufficiency’s is done. Then the method of treatment becomes much more effective.

Diagnosis of Convergence Insufficiency

An Ophthalmologist or an Optometrist diagnoses convergence insufficiency. After they have successfully accessed the condition of a patient’s symptoms and have precisely measured the convergence ability. After that, the patient’s eye examination is performed. The eye examination for this condition comprises of the measurement of the distance, from which the person can hold his eyes together. How far and how well a person can see without the occurrence of double vision is tested in this eye exam. If the person has any other eye-related ailments such as a dysfunctional eye’s muscles, then these medical conditions should also be properly evaluated.

Treatment of Convergence Insufficiency


The particular form of treatment which can be used also depends on the age of the patient. Below are the methods, which are used as a mode of treatment:-

Eye Exercise


 Various methods of eye exercise are used to treat the problem of convergence insufficiency such as pencil push-ups. In this form of exercise, a person must hold the pencil in front of him, to his arm’s length. He should also ensure that the pencil is in a vertical position and has a sharpened tip. Then the person must move the pencil in straight alignment and bring it near to his nasal section. The pencil must be placed in front of the face with the tip just below the level of eyesight. Then the person must keep seeing the pencil until he starts feeling hazy and after that, the person must move the pencil again to his arm’s length and hold it for a minimum of 12 seconds. This exercise must be repeated at least 8 times by the person, for an enhancement in his vision.

Pencil Push-Ups

pencil pushups

Pencil push-ups may prevent your eyes from feeling strained while looking at distant objects.

Steps to follow – Take a pencil (or pen). Hold it an arm’s length in the line of vision between the 2 eyes. Now bring the pencil towards the nose, slowly and gradually. As the pencil comes closer, the image becomes double at one point. Stop at this point, just before it starts to appear double. Again take the pencil away to arm’s length. Repeat this step number of times.

The objective is to bring the point of convergence closer to the eyes and to maintain the single image, as close as possible, at its last point. Increasingly, the point of seeing this image as a single image starts getting closer to the eyes.

Prism Glasses

prism glasses

To avoid the occurrence of symptoms of double vision, a person can also use prism glasses. These forms of glasses have a thicker and attenuated base. A prism performs the function of bending the light, which results in a single image being seen by the person. This method of treatment hasn’t been effective in most instances of double vision. Various forms of eye exercise help with the enhancement of a person’s vision.

Optical Illusion Cards Or Stereograms

optical illusion cards stereogram

These Optical Illusion Cards or Stereograms work by exercising convergence and focusing separately. It may need specific instructions from the Eye Hospital, as well as some practice to perform it correctly 

Steps to follow –

  1. Hold the stereogram card at an arm’s length and hold a pencil in front of the card.
  2. Focus on the tip of the pencil.
  3. Slowly bring the pencil forward towards you.
  4. Watch the pencil tip all the time but be aware of the images on the card in the background.
  5. As the pencil moves forward, the images should each appear to split apart.
  6. When the pencil is positioned approximately halfway to your nose, the 2 split images would appear overlapping and form the 3rd image.

Convergence Card

convergence card

To treat convergence insufficiency, various types of Convergence cards are also used by eye specialists. A person can initiate this exercise by holding a convergence card near the bridge of their nose and placing their focus on the most distant dot or circle and then successively moving their eyes towards a closer target. This mode of exercise helps in removing the insufficiency of convergence.

Steps- Hold the card touching the edge of your nose, angled at a slant so you can see all the symbols on it.

Look at the symbol farthest away and try to see it singly as one– all the other symbols would appear double and fan out towards you.

When you can see this symbol singly, count slowly to 10. Once you finish counting, look at the next symbol along with it and make it single by gently pulling the eyes together. Again hold it for a count of 10. All the other symbols will look double and make a cross through the symbol you are looking at. Continue up the line of symbols towards you, make sure that each one gets single. Hold your vision on each and count up to 10. If you cannot make it single, return to the previous one and try again.

Duration Of Doing Convergence Exercises

To begin with, do one exercise for 5 minutes in the morning and 5 minutes in the evening when you feel relatively fresh. Gradually increase the duration of the exercise to 15 minutes for the next 2 months. Stick to exercising regularly for 2 months. After some day exercising for 5 minutes would be sufficient to maintain good convergence of the 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. 

Precautions To Take While Doing Convergence Exercises

It is important that you feel relaxed in your eye muscles after exercising. It is normal if you feel slightly more strain or pain in the eyes and even feel a headache on the initial days of exercises. This is to be expected as the muscles involved are not used to working so hard. Especially for the first few days. But, gradually you will recover and your symptoms of CI will reduce.

After the exercises, make sure you rest your eyes. You can either keep them closed for 1 minute, at least. Or look out of the window into the distance. Do not practice the exercises for longer periods than advised by your eye specialist.

Surgery For Convergence Sufficiency

The rarest mode of treatment for convergence insufficiency is surgery. If any of the normal eye exercises fail in curing this condition. Then the eye specialist can recommend surgery. But the option of surgery in this particular case can lead to other eye-related complications in the nearby future.

Convergence insufficiency has ties with different kinds of neural disorders. Sometimes a severe form of head trauma can also cause this medical condition. The duration of treatment is a minimum of three months. And even after the problem has been cured, there can be recurring symptoms.

When To See A Doctor?

Convergence insufficiency can be symptomatic and asymptomatic as well. Treatment is only required in a patient with symptoms. A convergence sufficiency can be diagnosed during the routine eye examination. As there is no symptoms present, they are usually recognized when the patient is excited or can’t define the directions. Such patients should watch out for the symptoms in near future. Of course, they don’t need treatment but should follow up.

Patients with symptoms of double vision and convergence insufficiency should visit a doctor and get the proper treatment. The doctor will probably suggest eye exercises. And if it is not treatable with exercises, surgery will be performed. Although, Convergence insufficiency can be cured permanently with eye exercises. Still, the chances of resurfacing symptoms are there if the patient is stressed or does not get enough sleep. However, just like before these symptoms will disappear after the treatment again.

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