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Convergence Insufficiency - CI

Convergenceinsufficiency - CI is a near vision problem that interferes with a person's ability to see, read, learn, and/or work at close distances. It is an eye teaming problem in which the eyes have a strong tendency to drift outward when doing sustained close work such as reading. This can result in double vision. To prevent double vision, one has to exert more effort to keep the eyes aligned and teamed. This exertion causes eyestrain and headaches. Other symptoms include blurred or double vision, sleepiness during the close activity, short attention span, squinting,rubbing, closing, or covering an eye while reading, movement of print while reading, loss of comprehension while reading, words appearing to move, jump, swim or float while reading, and difficulty concentrating.

A person can pass a vision screening with 20/20 vision and yet have convergence insufficiency.

Convergence insufficiency, many times, is undetectedin school aged children. The tests todiagnose convergence insufficiency are not included in eye tests at thepediatrician’s office, eye screenings done at school, or standard eye exams atmany ophthalmology and/or optometry offices.

Treatments of convergence insufficiency include prism eyeglasses, pencil push ups, surgery, and/or vision therapy.Prism eyeglasses are not a "cure" but can eliminate or diminish someof the symptoms. Pencil push ups have been shown to be ineffective, and surgery should be considered as a last resort. Office based vision therapy has been shown to be the most effective treatment for convergence insufficiency.

References:

Scheiman M, Mitchell GL, Cotter S, et al; the ConvergenceInsufficiency Treatment Trial (CITT) Study Group. A randomized clinical trialof treatments for convergence insufficiency in children. Archives ofOphthalmology. 2005;123:14-24. Complete article - PDF versionBirnbaum MH,

Soden R, Cohen AH. Efficacy of vision therapy for convergence insufficiency in an adult male population. J Am Optom Assoc. 1999;70:225-232.

Scheiman M, Cooper J, Mitchell GL, et al. A survey of treatment modalities for convergenceinsufficiency. Optom Vis Sci. 2002;79:151-157.

Gallaway M, Scheiman M, Malhotra K. Effectiveness of pencil pushups treatment of convergenceinsufficiency: a pilot study. Optom Vis Sci. 2002;79:265-267.

Rouse MW, Borsting E, Hyman L, Hussein M, Cotter SA, Flynn M, ScheimanM, Gallaway M, De Land PN. Frequency of convergence insufficiency among fifth and sixthgraders. Optom Vis Sci. 1999 Sep;76(9):643-9.