Convergence Insufficiency
Also known as CI, Eye Teaming Problem, Near Vision Double Vision, Binocular Vision Disorder, Reading Eye Strain
Bottom Line
Convergence insufficiency means the eyes have trouble turning inward together for near work. It can cause eye strain, headaches, blur, or double vision while reading.
Convergence insufficiency is an eye teaming problem. The eyes do not turn inward well enough for near tasks like reading 1.
Symptoms can include eyestrain, headaches, blurred near vision, double vision, losing place while reading, or avoiding near work 1.
A randomized trial in children found office-based vergence and focusing therapy improved symptoms and near-eye teaming more than home pencil push-ups or placebo therapy 2.
Symptoms
Symptoms usually show up during reading, homework, phone use, or computer work.
- Eye strain or tired eyes.
- Headache after near work.
- Blurred or double words.
- Losing your place while reading.
- Closing one eye to focus.
- Avoiding near tasks.
Diagnosis
A standard eye chart alone can miss convergence insufficiency. The doctor needs to test how the eyes team up at near.
- Near point of convergence checks how close a target can come before one eye drifts.
- Eye alignment testing compares distance and near posture.
- Fusional vergence testing checks how much the eyes can turn inward together.
- Focusing tests look for related accommodative problems.
Adult evaluation also reviews neurologic, concussion, and medication history 3.
Treatment
Treatment depends on age, symptoms, exam results, and access to therapy.
- Office-based vergence therapy has the strongest child trial evidence.
- Home exercises may be used as reinforcement or when office therapy is not available.
- Prism glasses may help selected patients, especially adults.
- Regular glasses updates can reduce extra focusing stress.
The child treatment trial found office-based therapy improved symptoms and clinical measures more than other study groups 2.
When to Seek Care
Call 911 for sudden double vision with face droop, weakness, confusion, or trouble speaking. Get urgent eye care after eye trauma or head injury, or for constant new double vision.
Near-only eyestrain is less urgent, but it still deserves an eye exam if it affects school, work, or reading.
Children and School
Children may not say they see double. They may avoid reading, lose their place, cover one eye, or complain that words move.
Tell the eye doctor if homework takes much longer than expected. School symptoms can guide treatment goals.
Common Questions About Convergence Insufficiency
Next Steps
- 1Schedule an eye exam that includes near eye teaming tests.
- 2Bring notes about headaches, double vision, reading time, and school or work problems.
- 3Ask whether office-based therapy, home practice, prism, or glasses changes fit.
- 4Follow the treatment schedule long enough to measure progress.
- 5Call 911 for sudden double vision with stroke symptoms.
Find specialists for Convergence Insufficiency
Board-certified ophthalmologists who treat Convergence Insufficiency.
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