Convergence insufficiency occurs in an estimated 2 to 13 percent of people in the U.S, and is one of the leading causes of reading problems in children.

In everyday life, convergence is a basic skill that we use to look up close. As we bring an object close to our eyes, our eyes have to work together or converge to see it. Some people have difficulty concentrating at close range due to their inability to move their eyes inward, which is something they cannot control.

Take for example the estimated 2-3 children in every classroom with convergence issues. When they need to read, they struggle to have their eyes focus on the text, leading to eye strain, becoming tired easily, and often blurry or double vision. This in turn makes them less likely to want to read or makes it difficult for them to succeed in the classroom.

What are the symptoms of convergence insufficiency?

If you have a problem with converging your eyes, you might experience the following symptoms:

  • Eye strain
  • Eye pain
  • Headaches when you're reading
  • Tired eyes
  • Blurred vision
  • Double vision
  • Difficulty concentrating
  • Motion sickness
  • Clumsiness with hand-eye coordination activities

How can you test convergence with the pencil push-up test?

This is a visual skill that is evaluated with a pencil push-up test. Basically you hold a pencil and bring it close to your eyes. Your eyes will turn in toward the pencil as it gets closer to your nose. An example of what that might look like when the patient is doing the test and failing, is that at a certain point, their eyes give up, and they stop following the test. This is a common way to diagnose convergence insufficiency in the office.

Convergence insufficiency occurs when the brain does not have good control over the eyes, so the eyes do not converge well.

How is convergence insufficiency (CI) treated?

According to research conducted by COVD and the National Eye Institute, office-based vision therapy, accompanied by at-home vision therapy exercises, is the best treatment for convergence insufficiency. It is beneficial to receive vision therapy in a doctor's office with a trained vision therapist working under the guidance of a functional optometrist who can correct eye problems appropriately and monitor progress.

In most cases the treatment is extremely effective and long lasting. After 12-24 weeks of therapy with a therapist, most kids' vision becomes effortless and their ability to read and see is much improved. In extreme cases where vision therapy fails to improve your symptoms, you may need special "prism glasses" in order to read or perform other up-close activities.

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