Esophoria also known as Divergence Insufficiency is a condition in which our eyes are naturally more in than out when viewing something near or far away.

How do symptoms of esophoria occur?

When your eyes are closed, they are in their natural position. Eyes are naturally pointed in when they're resting, but when you wake up they have to move out to see straight, which can strain the visual system and cause many symptoms. 

Esophoria is characterized by the following symptoms:

  • Eyestrain
  • Headaches
  • Tired eyes
  • Double vision
  • Motion sickness
  • Tendency to close one eye

If you notice any of these symptoms or experience sudden changes in your vision and find it difficult for you to perform your daily activities, please schedule a functional or developmental eye exam. 

How is esophoria diagnosed?

Esophoria is an easy condition to diagnose. The first step in diagnosing esophoria is to visually examine the eyes for any alignment problems, which may include tropias and phorias. In order to pinpoint the problem, a series of cover tests are conducted. These include the:

  • Cover-uncover test 
  • Alternate cover test 
  • Alternate prism cover test 

How can esophoria be treated?


Here are some common treatment methods:

  • Vision Therapy - The purpose of vision therapy is to teach you how to quickly and efficiently team both eyes together. The key focus of vision therapy for esophoria is divergence. Various guided tasks or exercises are used to work on critical skills such as recognizing poor eye coordination, improving convergence ability, improving divergence ability, and adjusting quickly between convergence and divergence. Esophoria usually requires 30 hours of office therapy under the guidance of a vision therapist and functional optometrist.
  • Prisms - There is some evidence that prismatic lenses can be effective for esophoria, and you may benefit from prismatic lenses significantly. Prisms are often oriented in a base-out direction, which decreases the divergence demand placed on your visual system.
  • Eyeglasses - When a patient has a high prescription for glasses (often one for far-sightedness or hyperopia) or significant imbalance between his or her eyes, glasses may affect the patient's eye position.
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