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In studies that used standardized definitions of convergence insufficiency, investigators have reported a prevalence of 4.2–6% in school and clinic settings. The standard definition of convergence insufficiency is exophoria greater at near than at distance, a receded near point of convergence, and reduced convergence amplitudes at near. [5]
Accommodative excess may occur secondary to convergence insufficiency also. In convergence insufficiency near point of convergence will recede, and positive fusional vergence (PFV) will reduce. So, the patient uses excessive accommodation to stimulate accommodative convergence to overcome reduced PFV. [5]
Fusional amplitude and relative fusional amplitude training are designed to alleviate convergence insufficiency. The CITT study (Convergence Insufficiency Treatment Trial) was a randomized, double-blind multi-center trial (high level of reliability) indicating that orthoptic vision therapy is an effective method of treatment of convergence ...
Burt Kushner is an American pediatric ophthalmologist specializing in the diagnosis and treatment of strabismus.Kushner's contributions include demonstration of improved visual fields of patients following strabismus surgery, elucidation of torsional contribution to patients with diplopia, corticosteroid treatment of periocular capillary hemangioma, and novel hypotheses on the mechanism of ...
Accommodative insufficiency (AI) involves the inability of the eye to focus properly on an object. Accommodation is the adjustment of the curvature of the lens to focus on objects near and far. In this condition, amplitude of accommodation of a person is lesser compared to physiological limits for his age. [ 1 ]
Treatment is primarily directed towards etiology of the dorsal midbrain syndrome. A thorough workup, including neuroimaging is essential to rule out anatomic lesions or other causes of this syndrome. Visually significant upgaze palsy can be relieved with bilateral inferior rectus recessions. Retraction nystagmus and convergence movement are ...
Near (1/3m): 15Δ BI → 35-40Δ BO; Distance (6m): 5-7Δ BI → 15Δ BO; Vertical: 3Δ BU → 3Δ BD; If patient results do not reflect the normal values, they may have the following issues: Convergence insufficiency - usually associated with accommodative difficulties, the fusional convergence range of these patients is reduced.
In a small-scale study, adults whose reading difficulties due to convergence insufficiency had been unsuccessfully addressed by convergence exercises, base-in prism glasses or strabismus surgery showed improved reading after botulinum toxin therapy, maintaining improved reading remaining also after six months. [5]