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The symptoms and signs associated with convergence insufficiency are related to prolonged, visually demanding, near-centered tasks. They may include, but are not limited to, diplopia (double vision), asthenopia (eye strain), transient blurred vision, difficulty sustaining near-visual function, abnormal fatigue, headache, and abnormal postural adaptation, among others.
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 ]
Light from a single point of a distant object and light from a single point of a near object being brought to a focus. The accommodation reflex (or accommodation-convergence reflex) is a reflex action of the eye, in response to focusing on a near object, then looking at a distant object (and vice versa), comprising coordinated changes in vergence, lens shape (accommodation) and pupil size.
This test is performed on patients suspected to have small angle deviations of less than 10 prism dioptres, a microtropia, that may or may not have been observed on cover test because of subtle eye movements. The test determines whether the patient has bifoveal fixation or monofixation despite their eyes seeming straight.
The convergence will stretch the extraocular muscles – the receptors for this are muscle spindles. As happens with the monocular accommodation cue, kinesthetic sensations from these extraocular muscles also help in distance and depth perception. The angle of convergence is smaller when the eye is fixating on objects which are far away.
Clinically, accommodative convergence is measured as a ratio of convergence, measured in prism diopters, to accommodation, measured in diopters of near demand. The patient is instructed to make a near target perfectly clear and their phoria is measured as the focusing demand on the eye is changed with lenses.
The prism fusion range (PFR) or fusional vergence amplitude is a clinical eye test performed by orthoptists, optometrists, and ophthalmologists to assess motor fusion, specifically the extent to which a patient can maintain binocular single vision in the presence of increasing vergence demands.
Accommodation is the process by which the vertebrate eye changes optical power to maintain a clear image or focus on an object as its distance varies. In this, distances vary for individuals from the far point—the maximum distance from the eye for which a clear image of an object can be seen, to the near point—the minimum distance for a ...