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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.
Incorrect vergence response can cause double vision. Accommodation is the eye’s focusing mechanism and it is engaged to produce a sharp image on a retina. Both of these mechanisms are neurally linked forming the accommodation-convergence reflex [1] of eyes.
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 ]
Hypermetropia: Young hypermetropes use excessive accommodation as a physiological adaptation in the interest of clear vision. Myopia: Young myopes performing excessive near work may also use excessive accommodation in association with excessive convergence. Astigmatism: Astigmatic eye may also be associated with accommodative excess.
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.
A spasm of accommodation (also known as a ciliary spasm, an accommodation, or accommodative spasm) is a condition in which the ciliary muscle of the eye remains in a constant state of contraction. Normal accommodation allows the eye to "accommodate" for near-vision. However, in a state of perpetual contraction, the ciliary muscle cannot relax ...
However, errors in this relationship can cause problems, such as hyperopic individuals having a tendency for crossed eyes because of the over exertion of their accommodation system. Clinically, accommodative convergence is measured as a ratio of convergence, measured in prism diopters, to accommodation, measured in diopters of near demand.
A common form of exotropia is known as "convergence insufficiency" that responds well to orthoptic vision therapy including exercises. This disorder is characterized by an inability of the eyes to work together when used for near viewing, such as reading. Instead of the eyes focusing together on the near object, one deviates outward.