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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.
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.
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 ...
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.
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 ]
Spasm of accommodation is frequently resistant to treatment. However, some patients do find relief through the use of daily eye dilation with cycloplegic drops. One side effect of cycloplegic drops is that they often have BAK as a preservative ingredient, which, with daily use, can erode the tear shield:
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.
Binocular Vision Disorders: These are issues with how the eyes work together, such as strabismus (eye misalignment) or convergence insufficiency (difficulty bringing the eyes together to focus on near objects). Amblyopia (Lazy Eye): Behavioral optometrists may provide therapy and treatments to improve vision in individuals with amblyopia.
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