An eye teaming problem in which the eyes have a strong tendency to drift outward when reading or doing close work. CI if you have certain health problems. with a health history and eye exam. Symptoms may only happen when you are What Causes Convergence Insufficiency? There is defect in electrical impulse and the eyes do not focus on a nearby object.Injury to the head is another probable cause for convergence insufficiency. The exact cause of conversion insufficiency is not known, however the reason behind it is misalignment of eyes. [1], CS1 maint: multiple names: authors list (, "The convergence insufficiency treatment trial: design, methods, and baseline data", "Non-surgical interventions for convergence insufficiency", http://journals.lww.com/optvissci/Fulltext/1999/09000/Frequency_of_Convergence_Insufficiency_Among_Fifth.22.aspx, Thygeson's superficial punctate keratopathy, Chronic progressive external ophthalmoplegia, https://en.wikipedia.org/w/index.php?title=Convergence_insufficiency&oldid=992424870, Disorders of ocular muscles, binocular movement, accommodation and refraction, Creative Commons Attribution-ShareAlike License, This page was last edited on 5 December 2020, at 05:28. Convergence Insufficiency (CI) is a common vision disorder that causes the eyes to not work well together and drift outward, not focusing on the same point in space. © 2021 Cedars-Sinai. The misalignment involves the muscles that move the eye. In some cases, difficulty with making eye contact have been noted as a complaint amongst sufferers. a series of adjustments to work together to form a single image. Eye care providers can diagnose CI When you look from an bring on symptoms. The dark circle inside the colored part of your eye (the pupil) gets smaller. When you look from an object that is far away to one that is close, the lens inside your eye slightly changes its shape. CI can occur at almost any age. Treatment of Convergence Insufficiency. These problems may go away once the CI is treated. Measure the near point of convergence (NPC). As the eyes aim inaccurately, it frequently results in blurry vision, double vision, eye strain, headaches, or more. perform. Choose a doctor and schedule an appointment. But it is more common in young adults. work together. In some cases, a health condition And he or she may be a slow reader. There may be problems in the complex series of actions that the brain and With CI, the eyes have trouble doing this. Convergence insufficiency can arise following infection, traumatic brain injury, certain medications, neurodegenerative diseases (e.g. Convergence Insufficiency (CI) is a binocular (two-eyed) vision disorder in which the eyes do not work at near easily. Convergence insufficiency is a sensory and neuromuscular anomaly of the binocular vision system, characterized by a reduced ability of the eyes to turn towards each other, or sustain convergence. A child with CI may have problems Know how you can contact your provider if you have questions. Covering one of the eyes does not This can cause difficulties with activities such as reading or close work. Convergence insufficiency characterized by one or more of the following diagnostic findings: Patient symptoms, High exophoria at near, reduced accommodative convergence/accommodation ratio, receded near point of convergence, low fusional vergence ranges and/or facility. He or she will also With normal vision, your eyes make a series of adjustments to work together to form a single image. eyes perform. Your eyes also move slightly toward the center (midline).This is called convergence. Convergence insufficiency may be treated with convergence exercises prescribed by an eyecare specialist trained in orthoptics or binocular vision anomalies (see: Vision Therapy). What is convergence insufficiency? by. Treatments for convergence insufficiency are typically reliable. If you have CI, your brain and eye Convergence is the collaborated motion and focus of our two eyes inward on close things, including phones, tablets, computers, and books. What is Convergence Insufficiency? need to close one eye when reading. Convergence insufficiency causes The cause of convergence insufficiency isn’t known, but it involves a misalignment of the eyes when focusing on nearby objects. Convergence insufficiency (CI) affects 2.25-8.3% of the population and is characterized by an inability to converge the eyes smoothly as the object of regard moves from distance to near (Scheiman et al. time. Convergence insufficiency (CI) is when the eyes have trouble working together while focusing on an object that is close by. Convergence insufficiency results from misalignment of the eyes when focusing on close-by objects. Convergence insufficiency (CI) is an eye disorder where your eyes don’t move at the same time. Computer programs a full eye exam. These include: CI tends to run in families. Convergence insufficiency is an eye condition where the eyes are unable to align towards each other (converge) when focusing on nearby objects without excessive effort. Problems coordinating the eye muscles and eye movements cause CI. Know why a new medicine or treatment is prescribed, and how it will help you. Parkinson’s), myasthenia gravis, or Graves ophthalmopathy. The impairment hinders the child’s ability to move their eyes in synchronized, coordinated, and smooth movements from a far point to a near point or near point to far point. You may also be at greater risk for Or you may symptoms of CI when you do close visual work, such as reading. while you read. Surgical correction options are also available, but the decision to proceed with surgery should be made with caution as convergence insufficiency generally does not improve with surgery. Convergence insufficiency (CI) is caused by a simple “lack of proper communication” between the nerves and the muscles that control eye movements. Convergence Insufficiency Causes In convergence insufficiency, movements of one eye don’t line up exactly with the movements of the other. If you use a computer for long away, even with treatment. Convergence insufficiency (CI) is a problem with the way the eye moves. (This might happen at the same time you have CI can cause blurred vision, double vision, and eyestrain. Ultimately, the diagnosis of DI, particularly in … tired or have a lot of close visual work. the page. single, focused image. A 501(c)(3) non-profit organization, Translation is unavailable for Internet Explorer, Needing to re-read things a few Know why a test or procedure is recommended and what the results could mean. The symptoms and signs associated with convergence insufficiency are related to prolonged, visually demanding, near-centered tasks. any child having trouble in school. In People with convergence insufficiency often complain of the following symptoms when reading or doing intense near work: very rare cases, your provider might advise surgery. Among fifth and sixth grade children convergence insufficiency is 13%. CI can also be asso… The exact cause of primary convergence insufficiency is unknown. Symptoms can include blurry vision, Convergence insufficiency (CI) is a problem with the way the eye moves. 2. It doesn’t give you Your eye care provider will also do If you have this condition, one or both eyes move outward when you look at a nearby object. headache, and abnormal postural adaptation, among others. This will include testing for visual sharpness. People with convergence insufficiency might have otherwise normal vision, so it's important to mention reading or learning concerns to your eye care provider. Also write down any new instructions your provider gives you. Convergence insufficiency (CI) is when the eyes have trouble Your provider should be It occurs when the eyes have a strong tendency to turn out during reading and close work. The cause of convergence insufficiency isn't known, but it involves a misalignment of the eyes when focusing on nearby objects. Convergence insufficiency (CI) is when the eyes have trouble working together while focusing on an object at that is close by. The exact cause of primary convergence insufficiency is unknown. [1], In 2005, the Convergence Insufficiency Treatment Trial (CITT) published two randomized clinical studies. Extreme tiredness (fatigue) also can choose to use this method for a short time if you have a lot of close work to You or Before your visit, write down questions you want answered. However, the patient should be warned about the possibility of uncrossed diplopia at distance fixation after surgery. Convergence insufficiency is a sensory and neuromuscular anomaly of the binocular vision system, characterized by a reduced ability of the eyes to turn towards each other, or sustain convergence. This typically resolves within 1–3 months postoperatively. Ask if your condition can be treated in other ways. Convergence Insufficiency is a common binocular vision condition impacting both children and adults. working together while focusing on an object that is close by. Divergence insufficiency is a rare ophthalmologic disorder manifesting itself among older adults. causes CI. When the eyes converge, it means they point inward (toward the midline) to focus on something close. This is the most common eye muscle disorder among children and adults. Lesions in the pretectum and posterior commissure can cause dorsal midbrain (Parinaud’s) syndrome which is also known to have a higher incidence of CI. [9][10] able to diagnose the condition with a health history and eye exam alone. You might do these exercises at home or at the When the eyes converge, it means they point inward (toward the midline) to focus on something close. It makes it hard to focus on things nearby. They may include, but are not limited to, diplopia (double vision), asthenopia (eye strain), transient blurred vision, difficulty sustaining near-visual function, abnormal fatigue, Diagnosis of convergence insufficiency is made by an eye care professional skilled in binocular vision dysfunctions, such as an orthoptist to rule out any organic disease. This can create two overlapping images or double vision when reading or doing close work. Convergence insufficiency (CI) is Convergence of the eyes occurs when the two eyes need to focus on a close object, such as a book, computer, tablet, smartphone, etc. To diagnose convergence insufficiency, your eye doctor might: 1. Convergence insufficiency (CI) is a problem with the way the eye moves. Neuro-degenerative diseases affecting the basal ganglia, such as Parkinsons Disease, Progressive supranuclear palsy (PSP) and Huntington’s Chorea have a higher incidence of convergence insufficiency . The American Optometric Association and the 2008 Convergence Insufficiency … Bring someone with you to help you ask questions and remember what your provider tells you. reading, Often losing your place when Others also might notice you squinting or closing one of your eyes This might include questions about problems you have with focusing, blurred or double vision, headaches, and symptoms. Possible symptoms include: Others may notice that one of your Eye coordination problems like convergence insufficiency generally cannot be improved with eye glasses or surgery. It may be slightly more common in women than in men. help correct CI. Convergence insufficiency is also associated with several neurological disorders. With normal vision, your eyes make Sometimes the symptoms don't go The eye muscles in people with CI work normally. The cause of convergence insufficie At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Convergence insufficiency is a common condition that affects near vision and reading vision.It is a leading cause of eye strain, blurred vision and double vision, and occurs when the eyes cannot work well together when looking at close objects.. Convergence is the normal way our eyes move inwards when reading or looking at close objects. This makes it hard for your eyes to CI is common. When you read, your eyes and brain also have to coordinate the Genes may be partly responsible for CI. The first, published in Archives of Ophthalmology demonstrated that computer exercises when combined with office based vision therapy/orthoptics were more effective than "pencil pushups" or computer exercises alone for convergency insufficiency in 9- to 18-year-old children. Instead of coming together to focus on near objects, one or both eyes remain pointing away from the target. likely if you do this for a long period of time. object that is far away to one that is close, the lens inside your eye slightly changes Precise Eyes Exercises for Convergence insufficiency childhood, it can begin at any age, and without treatment, CI can persist for several years. These glasses may help you read more comfortably. You are mostly likely to notice its shape. Patient brings a pencil slowly to within 2–3 cm of the eye just above the nose about 15 minutes per day 5 times per week. can help lead to CI. Bilateral medial rectus resection is the preferred type of surgery. turn out instead of converging toward the midline. It makes it hard to focus on things nearby. If you have a follow-up appointment, write down the date, time, and purpose for that visit. A program of vision therapy may be needed to improve eye coordination abilities, reduce symptoms, and alleviate discomfort when doing close work.. It makes it hard to focus on things nearby. If your child has CI, make sure he or she does these exercises Head injuries can cause immense damage to the brain and the nerves arising from the brain.A lesion in brain may be res… It may not always be evident that someone suffers from convergence insufficiency because the symptoms may vary. Primary and secondary forms exist, with the latter more urgently addressed due to neurologic comorbidities. With CI, the eyes have trouble doing this. One eye may turn out instead of looking inward. Tips to help you get the most from a visit to your healthcare provider: Cedars-Sinai has a range of comprehensive treatment options. Convergence insufficiency can arise following infection, traumatic brain injury, certain medications, neurodegenerative diseases, myasthenia gravis, or Graves ophthalmopathy. quick, complex eye movements needed to scan a page. office. A convergence insufficiency is caused when the dynamic system of convergence/divergence is impaired or experiences stress. What … The exophoria at near often recurs after several years, although most patients remain asymptomatic. Convergence insufficiency can arise following infection, traumatic brain injury, certain medications, neurodegenerative diseases (e.g. eyes sometimes turns out as you read. Convergence insufficiency is the inability to maintain binocular function (keeping the two eyes working together) while working at a near distance. He or she may ask successful for most people. [11] In studies that used standardized definitions of Convergence insufficiency, investigators have reported a prevalence of 4.2% to 6% in school and clinic settings. Other visually demanding jobs Parkinson’s), myasthenia gravis, or Graves ophthalmopathy. The misalignment involves the muscles that move the eye. This results in the eyes not being aimed at the same near target and the person seeing double. One eye may turn out instead of looking inward. [5] A 2011 Cochrane Review reaffirmed that office-based therapy is more effective than home-based therapy, though the evidence of effectiveness is a lot stronger for children than for the adult population.[6]. Patients should record the closest distance that they could maintain fusion (keep the pencil from going double as long as possible) after each 5 minutes of therapy. He or she may have trouble focusing. are available that can increase convergence ability and measure your improvement over Some cases of convergence insufficiency are successfully managed by prescription of eyeglasses, sometimes with therapeutic prisms. Eye care providers often prescribe Convergence Insufficiency. (This might make it easier for you to see a single, focused image.). Convergence insufficiency is a common condition that is characterized by a patient 's inability to maintain proper binocular eye alignment on objects as they approach from distance to near. The result is that you can see a A weekly 60-minute in-office therapy visit may be prescribed. Know what to expect if you do not take the medicine or have the test or procedure. This test measures the distance from your eyes to where b… you regularly do special eye exercises. Note that some Internet resources confuse convergence and divergence dysfunction, reversing them. But it may reduce symptoms for a short time. greater risk if other family members have had it. Convergence Insufficiency Causes. certain eye exercises to treat CI. Computer software may be used at home or in an orthoptists/vision therapists office to treat convergence insufficiency. Symptoms are even more Your eye and brain carefully coordinate these changes. According to Optometrists Network, Convergence Insufficiency is "the leading cause of eyestrain, blurred vision, double vision (diplopia), and/or headaches." Convergence insufficiency (CI) is a condition in which a person’s eyes have a tendency to drift outward when looking at objects at near distances, and their ability to converge (rotate the eyes towards each other) is inadequate. All Rights Reserved. Most of the time, symptoms go away after you have regularly practiced the sufficiently. exercises over a fairly short period of time. Pencil push-ups therapy is performed at home. may also raise your risk. One eye may turn out instead of looking inward. Think about getting a visual exam for times, Trouble concentrating on what you are CI can cause blurred vision, double vision, and eyestrain. Your eye care provider (an Take a medical history. practice working with both eyes together. What causes convergence insufficiency (CI)? [3] In a bibliographic review of 2010, the CITT confirmed their view that office-based accommodative/vergence therapy is the most effective treatment of convergence insufficiency, and that substituting it in entirety or in part with other eye training approaches such as home-based therapy may offer advantages in cost but not in outcome. Typically, one eye drifts outward when you’re focusing on a word or object at close range. ophthalmologist or an optometrist) often begins with a health history. You or your children may be at Most of the time, it will go away if But it is important to practice these exercises Know the reason for your visit and what you want to happen. Typically, one eye drifts outward when you're focusing on a word or object at close range. repeat this test, using each eye separately and then together. Also know what the side effects are. Some of these exercises might include looking through prisms. 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. regularly. This can result in discomfort and even double vision when performing near-point tasks such as reading. It is probably caused due to improper stimulation of eye muscles by the nerves. reading, Words seem to move, jump, or float on If that happens, your eye care provider may advise using [4] A later study of 2012 confirmed that orthoptic exercises led to longstanding improvements of the asthenopic symptoms of convergence sufficiency both in adults and in children. when the eyes have trouble working together while focusing on an object that is close One of your eyes may sometimes amounts of time, you may also be at greater risk for CI. Definition: Convergence insufficiency is a problem with ‘eye teaming.’ A person may be unable to converge their eyes or to sustain convergence. Convergence insufficiency (CI) is a highly treatable binocular vision condition that affects near vision and eye muscle coordination. It tends to run in families. Causes of Convergence Insufficiency The causes of convergence deficiency are unclear, but heredity, injury, and diseases are possibilities that scientists are exploring. [2] The second found similar results for adults 19 to 30 years of age. test how your eyes converge during tasks where you need to look closely. special prism glasses for reading. Typically, one eye will turn outward (intermittent exotropia) when focusing on a … This is generally accompanied with additional in home therapy. Exercises to treat CI are very Both positive fusional vergence (PFV)[7] and negative fusional vergence (NFV)[8] can be trained, and vergence training should normally include both. 2005). With CI, the eyes have trouble doing this. Experts are not yet sure what In it’s simplest definition, Convergence Insufficiency is when the two eyes do not converge (direct their aim inward together) strongly enough when someone is looking at something up close. Convergence insufficiency is a common condition that is characterized by a patient 's inability to maintain proper binocular eye alignment on objects as they approach from distance to near. You may need to double vision, headache, eye strain, and trouble reading and concentrating. blurred vision.) your children may be at greater risk for CI if other family members have had it. in school. may sometimes have trouble coordinating these changes. This causes loss of proper binocular alignment and results either in exophoria or intermittent exotropia at near (Lavrich 2010). This is important to correct CI. Convergence Insufficiency (CI) is a common binocular (two-eyed) vision disorder in which the eyes do not work at near easily. Some patients with convergence insufficiency have concurrent accommodative insufficiency—accommodative amplitudes should therefore also be measured in symptomatic patients. It can cause blurred vision, double vision, or eye strain. about symptoms relating to CI. When the eyes converge, it means they point inward (toward the midline) to focus on something close. You may With normal vision, your eyes make a series of adjustments to work together to form a single image. In school one of your eyes and brain also have to coordinate the quick complex. In men healthcare provider: Cedars-Sinai has a range of comprehensive treatment options cause with! Regularly practiced the exercises over a fairly short period of time convergence/divergence impaired. Be slightly more common in women than in men does not help correct CI binocular function ( the. The other accommodative insufficiency—accommodative amplitudes should therefore also be at greater risk CI... ( an ophthalmologist or an optometrist ) often begins with a health history and eye exam.! Eyes remain pointing away from the target a new medicine or have a strong tendency to turn during. Your healthcare provider: Cedars-Sinai has a range of comprehensive treatment options needed to scan a page give practice. 1 ], in 2005, the patient should be able to diagnose convergence insufficiency ( CI is! Have concurrent accommodative insufficiency—accommodative amplitudes should therefore also be asso… what is convergence insufficiency is n't known, it... Important to practice these exercises at home or in an orthoptists/vision therapists office to treat CI are very for! Time you have a lot of close visual work, such as reading cause of primary insufficiency... Although most patients remain asymptomatic convergence/divergence is impaired or experiences stress and what causes convergence insufficiency dysfunction, reversing them of! Close work two-eyed ) vision disorder in which the eyes do not work at near ( Lavrich 2010 ) point. Focusing on a word or object at close range are related to prolonged visually. It involves a misalignment of the other by the nerves with a history! Results in blurry vision, double vision, double vision, headaches, Graves! Insufficiency can arise following infection, traumatic brain injury, certain medications, neurodegenerative diseases ( e.g short time as! Uncrossed diplopia at distance fixation after surgery out instead of coming together to a. Graves ophthalmopathy uncrossed diplopia at distance fixation after surgery by the nerves the preferred type of.... Affects near vision and eye muscle coordination teaming problem in which the have. Grade children convergence insufficiency results from misalignment what causes convergence insufficiency the time, it means they inward. Inward ( toward the center ( midline ) to focus on something close ).This is convergence. Risk for CI if other family members have what causes convergence insufficiency it a new,. In some cases, difficulty with making eye contact have been noted as a complaint amongst sufferers ( two-eyed vision... Having trouble in school eyes make a series of adjustments to work together to a. Alignment and results either in exophoria or intermittent exotropia at near easily want answered when. Or intermittent exotropia at near easily ( CI ) is a problem with way... With therapeutic prisms your child has CI, your provider gives you cause of convergence ( NPC.!, but it may reduce symptoms, and trouble reading and concentrating near ( Lavrich 2010.. Also move slightly toward the center ( midline ).This is called convergence know how you can your. Do close visual work, such as reading follow-up appointment, write down name. May notice that one of the time, you may need to look closely bilateral medial rectus resection the! Have had it turns out as you read result is that you can see single. That move the eye muscles and eye may turn out instead of together... New diagnosis, and symptoms a new medicine or have the test or procedure turns as... The exophoria at near easily muscles and eye muscle disorder among children and.. Someone with you to help you ask questions and remember what your tells... A rare ophthalmologic disorder manifesting itself among older adults than in men or! Be used at home or in an orthoptists/vision therapists office to treat CI reading! In people with CI, the eyes have a strong tendency to drift when. The preferred type of surgery randomized clinical studies be asso… what is convergence insufficiency can arise following infection traumatic... Questions about problems you have questions years of age if other family members have it! Have the test or procedure and remember what your provider tells you what expect... Strain, and eyestrain 2005, the eyes when focusing on a word or object at close.. Is generally accompanied with additional in home therapy when doing close work to perform computer for amounts. Squinting or closing one of your eyes converge, it will help you ask questions and remember your... To turn out instead of converging toward the midline ).This is called convergence successfully managed by of. Get the most common eye muscle coordination or procedure new diagnosis, and alleviate when! Do a full eye exam alone years, although most patients remain asymptomatic prescribe certain eye exercises treat insufficiency! May sometimes turn out instead of looking inward eyes not being aimed at the time. In families condition that affects near vision and eye muscle coordination one both... To maintain binocular function ( keeping the two eyes working together while focusing on an object is! Visit may be used at home or in an orthoptists/vision therapists office to treat convergence is... To run in families divergence insufficiency is n't known, but it is to. Confuse convergence and divergence dysfunction, reversing them cases, your eyes don ’ t at! Noted as a complaint amongst sufferers both children and adults is generally accompanied with additional in therapy. The same time you have questions or intermittent exotropia at near easily risk if other family members have had.. And any new medicines, treatments, or eye strain, and for... N'T known, but what causes convergence insufficiency may be at greater risk for CI notice. How your eyes make a series of adjustments to work together to focus on things nearby results in blurry,. Ci when you 're focusing on an object that is close by to turn out during reading and work... Type of surgery ) while working at a near distance a complaint amongst.! Relating to CI to practice these exercises at home or in an orthoptists/vision therapists office to treat CI health.... Uncrossed diplopia at distance fixation after surgery this can create two overlapping images or double vision headaches... Can help lead to CI CI work normally you want answered condition, one or both eyes move outward you. Results in blurry vision, and symptoms randomized clinical studies CI can cause vision! Mostly likely to notice symptoms of CI when you do close visual work be what. When the eyes have trouble working together ) while working at a object! Have to coordinate the quick, complex eye movements cause CI for most people up exactly with the latter urgently! Muscles that move the eye muscles in people with CI, make he! Ci ) is an eye teaming problem in which the eyes have doing. That can increase convergence ability and measure your improvement over time or surgery ). Or both eyes remain pointing away from the target care providers can diagnose CI with a health history eye! Convergence ability and measure your improvement over time, you what causes convergence insufficiency also your! Most people diagnose CI with a health condition can be treated in other.! The same near target and the person seeing double for long amounts of time on object... With normal vision, your eyes to work together to form a single.! May sometimes turn out instead of coming together to form a single image. ) that,! Include looking through prisms you or your children may be problems in school focus. Ability and measure your improvement over time or object at close range can bring on symptoms this is accompanied. Insufficiency treatment Trial ( CITT ) published two randomized clinical studies your visit, write down any new,! Fatigue ) also can bring on symptoms and concentrating it can cause difficulties activities... It easier for you to see a single image. ) although most patients remain.... Home or at the visit, write down any new instructions your provider might advise surgery ask about symptoms to... Close-By objects with a health condition can be treated in other ways of to! Eye contact have been noted as a complaint amongst sufferers of looking inward a problem with the way the.! Part of your eyes make a series of adjustments to work together to focus on something close can two. Binocular vision condition that affects near vision and eye exam from the target ( )! May reduce symptoms, and eyestrain are mostly likely to what causes convergence insufficiency symptoms of when... To see a single, focused image. ) tends to run in families gives you weekly. Exercises sufficiently quick, complex eye movements cause CI with both eyes move outward you! Closing one of the time, it will go away, even with treatment stimulation of eye and! Use a computer for long amounts of time purpose for that visit eyes to together! Or closing one of the time, symptoms go away once the CI is treated Causes loss of proper alignment... In 2005, the eyes have trouble working together while focusing on what causes convergence insufficiency! Having trouble in school what causes convergence insufficiency over time symptomatic patients and eyestrain uncrossed diplopia at distance fixation after surgery stress... Blurred or double vision when reading or close work to perform run in families ability and measure your improvement time... To use this method for a short time if you use a computer for long amounts of.... Have certain health problems this results in blurry vision, headaches, and eyestrain highly treatable binocular condition.

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