{"id":1175,"date":"2020-04-22T16:26:52","date_gmt":"2020-04-22T16:26:52","guid":{"rendered":"https:\/\/www.optometrists.org\/wordpress\/?page_id=1175"},"modified":"2021-10-19T12:05:52","modified_gmt":"2021-10-19T12:05:52","slug":"convergence-insufficiency-2","status":"publish","type":"page","link":"https:\/\/www.optometrists.org\/vision-therapy\/vision-therapy-for-children\/convergence-insufficiency-2\/","title":{"rendered":"Convergence Insufficiency"},"content":{"rendered":"<h2>Up to 15% of all children suffer with this eye condition.<\/h2>\n<p>Convergence insufficiency (CI) is a highly treatable binocular vision condition that affects near vision and eye muscle coordination. Convergence of the eyes occurs when the two eyes need to focus on a close object, such as a book, computer, tablet, smartphone, etc.<\/p>\n<h2>What is Convergence Insufficiency (CI)?<\/h2>\n<p>Convergence insufficiency means the eyes struggle to focus easily for near tasks, affecting school work, attention and office performance in adults<i>.\u00a0<\/i><\/p>\n<p><strong>A proper diagnosis of CI can prevent a child from being labelled as &#8220;lazy,&#8221; &#8220;spacey,&#8221; \u201cclumsy\u201d, &#8220;anxious,&#8221; and even misdiagnosed with <a href=\"https:\/\/www.optometrists.org\/vision-therapy-for-adhd\/what-is-add-adhd\/\">ADHD<\/a>, <a href=\"https:\/\/www.optometrists.org\/vision-for-school\/dyslexia\/\">dyslexia<\/a>, or mild <a href=\"https:\/\/www.optometrists.org\/vision-therapy-for-special-needs\/autism-vision\/\">autism<\/a>.\u00a0<\/strong><\/p>\n<h2><b>How common is CI?<\/b><\/h2>\n<p><strong>CI affects up to 1 in every 8 children, that is 13% of all school-aged students.<\/strong><\/p>\n<p>It is therefore possible, that four children in every classroom may be struggling with this condition!<\/p>\n<p>Diagnosis and treatment of CI is essential for your child\u2019s success in reading, learning, sports performance, and more.<\/p>\n<h2><b>What are the symptoms of CI?<\/b><\/h2>\n<p>There are many different symptoms that can develop as a result of CI\u2014 these are the most common:<\/p>\n<ul>\n<li style=\"font-weight: 400;\">Eyestrain<\/li>\n<li style=\"font-weight: 400;\">Headaches or muscle tension<\/li>\n<li style=\"font-weight: 400;\">Blurred or double vision<\/li>\n<li style=\"font-weight: 400;\">Difficulty reading and concentrating<\/li>\n<li style=\"font-weight: 400;\">Uses finger or ruler when reading<\/li>\n<li style=\"font-weight: 400;\">Avoidance of close work<\/li>\n<li style=\"font-weight: 400;\">Poor hand-eye coordination<\/li>\n<li style=\"font-weight: 400;\">Anxiety<\/li>\n<li style=\"font-weight: 400;\">Motion sickness\/dizziness<b><\/b><\/li>\n<\/ul>\n<p><strong>If your child has CI, the following tasks may be challenging:<\/strong><\/p>\n<ul>\n<li style=\"font-weight: 400;\">Homework<\/li>\n<li style=\"font-weight: 400;\">Computer work<\/li>\n<li style=\"font-weight: 400;\">Attention<\/li>\n<li style=\"font-weight: 400;\">Reading<\/li>\n<li style=\"font-weight: 400;\">Writing<\/li>\n<li style=\"font-weight: 400;\">Comprehension<\/li>\n<li style=\"font-weight: 400;\">Making crafts<\/li>\n<\/ul>\n<p><strong><a href=\"https:\/\/www.optometrists.org\/practice-search\/\">Schedule an exam<\/a><\/strong> with an eye doctor who has experience diagnosing and treating CI with vision therapy, if you think that your child could be 1 of the 8 children affected by CI.<\/p>\n<p><strong>SEE RELATED: <\/strong><a href=\"https:\/\/www.optometrists.org\/vision-therapy\/vision-therapy-for-children\/convergence-insufficiency-2\/do-i-have-convergence-insufficiency\/\">Do I Have Convergence Insufficiency?<\/a><\/p>\n\n\t<div class=\"practice-search-widget\">\n\t\t<h3>Find an Eye Doctor for Convergence Insufficiency<\/h3>\n\t\t\n\t<form class=\"practice-search-form practice-search-form-widget\" action=\"https:\/\/www.optometrists.org\/practice-search\/results\/\" method=\"get\">\n\n\t\t<input type=\"hidden\" name=\"distance\" value=\"100\" class=\"practice-search-distance\">\n\t\t<input type=\"hidden\" name=\"page\" class=\"practice-search-page\">\n\t\t<input type=\"hidden\" name=\"address_latitude\"><input type=\"hidden\" name=\"address_longitude\">\n\n\t\t<input type=\"text\" name=\"address\" class=\"practice-search-address\" placeholder=\"City, Surburb or Address\" value=\"\">\n\n\t\t\n\t\t\t<input type=\"hidden\" name=\"distance\" value=\"100\" class=\"practice-search-distance\">\n\n\t\t\n\n\t\t<button type=\"submit\" class=\"practice-search-button\">\n\t\t\t\t\t\t\t\t\t<svg width=\"19\" height=\"19\" viewBox=\"0 0 19 19\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M10.6796 0.130005C9.15708 0.130059 7.66615 0.5646 6.38198 1.38258C5.09781 2.20057 4.07373 3.36803 3.43004 4.74783C2.78634 6.12763 2.54976 7.66246 2.74808 9.17205C2.9464 10.6816 3.57139 12.1033 4.54964 13.27L0.729639 17.08C0.6364 17.1732 0.562439 17.2839 0.511979 17.4058C0.461519 17.5276 0.435547 17.6581 0.435547 17.79C0.435547 17.9219 0.461519 18.0524 0.511979 18.1743C0.562439 18.2961 0.6364 18.4068 0.729639 18.5C0.917942 18.6883 1.17334 18.7941 1.43964 18.7941C1.5715 18.7941 1.70207 18.7681 1.82389 18.7177C1.94571 18.6672 2.0564 18.5932 2.14964 18.5L5.99964 14.62C7.35406 15.6038 8.98566 16.1324 10.6596 16.13C12.7814 16.13 14.8162 15.2871 16.3165 13.7869C17.8168 12.2866 18.6596 10.2517 18.6596 8.13C18.6596 6.00827 17.8168 3.97344 16.3165 2.47315C14.8162 0.97286 12.7814 0.130005 10.6596 0.130005H10.6796ZM10.6796 14.13C9.49295 14.13 8.33291 13.7781 7.34622 13.1188C6.35952 12.4595 5.59049 11.5225 5.13636 10.4261C4.68224 9.32975 4.56342 8.12335 4.79493 6.95946C5.02644 5.79558 5.59788 4.72648 6.437 3.88736C7.27611 3.04825 8.34521 2.4768 9.5091 2.24529C10.673 2.01378 11.8794 2.1326 12.9757 2.58673C14.0721 3.04085 15.0092 3.80989 15.6685 4.79658C16.3277 5.78328 16.6796 6.94332 16.6796 8.13C16.6796 9.7213 16.0475 11.2474 14.9223 12.3726C13.7971 13.4979 12.2709 14.13 10.6796 14.13Z\" fill=\"#fff\"\/><\/svg>\n\t\t\t\t\t<\/button>\n\n\t\t<button type=\"button\" class=\"practice-search-use-my-location\">\n\t\t\tSearch near me\n\t\t<\/button>\n\n\n\t<\/form>\n\n\n\n\t\t<\/div>\n\n\t\n<h2><b>How is CI diagnosed?<\/b><\/h2>\n<p><strong>A <a href=\"https:\/\/www.optometrists.org\/childrens-vision\/pediatric-eye-exams-2\/\">comprehensive eye exam<\/a> including specific analysis of visual skills, binocular vision, convergence and focusing is required to enable identification of CI. <\/strong><\/p>\n<p>A basic eye exam or screening with the 20\/20 eye chart is not adequate for the detection of CI.<\/p>\n<h2><b>Why is CI often undetected?<\/b><\/h2>\n<p>Convergence insufficiency frequently goes undetected in school age children because comprehensive testing for CI is not included in pediatrician or school vision screenings, and standard eye exams conducted by ophthalmologists.<\/p>\n<p><strong>If an eye test does not include the specific tests mentioned above, this condition may remain undetected, affecting the child\u2019s school and sports performances.<\/strong><\/p>\n<p>While the good news is that CI responds well to proper treatment\u2014 unfortunately,\u00a0 since many children are not assessed\u00a0 for CI, they are not getting the help they need early in life, if ever at all.<\/p>\n<p>Children, teenagers and adults who remain undiagnosed and untreated tend to avoid reading and close work as much as possible or use various strategies to combat symptoms, such as using a ruler or finger to keep one&#8217;s place while reading or taking frequent breaks.<\/p>\n<h2><b>Can CI cause visual suppression?<\/b><\/h2>\n<p><strong>If untreated, CI can lead to more serious eye problems such as <a href=\"https:\/\/www.optometrists.org\/vision-therapy-for-lazy-eye\/amblyopia-lazy-eye\/\">lazy eye<\/a> (amblyopia) or even an eye turn (<a href=\"https:\/\/www.optometrists.org\/a-guide-to-eye-turns\/strabismus-crossed-eyes\/\">strabismus<\/a>).<\/strong><\/p>\n<p>If the convergence problems are left untreated, <i>suppression <\/i>can result. Suppression of vision in one eye occurs when the brain actively shuts off one eye, causing loss of binocular (two-eyed) vision and depth perception.<\/p>\n<p>In this case, some or all of the following symptoms may present:<\/p>\n<ul>\n<li style=\"font-weight: 400;\">Trouble catching balls and other objects thrown through the air<\/li>\n<li style=\"font-weight: 400;\">Avoidance of sports and games that require accurate depth perception<\/li>\n<li style=\"font-weight: 400;\">Frequent mishaps due to misjudgment of physical distances:\n<ul>\n<li style=\"font-weight: 400;\">Trips and stumbles on uneven surfaces, stairs, and curbs<\/li>\n<li style=\"font-weight: 400;\">Frequent spilling or knocking over of objects<\/li>\n<li style=\"font-weight: 400;\">Bumping into doors, furniture and other stationary objects<\/li>\n<li style=\"font-weight: 400;\">Sports accidents<\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400;\">Avoidance of eye contact<\/li>\n<li style=\"font-weight: 400;\">Poor posture while doing activities requiring near vision<\/li>\n<li style=\"font-weight: 400;\">Frequent head tilt<\/li>\n<li style=\"font-weight: 400;\">Problems with motion sickness and\/or vertigo<\/li>\n<\/ul>\n<p><strong><a href=\"https:\/\/www.optometrists.org\/practice-search\/\">Contact a vision therapy eye doctor<\/a><\/strong> near you, if your child has experienced any of the above symptoms.<\/p>\n<h2><b>What is the best treatment for CI?<\/b><\/h2>\n<p><strong><a href=\"https:\/\/www.optometrists.org\/vision-therapy\/what-is-vision-therapy\/\">Vision therapy<\/a> is the most effective treatment for CI.<\/strong><\/p>\n<p>Treatments for CI can be categorized as active or passive:<\/p>\n<ul>\n<li style=\"font-weight: 400;\"><strong>Active treatment<\/strong>: A multi-site randomized clinical trial funded by the National Eye Institute called the Convergence Insufficiency Treatment Trial showed:\n<ul>\n<li style=\"font-weight: 400;\">The best treatment for CI is supervised vision therapy in a clinical office with home reinforcement (15 minutes of prescribed vision exercises done in the home five days per week).<\/li>\n<li style=\"font-weight: 400;\">Children responded quickly to this treatment protocol<\/li>\n<li style=\"font-weight: 400;\"><strong>75% of all children achieved either full correction of their vision or saw marked improvements within 12 weeks.<\/strong><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400;\"><strong>Passive treatment<\/strong>: Prismatic (prism) eyeglasses can be prescribed to decrease some of the symptoms.\n<ul>\n<li style=\"font-weight: 400;\">Although prism eyeglasses can relieve symptoms, they are not a &#8220;cure&#8221; and the patient typically remains dependent on the prism lenses.<\/li>\n<li style=\"font-weight: 400;\">Adaptation problems can lead to the need for stronger prescriptions in the future.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Scientific research, as well as optometric and ophthalmological clinical trials, agree that the primary treatment of CI should be vision therapy.<\/p>\n<h2><b>Do pencil push-ups work?<\/b><\/h2>\n<p><em><strong>Unfortunately, No.<\/strong><\/em><\/p>\n<p>Some ophthalmologists may still treat children with \u2018pencil-push-ups\u2019. While a 2002 survey of <a href=\"https:\/\/www.optometrists.org\/vision-therapy-for-children\/what-is-the-difference-between-an-optometrist-and-an-ophthalmologist\/\">ophthalmologists and optometrists<\/a> indicated that home-based pencil-push-ups therapy is the most common treatment, scientific research does not support this method.<\/p>\n<p>Studies done on pencil push-ups have shown it to be ineffective in eliminating symptoms.<\/p>\n<h2><b>Vision therapy\u00a0<\/b><\/h2>\n<p><strong>Vision therapy is highly recommended for treatment of CI.<\/strong><\/p>\n<p>Standard eyeglasses, contact lenses, medications, and surgery will not be effective in treating the condition. Vision therapy focuses on training the eyes to work together to improve 3-D vision, depth perception, and clear binocular vision.<\/p>\n<p><b>Treatment exercises for CI may include:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\">Eye tracking with pursuits and saccades<\/li>\n<li style=\"font-weight: 400;\">Focusing for near and distance<\/li>\n<li style=\"font-weight: 400;\">Depth perception practice<\/li>\n<li style=\"font-weight: 400;\">Specialized equipment and tools such as prisms and lenses<\/li>\n<li style=\"font-weight: 400;\">Training with computerized technology<\/li>\n<\/ul>\n<p>The goal of vision therapy is to stimulate the communication between the brain and eyes, to enable clear and comfortable vision at all times.<\/p>\n<p>According to Dr. Michael J. Bartiss, O.D., M.D., F.A.A.O., F.A.A.P., F.A.C.S, Pediatric Ophthalmologist, &#8220;<i>Fortunately, in most cases, convergence insufficiency is very amenable to orthoptics and vision therapy.&#8221;<\/i><\/p>\n<p><strong>If you think your child may have CI, schedule an eye exam to assess your child\u2019s vision skills.<\/strong><\/p>\n<p><strong>Recent <a href=\"https:\/\/www.optometrists.org\/vision-therapy\/vision-therapy-evidence-based-published-research\/\">published studies<\/a> have shown that CI can be effectively treated.<\/strong><\/p>\n<p><strong>LEARN MORE:<\/strong> <a href=\"https:\/\/www.optometrists.org\/vision-therapy\/guide-to-vision-therapy\/\">Guide to Vision Therapy<\/a><\/p>\n<p><strong><a href=\"https:\/\/www.optometrists.org\/practice-search\/\">An eye doctor near you<\/a><\/strong> can prescribe a customized vision therapy program, tailored to your child\u2019s specific needs. Vision therapy can improve your child\u2019s binocular vision\u2014 facilitating your child\u2019s healthy development of many essential life skills.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Convergence Insufficiency (CI) impacts the lives of up to 15% of all students. This is a highly treatable binocular vision condition that affects near vision and eye muscle coordination.<br \/>\nChildren with CI can be mislabeled as &#8216;lazy&#8217;, &#8216;clumsy&#8217;, &#8216;poor students&#8217; and &#8216;anxious&#8217;, or even misdiagnosed with ADHD and dyslexia.<\/p>\n","protected":false},"author":4,"featured_media":1201,"parent":990,"menu_order":118,"comment_status":"closed","ping_status":"closed","template":"template-article.php","meta":{"footnotes":""},"categories":[],"tags":[108,85,95,111,151,150,113,103,152,83],"class_list":["post-1175","page","type-page","status-publish","has-post-thumbnail","hentry","tag-attention","tag-children","tag-childrens-vision","tag-convergence","tag-eyestrain","tag-insufficiency","tag-lazy-eye","tag-reading","tag-treatment","tag-vision-therapy"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Convergence Insufficiency - Optometrists.org<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.optometrists.org\/vision-therapy\/vision-therapy-for-children\/convergence-insufficiency-2\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Convergence Insufficiency - Optometrists.org\" \/>\n<meta property=\"og:description\" content=\"Convergence Insufficiency (CI) impacts the lives of up to 15% of all students. This is a highly treatable binocular vision condition that affects near vision and eye muscle coordination. 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