Convergence Insufficiency

Sunil Kumar Singh, Akhilesh Mandal, (B.Optometry), 2012-2015

Sankara College of Optometry, Chitkara University
Introduction: Convergence Insufficiency (CI) is the leading cause of eyestrain,
blurred vision, double vision, and/or headaches. Convergence insufficiency
occurs when your eyes don't work together while you're trying to focus on a
nearby object.
Case details: 14YRS/M, visited sankara eye hospital with chief complains of
frontal and temporal headache during near work and mobile use. No significant
ocular, Systemic and family history and birth history was normal.
Clinical Examination : Visual acuity was 6/6, N6 in B.E, Refraction under
fogging: + 0.50DS (both eyes). And after dilation objective refraction was found
to be +0.75 in both the eyes.
Orthoptic evaluation after 2 days was found to be exophoria for distance and
near, NPC and NRA was also low with problem in vergence facility with base out
prism and during binocular accommodative facility patient had difficulties with
plus lens too.
Diagnosis: Convergence insufficiency
Management: Vision therapy
Discussion: The studies conducted by CITT investigator group have shown that
the only treatment for CI was office vision therapy for 45-60 minute weekly and
was more effective than placebo vision therapy. In present case also patient
symptoms and diagnostic parameters improved to normal after 2 weeks of office
therapy.
Conclusion: CI more common in young patients especially those engaged in
near work. Therefore orthoptic examination in all cases of eye strain and
headache is essential.
Reference: Scheimanm, Rouse M and Kulp MT, et al. Treatment of convergence
insufficiency in childhood. A cument prespective optom vis sci 2009 may; 86(5):
420-428
Acknowledgement:
1. Sankara Eye Hospital and college of optometry
2. Chitkara University