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A Study on the Treatment of Convergence Insufficiency
Published in Jan-Tjeerd de Faber, 28th European Strabismological Association Meeting, 2020
F.F. Naqui, A. Bruce, J.A. Bradbury
Convergence insufficiency (CI) is one of the most common causes of ocular discomfort and is in fact the most common cause of asthenopia (Leeuwen et al 1999). It is also one of the most successful applications in the art of orthoptics. Orthoptic exercises are usually the first choice of treatment and are reported to relieve symptoms in the majority of treated patients (Wicks 1994).
Ophthalmology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Convergence insufficiency: usually seen in older children. Convergence exercises may help but there should be a low threshold to neuroimage if there are any neurological signs or worsening despite convergence exercises.
Disorders of Sensation, Motion, and Body Schema
Published in Rolland S. Parker, Concussive Brain Trauma, 2016
Common in TBI, convergence insufficiency is a binocular condition in which the eyes cannot rotate inwardly and maintain single vision at close distances. It is associated with eyestrain, the intermittent closing of one eye, diplopia, abnormal sensitivity to visual motion, and illusions of apparent movement of a line of print.
Near work symptoms and measures of accommodation in children
Published in Clinical and Experimental Optometry, 2023
Angela M Chen, Eric J Borsting
The proportion of children in each group who met the criteria for accommodative insufficiency and accommodative infacility was determined. Accommodative insufficiency was defined as having an accommodative amplitude 2D below the minimum expected amplitude based on the Hofstetter’s formula of 15 – (1/4)age.14 The diagnosis for accommodative infacility was defined as having a monocular accommodative facility rate lower than 6 cycles per min.14,16,17 Because convergence insufficiency and accommodative insufficiency are comorbid conditions, the proportion of children in each group who met the criteria for convergence insufficiency was also determined. The diagnosis for convergence insufficiency was defined as having a near exodeviation at least 4∆ larger than the distance deviation, near point of convergence break value ≥6 cm and insufficient positive fusional vergence at near (either failing Sheard’s criterion or positive fusional vergence break <15∆).14
Ocular Findings in Children with Headache
Published in Ophthalmic Epidemiology, 2023
Lisa Y. Lin, Wei Pan, Gui-Shuang Ying, Gil Binenbaum
The most common finding in our cohort was a refractive issue, identified in 18.2% of children with headache in a tertiary pediatric ophthalmology clinic. Prior studies have reported associations between refractive errors and headaches.15–18 Asthenopia, which may be characterized by chronic headache and eye fatigue, can be caused by uncorrected refractive errors or impairment of convergence.19 In our study, among children who had a full cycloplegic refraction, 6.9% had a significant change in spherical equivalent refractive error, 12.9% had an astigmatic change ≥1D, and 8.0% had an anisometropic change ≥1 D. Two children had either their astigmatic axes or amounts switched between the eyes. Thus, even in children with a recent refraction, if there is a new onset of headache, it is important to consider refractive issues as a potential cause. Further, children may be more likely than adults to describe symptoms of asthenopia as a headache, as they may not have the words to report eye strain, and as with other diseases in children, it is important to think more broadly as to what a child means when they report head pain. Convergence insufficiency can cause difficulty with prolonged reading and near work, which can contribute to headaches particularly in school-aged children. We found that children complaining of headache with reading or at the end of the day were more likely to have strabismus on exam (p = .02), 4.4% of children were diagnosed with new or worsening strabismus when they presented with headache, and 25.3% of those with new strabismus had convergence insufficiency.
Evaluation and Management of Convergence Insufficiency in Adults
Published in Journal of Binocular Vision and Ocular Motility, 2022
Convergence insufficiency is the inability to comfortably achieve and maintain clear single binocular vision at near. Prevalence in the population is approximately five percent, increasing in frequency in adults as they age.1,2 Patient experience related to convergence insufficiency includes symptoms of blurred vision, asthenopia, or eye strain, with sustained near work and complaints of re-reading lines or sections of text or losing their place3–6 as well as neck pain.6,7 Clinical indicators of convergence insufficiency include remote near point of convergence (NPC) and reduced positive vergence,8–10 abnormal eye movements,11 and reduced fine motor and spatial skills.12 Neuroscientific investigation into the mechanisms involved in control of eye movements while reading have revealed a difference in the activity in the cuneus, a structure near the oculomotor vermis in the occipital lobe,13,14 between binocularly normal patients and those with convergence insufficiency.11,13,14 The bulk of published literature addressing convergence insufficiency is concentrated on the evaluation and management in children and young adults.15 The purpose of this literature review was to investigate the research published since 2000 on the etiology, identification, evaluation, and management of convergence insufficiency in adults including a wide range of professional perspectives.