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Treatments and drugs
By Mayo Clinic staffIf convergence insufficiency isn't causing symptoms, you generally don't need treatment. But for people with symptoms, treatment with eye-focusing exercises can increase the eyes' convergence ability. Treatment may take place in the office of a trained therapist or at your home. Treatments may include:
- Pencil pushups. In this simple exercise, you focus on a small letter on the side of a pencil as you move it closer to the bridge of your nose, stopping the movement if you have double vision. The exercise is often done for 15 minutes a day, five or more days a week.
- Computer vision therapy. Eye-focusing exercises are done on a computer using special software designed to improve convergence. You may print out the results to share with your eye doctor.
- Reading glasses. Glasses with built-in prisms force your eyes to work harder to align and are sometimes used for people who need help with their reading vision. But they can be tiring to your eyes and generally haven't proved effective.
A study sponsored by the National Eye Institute of the National Institutes of Health compared home-based treatment with doctor office-based treatment for convergence insufficiency in children ages 9 to 17. Study results showed that the most effective therapy was a weekly hourlong session of in-office vision therapy with at-home reinforcement exercises. Other studies have also found that office-based treatment is effective about 75 percent of the time.
Home-based treatment with pencil pushups or computer programs hasn't been shown to be as effective — in some studies, it works only about one-third of the time. But home treatment costs less and is more convenient. Only a small percentage of eye care providers offer in-office therapy for convergence insufficiency. Many people who can't find or can't afford in-office therapy opt for home-based treatment.
If you choose home treatment, many experts recommend using computer software programs along with pencil pushups. The combined approach may be more effective, and the computer therapy is more engaging for children.
Treatment for convergence insufficiency may take three months or longer, though you'll likely start to see improvement in your symptoms after four weeks. After your convergence ability has improved, you can help maintain your improved vision by continuing to read and do other near tasks. Treatment can permanently cure convergence insufficiency, but symptoms may come back after an illness, lack of sleep or when you're doing a lot of reading or other close work. In rare cases, eye-focusing exercises don't work and your doctor may recommend surgery.
- Lavrich JB. Convergence insufficiency and its current treatment. Current Opinion in Ophthalmology. 2010;21:356.
- Scheiman M, et al. Non-surgical interventions for convergence insufficiency. Cochrane Database of Systematic Reviews. 2011;(3)CD006768. http://www2.cochrane.org/reviews. Accessed May 27, 2011.
- Convergence insufficiency. American Association for Pediatric Ophthalmology and Strabismus. http://www.aapos.org/terms/show/38. Accessed May 27, 2011.
- Serna A, et al. Treatment of symptomatic convergence insufficiency with a home-based computer orthoptic exercise program. Journal of the American Association for Pediatric Ophthalmology and Strabismus. 2011;15:140.
- Convergence Insufficiency Treatment Trial Study Group. Randomized clinical trial of treatments for symptomatic convergence insufficiency in children. Archives of Ophthalmology. 2008;126:1336.
- Scheiman M, et al. Treatment of convergence insufficiency in childhood: A current perspective. Optometry and Vision Science. 2009;86:420.
- Scheiman M, et al. Vision therapy/orthoptics for symptomatic convergence insufficiency in children: Treatment kinetics. Optometry and Vision Science. 2010;87:593.
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