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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 push-ups. 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. During one session, the push-ups may be repeated 100 or more times.
- 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 prisms built in force your eyes to work harder to align and are sometimes used for reading. 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 push-ups 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 treatment 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 push-ups. The combined approach is more effective, and the computer therapy is more engaging for children.
Treatment for convergence insufficiency may take three months or longer. 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. But this would be highly unusual for anyone under age 30.
- Convergence insufficiency. American Association for Pediatric Ophthalmology and Strabismus. http://www.aapos.org/displaycommon.cfm?an=1&subarticlenbr=76. Accessed June 12, 2009.
- Wallace DK. Treatment options for symptomatic convergence insufficiency. Archives of Ophthalmology. 2008;126:1455.
- Convergence Insufficiency Treatment Trial Study Group. Randomized clinical trial of treatments for symptomatic convergence insufficiency in children. Archives of Ophthalmology. 2008;126:1336.
- More effective treatment identified for common childhood vision disorder. National Eye Institute. http://www.nei.nih.gov/news/pressreleases/101308.asp.
- Scheiman M, et al. Treatment of convergence insufficiency in childhood: A current perspective. Optometry and Vision Science. 2009;86:420.
- Maples WS, et al. Near point of convergence norms measured in elementary school children. Optometry and Vision Science. 2007;84:224.
- Robertson DM (expert opinion). Mayo Clinic, Rochester, Minn. July 9, 2009.
