Convergence Insufficiency and Convergence Excess
This condition is diagnosed by taking measurements of eye alignment at near using several different techniques. It also is confirmed by testing the Near Point of Convergence (NPC).

Symptom Checklist
- Loses place when reading/re-reads lines
- Words appear to “move” on page
- Trouble aligning columns
- Frontal headaches
- Tired eyes after school
When our two eyes point behind an object rather than directly at it, we call this eye misalignment an Exophoria. When an Exophoria occurs when looking at near objects like books or computers, it is called Convergence Insufficiency.
When our two eyes point in front of an object rather than directly at it, we call this eye misalignment an Esophoria. When an Esophoria occurs when looking at near objects like books or computers, it is called Convergence Excess.
Treatment of CI
Office-based Vision Therapy is the preferred treatment strategy for convergence insufficiency. Vision Therapy has proven very effective at eliminating the symptoms associated with CI. CI is one of the most common conditions we treat at Four Rivers Vision Therapy and we have found virtually all patients are symptomless following treatment. Learn more about the Convergence Insufficiency Treatment Trial (CITT) at the link below.
Treatment of CE
Treatment of CE often involves near point reading glasses or even bifocals with or without Vision Therapy. These glasses aren’t for clarity, but rather, for comfort. Plus lenses at near help relax the eyes while reading and encourage them to turn outward toward proper alignment. While glasses often alleviate immediate symptoms, they are not a permanent fix for CE. Vision Therapy helps to teach the eyes to relax and point at the appropriate location. CE typically has a favorable outcome following the appropriate use of glasses and VT.


Convergence Insufficiency: Randomized Clinical Trial
Convergence Insufficiency Attention and Reading Trial
COVD: Convergence Insufficiency
AOA Clinical Practice Guidelines: CI and CE (Refer to Pages 54 and 56)
Improvement in Academic Behaviors After Successful Treatment of Convergence Insufficiency.
Vision Therapy/Orthoptics For Symtpomatic Convergence Insufficiency in Children: Treatment Kinetics.