Convergence Insufficiency and Convergence Excess

Convergence Insufficiency and Convergence Excess describe a difficulty in the ability to point both eyes at a near target, like a book, tablet, or computer. Both can cause frustrations with any prolonged near work.

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

Convergence Insufficiency (CI)

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.

Convergence Excess (CE)

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.