Divergence Insufficiency and Divergence Excess

Divergence Insufficiency and Divergence Excess describe a difficulty in the ability to point both eyes at a distance target, like a the board at school or a TV screen. Both can cause double vision when looking at distant objects.

This condition is diagnosed by taking measurements of eye alignment at distance using several different techniques, both with and without the patient’s feedback.

Symptoms Checklist

  • Double Vision in distance
  • “Wandering” Eye
  • Loses place when reading/re-reads line
  • Frontal headaches
  • Tired eyes after school

Divergence Excess

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 distant objects like TV screens or blackboards, it is called Divergence Excess.

Divergence 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 distant objects like TV screens or blackboards, it is called Divergence Insufficiency.

Treatment of Divergence Excess

The best available treatment option for Divergence Excess is Vision Therapy. Fortunately, Vision Therapy has proven very effective at eliminating the symptoms associated with Exophoria and Divergence Excess.  Exophoria is a very common condition we treat at Four Rivers Vision Therapy and we have found most patients are symptomless following our custom-designed VT plan.

Treatment of Divergence Insufficiency

In Vision Therapy for Esophoria and Divergence Insufficiency, we work to teach the patient where their eyes are pointing by teaching the activities that give them direct feedback. This helps to teach the eyes to relax and point at the appropriate location. Esophoria typically has a favorable outcome following the appropriate use of VT and glasses, if needed.

Clinical Research on Exophoria and Esophoria

 

AOA Clinical Practice Guidelines: Divergence Excess/Insufficiency (Refer to Pages 54 and 56)

 

Management of Intermittent Exotropia of the Divergence Excess Type: a Teaching Case Report

 

Optometric management of intermittent exotropia of the divergence excess type following strabismus surgery

 

Vision Therapy for Divergence Excess

 

%d bloggers like this: