Convergence Insufficiency - Treatment

Treatment

Convergence insufficiency may be treated with convergence exercises prescribed by an eyecare specialist trained in orthoptics or binocular vision anomalies. Some cases of convergence insufficiency are successfully managed by prescription of eyeglasses, sometimes with with therapeutic prisms.

In 2005, the Convergence Insufficiency Treatment Trial (CITT) published two randomized clinical studies. The first, published in Archives of Ophthalmology demonstrated that computer exercises when combined with in-office based vision therapy was more effective than "pencil pushups" or computer exercises alone for convergency insufficiency in 9 to 18 year old children. The second found similar results for adults 19 to 30 years of age.

Surgical correction options are also available, but the decision to proceed with surgery should be made with caution.

Bilateral medial rectus resection is usually the most effective operation for convergence insufficiency. However, the patient should be warned about the possibility of uncrossed diplopia at distance fixation after surgery. This typically resolves within 1-3 months postoperatively. The exophoria at near often recurs after several years, although most patients remain asymptomatic.

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