Convergence problems arise when the eyes struggle to turn inwards together for near tasks. Convergence insufficiency is the most common form.
Origins
Primary convergence insufficiency often has no clear structural cause but relates to imbalance in the vergence system. Secondary problems occur after trauma, concussion, neurological disease, or decompensation of a latent squint.
- Symptoms include eye strain, headaches, double vision, and loss of place when reading
- Children may avoid near work or complain of tired eyes
- Some systemic conditions and medications affect vergence control
- Measurement of near point of convergence and fusional reserves confirms diagnosis
Treatment
Management may involve convergence exercises, prisms, or addressing associated refractive and accommodative errors. Neurological causes require broader evaluation.
- Structured home and in‑office therapy can significantly improve symptoms
- Persistence and regular follow‑up are key to success
- Sudden onset with neurological signs should prompt urgent assessment
- School and workplace adaptations may be helpful during treatment
