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David K. Wallace, MD, MPH

Arch Ophthalmol. 2008;126(10):1455-1456.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Convergence insufficiency is a relatively common problem encountered in clinical practice, especially for those specializing in pediatric ophthalmology and strabismus. It affects older children, teenagers, and adults, and typical symptoms are difficulty with reading, eye strain or discomfort with near work (asthenopia), and headaches. The diagnosis is established when patients demonstrate reduced near fusional convergence amplitudes and/or a remote near point of convergence. Older adults in particular may have concurrent accommodative insufficiency. Not all patients with convergence insufficiency are symptomatic, and for those patients, treatment is generally unnecessary. Conversely, many patients with asthenopic symptoms have normal convergence.

Ophthalmologists and orthoptists typically use a stepwise approach to treating convergence insufficiency, often prescribing pencil push-ups or computer orthoptics at home as the first treatment. If improvement is not sufficient after a few weeks, then the treatment modality or intensity can be modified. For example, base-out prisms may . . . [Full Text of this Article]

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