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Current concepts in convergence insufficiency

Trieu, Lynn H.; Lavrich, Judith B.

Current Opinion in Ophthalmology: September 2018 - Volume 29 - Issue 5 - p 401–406
doi: 10.1097/ICU.0000000000000502

Purpose of review As the majority of our patients are spending significant time using computers and reading, it is important to understand any disease process that can affect one's near vision. Convergence insufficiency, not an uncommon condition, is still not screened for by most eyecare professionals. This review aims to report the current screening methods and diagnostic criteria, and to summarize the current treatment of convergence insufficiency.

Recent findings The current literature shows that convergence insufficiency has a prevalence of 2–17% in the general population and an even higher rate, up to 49%, in patients who have suffered a traumatic brain injury. Although the measurement is still not standardized, near point of convergence and patient symptomatology appear to be an appropriate screen for convergence insufficiency. Further study is needed to establish standardization of diagnostic criteria. It is now well recognized that orthoptic/vergence therapy provides excellent improvement in the clinical measurements and symptoms associated with convergence insufficiency.

Summary Convergence insufficiency is a condition that causes a significant impact on near vision. Treatment with orthoptic/vergence therapy can reduce symptomatology and greatly improve one's quality of life. Further study is needed to provide an evidence-based definition that encompasses all cases of convergence insufficiency, research possible subtypes of the disease and establish the efficacy of home-based computer therapy as compared to office-based orthoptic/vergence therapy.

Wills Eye Hospital, Department of Pediatric Ophthalmology and Adult Strabismus, Philadelphia, Pennsylvania, USA

Correspondence to Lynn H. Trieu, OD, 840 Walnut Street, Suite 1210, Philadelphia, PA 19107, USA. Tel: +1 215 928 3214; fax: +1 215 928 3983; e-mail:

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