Convergence Insufficiency Treatment with Vision Therapy

With report cards just released and the school year in full swing, now is the perfect time to discuss a vision issue that can affect a child's learning experience - Convergence Insufficiency (CI). Whether you're a parent, educator, healthcare provider, or someone interested in learning more about vision therapy, this month’s newsletter will provide valuable insights into how CI affects students, important screening tools, and how vision therapy can help.

What is Convergence Insufficiency?

Convergence Insufficiency (CI) is a condition where the eyes struggle to work together when focusing on near objects, such as during reading or close-up tasks. This can lead to symptoms like eyestrain, headaches, fatigue with near work, and double or blurred vision, especially after prolonged near work.

Underdiagnosis in Clinical Practice

Particularly in children, CI is often underdiagnosed. This happens because CI symptoms can be easily mistaken for other issues, such as attention difficulties, fatigue, or behavioral concerns. For parents and educators, it’s important to recognize that children may not always verbalize their symptoms - assuming that the visual fatigue they experience is something others also face. A simple yet effective way to screen for potential CI is to use a screening symptoms questionnaire, which can be sent home or reviewed with the child.

For healthcare providers, it’s essential to understand that CI may not be immediately obvious during a standard eye exam. In some cases, an individual might initially demonstrate a normal near point of convergence (NPC) but experience fatigue or a decline in convergence ability over time. This highlights the importance of a detailed evaluation, particularly when a child or adult has reported ongoing visual discomfort or academic difficulties. Thorough assessments of vergence ability, suppression, fusion ability, near-far vergence facility, and the related accommodative responses can ensure a more accurate diagnosis and better treatment outcomes. By ensuring that CI is adequately recognized and addressed, we can help improve the quality of life for both children and adults affected by this condition.

How Can Vision Therapy Help?

The Convergence Insufficiency Treatment Trial (CITT) found that individuals who received in- office therapy by a trained therapist, combined with at-home treatment, reported fewer and less severe symptoms related to reading and other near work.

Typical treatment involves weekly sessions, where patients engage in exercises such as the Brock string, vectogram, accommodative flippers, dynamic vergence training, computer orthoptics, anti-suppression work, flat fusion, and more. These exercises help strengthen how the brain controls eye movements and coordination, leading to better visual comfort and function.

Vision Therapy Canada Resources

Did you know that the Vision Therapy Canada website hosts multiple tools for patients and providers? This includes access to recent research and literature, symptom checklist, position statements, and financial assistance for vision therapy.

One of their recent publications explores The Impacts of Screen Time of Visual and Mental Wellbeing, which can be found here. This guideline provides valuable insights on how prolonged screen use can contribute to eye strain, discomfort, and mental fatigue. It also offers practical guidance for managing screen time to support better eye health and overall well- being. This resource can help individuals understand the potential risks and solutions related to extended screen exposure. Another one of their initiatives includes the Fretz Fund, which provides financial assistance to individuals in need of vision therapy services. The fund is designed to support those who are facing financial hardships, allowing them to receive the care they need to enhance their quality of life. Patients can apply directly online and applications are reviewed quarterly.

CI related to Concussions

In addition to its impact on learning, CI can also be a significant concern for individuals recovering from concussions. In recognition of Brain Injury Awareness Month this March, we’ll discuss how CI can develop after a concussion. We’ll discuss red flag symptoms of post-concussion vision issues to help both healthcare providers and individuals know when vision may be impacted. We'll also cover essential tools and screening tips for identifying visual dysfunctions and will explore treatment options to address these issues and support recovery. We hope this will be insightful for both healthcare providers and individuals, helping them take proactive steps toward better visual function following a concussion.

Stay Connected!

We’re always here to answer your questions and provide support. Whether you’re looking for more information about vision therapy, have referral inquiries, or want to schedule an appointment, don’t hesitate to reach out to us.

Call us: 343-333-2211

Email us: napaneevisiontherapy@gmail.com

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If you or someone you know may be dealing with CI, we’re here to help. Don’t hesitate to reach out with any questions or to book an appointment!

Warmly,

Dr. Zoe Briggs, OD, FAAO, FOVDR