Convergence Excess

Convergence excess describes a condition where the eyes do not exactly aim together; rather, they aim too close or in front of the object. As a consequence, blur, confusion, or fatigue may result.

Convergence excess will effect near work tasks, especially reading and writing. Symptoms of convergence excess include eyestrain, headaches, blurred vision, double vision, sleepiness and trouble remembering what was read.

Rapid changes in convergence demands such as copying from the blackboard are often very difficult for children with convergence excess. This excess of convergence is commonly associated with an accommodative insufficiency. The eyes aim nearer than desired in an attempt to compensate for reduced focus stamina or focus ability. This leads to a mismatch between vergence (eye teaming) and focus, thus affecting binocular vision accuracy.

TREATMENT

Management of convergence excess requires therapeutic prescription lenses to enhance the focus efficiency thus reducing the need to pull the eyes closer in. The lenses are typically worn for close work tasks such as reading, writing, computer work and copying from the blackboard. This is a therapeutic treatment that requires monitoring over time to ensure the excessive demand is reduced to within a normal range of focus and convergence.

In some cases, vision therapy may be required in addition to the glasses. Vision therapy on its own does not work well to alleviate these problems. Therapy aims to provide better control and stamina however does not completely relieve the fatigue component.

If vision therapy is required it usually consists of six in-office visits spaced one week apart, along with home based therapy between these visits. Treatment duration will depend on the particular patient’s condition.