Convergence Excess: Symptoms, Causes, Diagnosis and Treatment

Experiencing Symptoms of Convergence Excess? Visit Our Optometrist for a Functional Eye Exam

According to the American Optometric Association, convergence insufficiency and convergence excess together are estimated to affect up to 20% of the population. Convergence excess is a condition in which the eyes over-converge, or turn inward, when trying to focus on nearby objects. This can cause symptoms such as eye strain, headaches, and double vision. These symptoms are commonly experienced after or during extended periods of close work, such as reading or using a computer. Treatment options for convergence excess may include vision therapy, corrective lenses, andor lifestyle changes. Early detection and treatment are important for maintaining healthy vision and preventing potential complications.

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Why Should You Visit Our Optometrist if You Suffer From Convergence Excess?

If you suffer from convergence excess, it is important to visit our optometrist to receive a proper diagnosis and treatment. Here are some of the reasons why:

Accurate diagnosis

We have the knowledge and experience to accurately diagnose convergence excess, which can often be mistaken for other vision problems.

Individualized treatment

We will create a treatment plan tailored to your specific needs, which may include vision therapy, prism lenses, reading glasses, or other options.

Preventing complications

Convergence excess can lead to eye strain, headaches, and difficulty reading or performing other tasks. By treating the condition, we can help prevent these complications from occurring.

Improved quality of life

Treating convergence excess can improve your vision and reduce symptoms, making it easier to perform daily tasks and improving your overall quality of life.

Early detection of underlying conditions

In some cases, convergence excess can be a symptom of an underlying condition such as multiple sclerosis. We can perform a comprehensive eye exam to rule out any other underlying conditions and refer you to a specialist if necessary.

The Signs and Symptoms of Convergence Excess

Symptoms of convergence excess can vary from person to person, but some of the most common ones include:

Eye strain: This is perhaps the most common symptom of convergence excess, and it is characterized by a feeling of discomfort or tiredness in the eyes after reading or doing close work for an extended period.
Headaches: Many people with convergence excess experience headaches, particularly after reading or doing close work for a prolonged period.
Double vision: Some people with convergence excess may experience double vision, which can be particularly noticeable when reading or looking at a computer screen.
Blurred vision: Another symptom of convergence excess is blurred vision, which can be particularly noticeable when looking at objects up close.
Difficulty concentrating: People with convergence excess may also experience difficulty concentrating, particularly when trying to read or do close work.
Light sensitivity: In some cases, people with convergence excess may be more sensitive to light than usual, particularly when doing close work.
Dizziness: A few people with convergence excess may experience dizziness or vertigo, particularly when reading or doing close work for an extended period.
Eye fatigue: Eye fatigue is a common symptom of convergence excess, and it can be particularly noticeable after a long day of reading or doing close work.

If you are experiencing any of these symptoms, please call us at (562) 925-6591 to schedule an evaluation. The earlier convergence excess is diagnosed, the easier it is to manage.

The Signs and Symptoms of Convergence Excess

There are various causes of convergence excess, including:

Genetics: Convergence excess can be hereditary and may run in families.
Eye muscle weakness: Weakness in the muscles responsible for controlling eye movements can cause the eyes to turn too much inward.
Accommodative dysfunction: Accommodation is the process by which the eyes focus on objects at varying distances. When the eyes struggle to adjust to changes in focus, it can lead to convergence excess.
Neurological conditions: Certain neurological conditions, such as multiple sclerosis, can affect the nerves that control eye movements and lead to convergence excess.
Trauma: In some cases, head trauma or injury to the eyes can cause convergence excess.
Eye strain: Prolonged periods of reading or doing close work can strain the eyes and may cause convergence excess.
Poor vision habits: Poor vision habits, such as holding reading material too close to the face or working in poorly lit environments, may contribute to convergence excess.
Eye fatigue: Eye fatigue may also contribute to convergence excess. When the eyes are tired, they may struggle to maintain proper alignment, leading to the eyes turning too much inward.

Understanding the Diagnosis of Convergence Excess and How We Can Help

Accurately diagnosing convergence excess is essential in developing an effective treatment plan. Here's what to expect during the diagnosis process:

Comprehensive eye exam

During a comprehensive eye exam, we will perform a range of tests to evaluate the health of your eyes and determine the presence of any underlying conditions that may be contributing to your symptoms.

Vision testing

Vision testing will evaluate the clarity of your vision and your ability to focus on objects at varying distances.

Eye alignment testing

Eye alignment testing will determine if your eyes are properly aligned when focusing on objects at varying distances.

Binocular vision testing

Binocular vision testing will evaluate how well your eyes work together as a team and assess the presence of any eye muscle imbalances.

Refraction

Refraction is a test that determines the precise prescription needed to correct any refractive errors you may have, such as nearsightedness, farsightedness, or astigmatism.

Cycloplegic refraction

Cycloplegic refraction involves using eye drops to temporarily paralyze the muscles that control the lens of the eye. This test can help determine the full extent of any refractive errors and rule out any underlying conditions.

Stereopsis testing

Stereopsis testing evaluates your ability to perceive depth and 3D images.

Cover testing

Cover testing evaluates the alignment of your eyes when focusing on objects at varying distances.

Near point of convergence testing

Near point of convergence testing assesses how closely your eyes can focus on a nearby object before they start to turn inward.

By performing a comprehensive eye exam and a range of specialized tests, we can accurately diagnose convergence excess and develop a personalized treatment plan to address your symptoms.

Effective Treatment Options for Convergence Excess

Convergence excess can be a challenging condition to manage. Fortunately, there are a range of treatment options available that can help alleviate symptoms and improve visual function. The Convergence Insufficiency Treatment Trial (CITT) showed that in-office vision therapy was the most effective treatment. In some cases our optometrist may discuss other treatment options, here are some of the treatment options that we may recommend:

Vision therapy

Vision therapy is a customized program of exercises and activities designed to improve the function of the visual system, including eye teaming and focusing skills. Vision therapy may be prescribed to help reduce symptoms of convergence excess.

Prism lenses

Prism lenses are designed to alter the way light enters the eyes, which can help alleviate symptoms of convergence excess. Prism lenses can be prescribed for eyeglasses or contact lenses.

Reading glasses

Reading glasses may be prescribed to help alleviate symptoms of convergence excess when reading or doing close work.

Pencil pushups

Pencil pushups are a type of vision therapy exercise that involves focusing on a small object, such as a pencil tip, held at arm's length and then gradually moving the object closer to the face. This exercise can help improve eye teaming and focusing skills, however is not as effective as in-office vision therapy according to the The Convergence Insufficiency Treatment Trial (CITT). Learn more about The Convergence Insufficiency Treatment Trial (CITT) here.

Computer glasses

Computer glasses may be prescribed to help alleviate symptoms of convergence excess when using a computer or other digital devices.

Lifestyle modifications

Making lifestyle modifications, such as taking breaks when reading or doing close work, can also help reduce symptoms of convergence excess.

Surgery

In rare cases, surgery may be recommended to correct a muscle imbalance that is contributing to convergence excess. This option is typically reserved for cases in which other treatment options have been unsuccessful.

It is important to note that the most effective treatment plan for convergence excess will vary depending on the individual patient's needs and symptoms. We will work with you to develop a customized treatment plan that is designed to alleviate your symptoms and improve your visual function.

Meet Dr. Eric T. Ikeda

Dr. Ikeda, FCOVD, DPNAP, is a leading optometrist in the field of neuro optometric rehabilitation and developmental optometry. He has made profound contributions to the field over the years and uses these expertise to provide the highest quality of eye care to his patients. He was Past-President of the Optometric Extension Program Foundation (OEPF) and of the Neuro-Optometric Rehabilitation Association (NORA). He received the “Founding Fathers Medal” for his continued service to NORA and he was recognized as “Physician of the Year” by the Rehabilitation Nurses Society. He is a clinical associate professor of the Western University of Health Sciences College of Optometry and was inducted as a Distinguished Practitioner into the National Academies of Practice (Optometry Academy).

How can I find an eye doctor near me?

If you don’t already have a trusted optometrist or you live too far from our optometry clinic in Bellflower, you could start your online search by typing in phrases such as "eye doctor near me," "optometrist near me," or "eye specialist near me."

Common Questions

What is convergence excess and insufficiency?

Convergence excess and convergence insufficiency are two conditions that affect the ability of the eyes to focus on nearby objects. Convergence excess occurs when the eyes turn too far inward when focusing on nearby objects, while convergence insufficiency occurs when the eyes have difficulty turning inward enough to focus on nearby objects.

How do you find excess convergence?

Excess convergence can be identified through a comprehensive eye exam, which may include tests of eye alignment, focusing ability, and visual acuity. One common test used to evaluate convergence excess is the near point of convergence test, which involves asking the patient to focus on a small object held at arm's length and slowly moving the object closer to the eyes until the patient reports seeing double or the eyes begin to drift outward.

What is esotropia and convergence excess?

Esotropia is a type of strabismus in which the eyes turn inward toward the nose. Convergence excess can contribute to the development of esotropia, as the excessive inward turning of the eyes can cause the eyes to become misaligned.

What is divergence excess?

Divergence excess is a condition in which the eyes turn too far outward when focusing on distant objects. This is the opposite of convergence excess, which involves excessive inward turning of the eyes when focusing on nearby objects.

Is convergence excess the same as divergence insufficiency?

No, convergence excess and divergence insufficiency are two separate conditions that affect the alignment of the eyes. Convergence excess involves excessive inward turning of the eyes when focusing on nearby objects, while divergence insufficiency involves difficulty turning the eyes outward to focus on distant objects.

What does convergence mean with eyes?

Convergence refers to the ability of the eyes to turn inward toward the nose when focusing on nearby objects. This is an important function of the visual system, as it allows us to maintain clear and single vision when reading, writing, or doing other close work.

What is accommodative excess?

Accommodative excess is a condition in which the eyes have difficulty relaxing their focusing muscles when looking at distant objects. This can lead to symptoms such as eyestrain, headaches, and difficulty seeing clearly.

What is convergence excess esophoria?

Esophoria refers to a type of eye misalignment in which the eyes tend to turn inward toward the nose, particularly when focusing on nearby objects. Convergence excess can contribute to the development of esophoria, as the excessive inward turning of the eyes can cause the eyes to become misaligned.

What is the difference between convergence and accommodative insufficiency?

Convergence insufficiency is a condition in which the eyes have difficulty turning inward enough to focus on nearby objects, while accommodative insufficiency is a condition in which the eyes have difficulty focusing on nearby objects. While these two conditions are related and may occur together, they involve different aspects of the visual system.

Schedule a Comprehensive Functional Eye Exam Today to Evaluate for Convergence Excess

If you are experiencing any of the symptoms mentioned, or have concerns about your vision, we highly recommend scheduling a comprehensive functional eye exam with our optometrist. This exam will allow us to thoroughly evaluate your vision and eye health, including assessing for convergence excess and other related conditions. Please call at (562) 925-6591 to schedule a functional eye exam.

Patients with functional vision issues visit our clinic from all over California, and we are proud to be a leading provider of neuro optometric rehabilitation services for patients from Bellflower, Long Beach, Lakewood, and Los Angeles.

Learn More

Learn about the Visual Conditions that Can Cause Strabismus

The various visual conditions that can cause strabismus, including amblyopia, esotropia, exotropia, down syndrome, cranial nerve palsies, etc.

Eye care for children with autism

The importance of a developmental eye exam for children on the spectrum.

Strabismus Treatment in : Understanding Symptoms, Treatment, Causes, Diagnosis, and Prevention

Early detection and treatment of strabismus is important to prevent further visual problems and maintain good eye health.

Exotropia: Causes, Symptoms, Diagnosis, and Treatment Options

Exotropia is a type of strabismus where one eye turns outward. If you suspect that you may have exotropia, please see our optometrist for a treatment plan.

Understanding Accommodative Insufficiency: What It Is, Symptoms and Impact on Learning and Work

Accommodative insufficiency causes eyestrain and headaches when focusing on nearby objects. Visit our eye doctor for proper treatment.

The Convergence Insufficiency Treatment Trial (CITT)

Best treatment for convergence insufficiency? In-office vision therapy proved most effective in the Convergence Insufficiency Treatment Trial.

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Testimonials

I haven't actually used the optometrist side, so my review is limited to the vision therapy offered. This office was recommended by my occupational therapist for the treatment of my double vision following a stroke.

Claire A.

Love this location. I had a brain injury accident from day one one. All the team make you feel you still important and hope in the horizon after when the medical system fell you miserably. Dr. Ikeda very professional and very understanding about your issue. Two tombs up.

Jim K.

My husband and I were immediately impressed with Dr Ikeda. I was hit by a car while cycling which caused broken bones and three brain injuries. The brain injuries caused double vision. Dr. Ikeda examined my eyes and got me started on vision therapy with his occupational therapist who specializes in vision therapy. She (Chris) is absolutely great. I am impressed with the array of tools used to help recover my binocular vision. I am doing things I never thought were possible (balance boards etc). Chris pushes me and keeps me motivated. I really enjoy my sessions with her. The office staff is always friendly and they have a wonderful appointment reminder tool that makes it easy to keep my calendar up to date. I am happy the rehab center at Little Co. of Mary recommended them!!

Teresa S.

The Vision Therapy is handled in a separate office through a different door from the shared waiting room. Chris, the vision therapist, has a wide and varied assortment of tools, equipment and resources to best evaluate and treat most vision issues. After just a few visits, my double vision became easier to control, using exercises developed during the therapy process. It was time well-spent.

Joe M.

I have been coming here since I can remember. I love it here. The staff is so amazing and nice. They explain everything they gonna do and never make you feel rushed. Dr. Ikeda has always been my doctor and I would never want another one. He is the doctor for my whole family and is always asking how everyone is doing. I am also so crazy about picking out my frames and have to try so many and each person who helps me take the time and lets me try them all on. I would never want to go anywhere else! I definitely would recommend this office to anyone looking for a great eye doctor.

Kayla W.

This is not for the eye exam but for the frames selection portion. I brought my prescription from Kaiser here with my VSP insurance. The reception staff was very polite and professional. Manny helped me to pick out frames and explain my coverage. Very helpful and patient not like the individual at the other place I rated here on Yelp. I was running late and he still helped me and was not bothered at all. I am so glad I came here ..........very pleased.

Very professional staff and pleasant.