Convergence insufficiency is a vision disorder in which your eyes can’t point inward together when looking at close-up objects, like tablets and smartphones. While it commonly starts in childhood, it can affect adults as well. Symptoms include headaches, blurred vision and double vision. Treatment is available through eye movement exercises.
Convergence insufficiency is a vision disorder involving binocular vision, which is vision using both of your eyes.
“Convergence” describes the way your eyes move together and point inward when you look at nearby objects, such as books, tablets or smartphone screens. With convergence insufficiency, there’s an eye coordination problem, in which your eyes instead drift outward as you look at objects close-up. This can cause double or blurred vision.
Convergence insufficiency typically starts in childhood, but often goes undiagnosed. Healthcare providers who do diagnose it often identify the condition when children are learning to read. Convergence insufficiency in adults can also occur after a brain injury, like a concussion.
Convergence insufficiency occurs in an estimated 2% to 13% of people in the U.S.
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People with convergence insufficiency may experience several symptoms when reading or looking at objects close-up, like books or smartphones. Convergence insufficiency symptoms may include:
A lack of communication between your nerves and the muscles that control your eye movements causes convergence insufficiency. Your eye muscles themselves are healthy, but the nerves that control them aren’t sending the proper message to your eyes to turn inward enough to aim at a close object. Instead of coming together to focus on near objects, one or both eyes remain pointing away from the target.
In some cases, a brain injury or neurodegenerative disease, such as Parkinson’s disease, can cause the condition.
People with brain injuries often develop convergence insufficiency. Healthcare providers haven’t identified any other risk factors.
Most of the complications associated with convergence insufficiency relate to the discomfort it creates and the interference with activities that require near vision.
In some people with convergence insufficiency, your brain suppresses (shuts down) vision in one eye to avoid experiencing double vision. This is your brain’s answer to dealing with your eyes not working as a team. Or your eyes may drift farther apart and start working independently instead of together. This can lead to problems beyond discomfort, including:
A routine eye exam with the familiar 20/20 eye chart doesn’t diagnose convergence insufficiency. People can pass the standard eye exam even if they have convergence insufficiency.
A specialized convergence insufficiency test measures the ability of your eyes to converge when looking at an object as it moves closer to your face.
Convergence insufficiency treatment involves eye movement exercises that retrain your nerves to aim your eyes properly. These convergence insufficiency exercises improve your eyes’ ability to move inward together by focusing on objects at different distances. They may be performed with a specialized optometrist or a therapist in your provider’s office and repeated at home.
Occasionally, people require a special type of glasses called prism glasses. These glasses redirect the light entering your eyes. Basically, prism glasses do the work that your nerves don’t know how to do.
Rarely, surgery can help make your eye muscles stronger. Regular eyeglasses and eye patches usually don’t improve the condition.
You may not notice an improvement right away. It can take three months or more to notice a change in your vision. Typically, the results are permanent, but your symptoms may come back after:
Because healthcare providers don’t know what causes the poor muscle coordination of convergence insufficiency, you can’t prevent it.
Most people who undergo eye exercise treatment for convergence insufficiency experience fewer symptoms and improved vision.
People with convergence insufficiency can go back to their normal activities immediately. With treatment, close-up activities such as reading and studying will become more comfortable.
Contact your child’s healthcare provider if they experience symptoms of convergence insufficiency when doing up-close work like reading.
If you or your child have convergence insufficiency, you may want to ask your provider:
Children being tested for attention-deficit/hyperactivity disorder (ADHD) frequently have an eye exam as part of their evaluation. The symptoms of convergence insufficiency often overlap with those of ADHD and can make it hard for children to concentrate on focused reading.
A 2005 study evaluated the link between convergence insufficiency and ADHD. This study stated that all children with an ADHD diagnosis should be examined for convergence insufficiency as well. This is because, compared to the general U.S. population, convergence insufficiency happens three times as often in children with ADHD.
A note from Cleveland Clinic
If you’re reading this on your phone and the words look wavy, blurry or have a halo effect, you may have convergence insufficiency. This common condition involves your binocular vision, which is vision using both of your eyes. Your eyes are supposed to work together as a team. When they don’t, you’re the one who’s going to suffer. While the condition often starts in childhood, it can affect adults too. Talk to your eye care provider if you think this condition may be affecting you.
Last reviewed by a Cleveland Clinic medical professional on 06/13/2023.
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