Convergence Insufficiency

What is convergence insufficiency?

This condition is one of the most frequently occurring binocular problems.

It is diagnosed when there is an inability to obtain, or to maintain, adequate binocular convergence with comfort, without undue effort.

It is most apparent for prolonged near tasks such as reading, writing, computer, and gaming.

This is not a “muscle problem”; it is not that the child cannot turn either eye inwards at all. They are unable to turn both eyes inwards together, and sustain this posture. As the visual system fatigues the brain may allow one eye to drift out. One of the reasons for this may be that the child had never perfected this ability.

With the commencement of school work and learning to read, this problem becomes more apparent. Such children generally have very few visual symptoms.

These children do however, have poorer fine eye-hand and visual motor skills and will tend to avoid near-centred tasks as they have difficulty attending to these. They may also require more tactile involvement (feeling) in learning about their world than would be expected for their age.

Young girl with hand in a heart shape around eye


  • Difficulty sustaining attention at visually demanding tasks.
  • Visual fatigue or stress symptoms such as red eyes, sore eyes, frontal or temporal headaches, transient near and/or distance blur.
  • Double vision or the letters moving or running (swirling)·
  • Abnormal postural adaptations when trying to centre on near tasks, including head tilting or holding their work very close.
  • General fatigue and orbital pain around the eyes.


If the child has never refined this ability, then Optometric Visual Therapy will be required, and in such cases spectacle lenses are usually not required.

If age and symptoms make it necessary, spectacles with focus, prisms or Irlen tints may be prescribed to reduce the visual fatigue.

Acquired Convergence Insufficiency is a common symptom following concussion and/or brain injury.

This however is often part of a cluster of oculomotor, accommodative, and binocular/vergence dysfunction.

Book an appointment with Mark Eagle to investigate this further.

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Young girl with hand in a heart shape around eye