Convergence Insufficiency (CI) is a vision problem in which it becomes hard to focus on close objects. This condition may lead to eye strain, headaches and double vision – potentially due to eye muscle imbalance, genetics or prolonged near work or trauma.
Convergence exercises can be performed successfully at home under medical supervision to treat this issue.
Pencil Pushups
Pencil pushups are an eye exercise frequently prescribed by physicians and occupational therapists to treat convergence insufficiency. With only the pencil needed to perform it, physicians find this treatment modality easy to prescribe as treatment modality.
Convergence insufficiency occurs when both eyes are misaligning to focus on close objects, leading to double vision and making reading or other tasks that require close focus more challenging. It may be caused by various causes including strabismus (crossed eyes), head injuries, medications side effects or infections in the eye or related diseases and infections.
Pencil push-ups are a simple exercise involving moving the tip of a pencil towards and away from your nose, to train the brain to use binocular vision more effectively. This treatment modality may also be combined with other therapies in order to maximize effectiveness of therapy.
One drawback of this technique is its ineffective feedback mechanism, making it hard to know if eyes are actually focused on the pencil or not. Without clear feedback it will be impossible to tell whether an exercise has had its intended results or not.
As well, pencil pushups tend to be held at arm’s length from the face, making it hard for patients to determine whether there are two pencils or whether one is in front or behind their nose. Finally, regularity of these exercises takes too much energy and time for it to reap their full benefits; which could potentially reduce them even further.
Overall, pencil pushups do not offer much in terms of treatment for convergence insufficiency as a standalone therapy option. Studies indicate that office-based vision therapy may be more beneficial. Home-based pencil pushups may be cheaper and easier to access; if prescribed by your physician however, it must only ever be part of a comprehensive vision therapy program.
Dot Cards
Dot cards are an easy and effective way to address convergence insufficiency exercises. They feature a series of dots on a piece of paper which the patient must focus on while gradually moving their eyes closer and closer towards it, with the aim being that every dot appears single rather than double until reaching the last dot on the card (X-shaped pattern). Patients should strive for every single dot before moving onto another one on their card.
This exercise should be performed four to five times every day for five minutes each time at near. Following each session it is beneficial to close your eyes and relax to help relieve any eye strain that may have occurred during or following the activity.
Jump Convergence is another variation of this exercise in which patients hold a target at some distance away and gradually bring it closer until it fuses with their nose, with the optometrist closely monitoring this exercise to make sure no suppressing or diverging occurs.
Prism exercises can be another helpful exercise, similar to Exophoria exercises, as patients hold out a prism base-out in front of their face and slowly advance it until images meld together with their nose. After this occurs, their optometrist will tell them to move back a position where fusion no longer occurs and repeat this cycle.
Vectograms are another convergence insufficiency exercise designed to expand convergence or divergence range. This can be done by placing two images of the vectogram together and asking each to converge or expand, with different shapes, colors, sizes or pictures used as added difficulty. Furthermore, changing distance between images helps develop eyes’ abilities to converge or diverge without crossing over each other – something which can be accomplished either on a computer using special software programs or at home using adjustable mirrors.
Vectograms
Vectograms (vectometery) is a visual therapy technique designed to teach patients how to use both eyes together as one team. Viewed through polarizing filters, Vectograms present one image to each eye simultaneously. Vectograms come with various degrees of disparity for training at actual working distances – stabilizing fusion, eliminating suppression and teaching simultaneous vision as well as helping develop binocular accommodative facility.
Vision therapy exercises aim to teach the eyes how to converge and diverge accurately in response to stimuli, eliminating symptoms like blurriness, headaches and double vision as a result. Exercise are initially performed to increase convergence accuracy in cases where over-convergence (convergence excess) often occurs before moving on to learn how to accurately diverge as demand increases.
To accomplish this goal, vectograms are presented to patients through polarized filters with each target labeled with its amount of prismatic demand at a given working distance. These targets can be used for convergence insufficiency, divergence insufficiency, basic esophoria and basic exophoria as they’re simple and allow therapists to quickly change working distance and adjust amount of prism needed as needed.
Vectograms can be used at close and distant distances. Common applications for convergence insufficiency, divergence excess, basic esophoria and basic esophoria typically utilize 40 cm as their distance of use; they may also be utilized at various other working distances including far. When dealing with distant vergence issues, for example distant vergence can be addressed by placing them on an overhead projector in clear horizontal holders before standing several feet away to explore degrees of freedom between accommodation and vergence.
To increase the difficulty of vectograms, therapists can cover one eye after fusion is established and wait ten seconds, breaking it and forcing the patient to regain it. Or they could use Polaroid flippers to switch polarization of slides in order to disrupt fusion, forcing patients to change how they view vectograms which alters vergence demands accordingly.
Computer Exercises
Computer exercises can be an invaluable addition to other vision therapy methods, helping train eyes to move in unison by using simple computer programs at home or work. Although less effective than in-office vision therapy sessions, computer exercises are still effective at relieving symptoms while offering great stretches for hands and wrists after long days at the office or behind a computer screen.
The most widely practiced computer exercises involve using a small picture or optotype at a fixed distance to induce eye crossing or uncrossing while stimulating vergence system; the resultant crossed and uncrossed diplopia helps strengthen both positive and negative fusional vergence.
One convergence exercise involves the merging of two incomplete images. A person must focus on a point within the picture until all aspects of it merge into one cohesive whole – often taking several months before becoming successful at doing this exercise successfully. But doing this exercise regularly can enhance one’s ability to bring near objects into focus.
Depending on their patient, therapists may employ various types of computer exercises to maximize progress. This allows greater flexibility and speeds up treatment time. Computer exercises may be performed up to three times daily for as little as two minutes at each session – always adhere to what your ophthalmologist advises!
As they begin performing exercises for convergence insufficiency, some may experience increased eye strain and headaches initially. It is normal for this sensation to subside after three months of regular practice; most often symptoms disappear completely by then.
Convergence insufficiency can be caused by several factors, including poor posture, nearsightedness, crossed eyes or stress. If left untreated properly it may result in serious complications; vision therapy is often recommended as an effective remedy.
