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Convergence insufficiency may be treated with convergence exercises prescribed by an eyecare specialist trained in orthoptics or binocular vision anomalies (see: vision therapy ). Some cases of convergence insufficiency are successfully managed by prescription of eyeglasses, sometimes with therapeutic prisms .
Today, the injection of botulinum toxin into the muscles that surround the eyes is one of the available options in the management of strabismus. Other options for strabismus management are vision therapy and occlusion therapy, corrective glasses (or contact lenses) and prism glasses, and strabismus surgery .
The prism cover test ( PCT) is an objective measurement and the gold standard in measuring strabismus, i.e. ocular misalignment, or a deviation of the eye. [1] It is used by ophthalmologists and orthoptists in order to measure the vertical and horizontal deviation and includes both manifest and latent components. [1]
Vision therapy is a subset of behavioral optometry. In general, vision therapists attempt to improve the vision, and therefore day-to-day well-being, of patients using "eye exercises," prism, and lenses, with more emphasis on the patient's visual function.
Convergence insufficiency - usually associated with accommodative difficulties, the fusional convergence range of these patients is reduced. Divergence insufficiency- although rare and usually associated with a neurological condition, the PFR is able to detect a reduced divergence range.
Orthoptic exercises have proven to be effective for reducing symptoms in patients with convergence insufficiency and decompensating exophoria by improving the near-point convergence of the eyes that is necessary for binocular fusion.
The Gottlieb button prism, and the Peli superior and inferior horizontal bands are some proprietary examples of prism glasses. These high power prisms "create" artificial peripheral vision into the non-blind field for obstacle avoidance and motion detection.
Suppression of an eye is a subconscious adaptation by a person's brain to eliminate the symptoms of disorders of binocular vision such as strabismus, convergence insufficiency and aniseikonia. The brain can eliminate double vision by ignoring all or part of the image of one of the eyes.
Binasal occlusion is used in treatment of patients with sensory deficits due to complications of traumatic brain injury or having had a stroke, as well as patients with diplopia, esotropia, convergence excess, divergence insufficiency, or visual overstimulation.
Prism lenses do not address torsional misalignment and this may limit their use in certain cases. An additional consideration of prism lenses is that they must be worn at all times. Prism lenses reduce vertical fusional demands by allowing the eyes to rest in their vertically misaligned state.