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The symptoms and signs associated with convergence insufficiency are related to prolonged, visually demanding, near-centered tasks. They may include, but are not limited to, diplopia (double vision), asthenopia (eye strain), transient blurred vision, difficulty sustaining near-visual function, abnormal fatigue, headache, and abnormal postural adaptation, among others.
Apart from testing binocular functions, Bagolini striated glasses can measure cyclotropia.The principle of the test is similar to that of double Maddox rod test. The glasses are placed in the trial frames with the striations vertical, giving rise to two horizontal line images when viewing a spotlight.
Listing's law, however, does not account for all cyclorotations. In particular, in the presence of cyclodisparity (that is, when two images are presented which would need to be rotated in relation to each other in order to allow visual fusion to take place), the eyes perform cyclovergence, rotating around their gaze directions in opposite directions, as a motor response to cyclodisparity.
Ophthalmoplegia (the inability or difficulty to move the eye) is usually symmetrical, therefore, patients are not affected by diplopia (double vision). The progressive ophthalmoplegia is often unnoticed till decreased ocular motility limits peripheral vision. Often someone else will point out the ocular disturbance to the patient.
diplopia or double vision - more seen in adults (maturity / plasticity of neural pathways) and suppression mechanisms of the brain in sorting out the images from the two eyes. cyclotropia , a cyclotorsional deviation of the eyes (rotation around the visual axis), particularly when the root cause is an oblique muscle paresis causing the hypertropia.
During an eye examination, the presence of suppression and the size and location of the suppression scotoma may be the Worth 4 dot test (a subjective test that is considered to be the most precise suppression test), or with other subjective tests such as the Bagolini striated lens test, or with objective tests such as the 4 prism base out test.