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Surgical correction options are also available, but the decision to proceed with surgery should be made with caution as convergence insufficiency generally does not improve with surgery. Bilateral medial rectus resection is the preferred type of surgery.
A common form of exotropia is known as "convergence insufficiency" that responds well to orthoptic vision therapy including exercises. This disorder is characterized by an inability of the eyes to work together when used for near viewing, such as reading.
In a small-scale study, adults whose reading difficulties due to convergence insufficiency had been unsuccessfully addressed by convergence exercises, base-in prism glasses or strabismus surgery showed improved reading after botulinum toxin therapy, maintaining improved reading remaining also after six months.
Strabismus surgery attempts to align the eyes by shortening, lengthening, or changing the position of one or more of the extraocular eye muscles. The procedure can typically be performed in about an hour, and requires about six to eight weeks for recovery.
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.
These include those aimed at convergence insufficiency – where it is often termed "vergence therapy" or "orthoptic therapy" – and at a variety of neurological, educational and spatial difficulties.
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Strabismus surgery itself does not improve visual acuity. Stereopsis following training procedures. 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 progressive ophthalmoplegia is often unnoticed till decreased ocular motility limits peripheral vision. Often someone else will point out the ocular disturbance to the patient. Patients will move their heads to adjust for the loss of peripheral vision caused by inability to abduct or adduct the eye.
For children, there is evidence that orthoptics is more effective at treating convergence insufficiency than home-based pencil or computer training; for adults the effectiveness is less evident. History. Orthoptics has a long history in supporting ophthalmic care.