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Some cases of convergence insufficiency are successfully managed by prescription of eyeglasses, sometimes with therapeutic prisms. Pencil push-ups therapy is performed at home. The patient brings a pencil slowly to within 2–3 cm (0.79–1.18 in) of the eye just above the nose about fifteen minutes per day five times per week.
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.
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.
The Brock string is commonly employed during treatment of convergence insufficiency and other anomalies of binocular vision. It is used to develop skills of convergence as well as to disrupt suppression of one of the eyes.
Clinically, accommodative convergence is measured as a ratio of convergence, measured in prism diopters, to accommodation, measured in diopters of near demand. The patient is instructed to make a near target perfectly clear and their phoria is measured as the focusing demand on the eye is changed with lenses.
Although glasses and/or patching therapy, exercises, or prisms may reduce or help control the outward-turning eye in some children, surgery is often required. A common form of exotropia is known as " convergence insufficiency " that responds well to orthoptic vision therapy including exercises.
Convergence insufficiency – near exodeviation greater than distance deviation. These can be due to nerve, muscle, or congenital problems, or due to mechanical anomalies. Unlike exotropia, fusion is possible in this condition, causing diplopia to be uncommon.
Factors influencing stereoacuity. Optimum stereoacuity requires that the following mitigating factors be avoided: Low contrast [6] Short duration exposures (less than 500 milliseconds) [7] Fuzzy or closely spaced pattern elements. [7] Uncorrected or unequally corrected refractive errors ( monovision)
This is most commonly achieved through the use of Fresnel prisms. These slim flexible plastic prisms can be attached to the patient's glasses, or to plano glasses if the patient has no refractive error, and serve to compensate for the inward misalignment of the affected eye.
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.