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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.
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.
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.
Signs and symptoms. Though present from birth, symptoms of congenital fourth cranial nerve palsy may start as subtle and increase with age. Hence, diagnosis by a healthcare practitioner may not be made until later childhood or adulthood.
Prism spectacles incorporate higher power prisms, with variable shapes and designs. The Gottlieb button prism, and the Peli superior and inferior horizontal bands are some proprietary examples of prism glasses.
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.