Evidence-based management of convergence insufficiency

Is convergence insufficiency (CI) diagnosed with too few clinical signs? Is management is too basic?

Share options


Of the binocular vision disorders encountered in optometric practice, convergence insufficiency (CI) is the one most likely to be diagnosed and managed within the practice setting. Clinical definitions of CI vary from simply a near point of convergence (NPC) more remote than the expected value, remote NPC with (presumed) associated symptoms to more complex diagnosis based on abnormal test values across a range of clinical tests of binocular vision and accommodation. But are we appropriately diagnosing and managing CI in UK optometric practice? From a personal perspective, it seems that CI in the UK may be diagnosed with too few clinical signs and management is too basic. This may be due to lack of equipment and familiarity with  a range of tests as well as reluctance to charge for additional time for investigation and treatment and short-term follow-up of treatment effectiveness. Where eye exercises or vision training are given there are time pressures to fit this within the sight test appointment structure. 
 Referral might be made to an orthoptics department for management where the need for more intensive vision training is determined, but this is not always the most convenient way for a patient to access services.


Login Required

Not yet a member of the College?

Start enjoying the benefits of College membership today. Take a look at what the College can offer you and view our membership categories and rates.

Read next

16 February 2016 Optometry in Practice

Visual perception in infantile nystagmus

A clinical perspective on recent developments in the field of Infantile nystagmus (IN).

18 November 2014 Optometry in Practice

Amblyopia and the relevance of uncorrected refractive error in childhood

This article provides practical advice on the detection and management of amblyopia and uncorrected refractive error in children.

30 August 2013 Optometry in Practice

Assessment of binocular vision in community practice

This article focuses on the tests used for the detection and measurement of binocular anomalies, many of which can be performed without the need for expensive or sophisticated equipment.