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Medical Forum / General / Vision / June 2006

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Convergence insufficiency

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engel2star@gmail.com - 10 Jun 2006 22:16 GMT
Over the past few months, I've been doing a lot of close work which has
aggravated my lazy eye (which started when i was 9 and i never got it
treated). I use the term "lazy eye" loosely, as I don't have amblyopia
as such, as the vision in my good eye is actually worse than in my lazy
eye.

I was wearing the wrong rx for the past few months - a diopter stronger
than what i should be wearing.

At a recent eye test, I got the proper rx. And since wearing my new
glasses, i've been having many headaches and squinting a lot, more at
distance than at near. Before with my stronger lenses I was squinting
more at near, as the rx was too strong for close work. My distance
vision is pretty poor now, probably because my lazy eye is not working
and needs to learn how to focus.

the orthoptist did various tests, and I have something called
convergence insufficiency. I got some eye exercises to do to get my
lazy eye to straighten, but the exercises are very tiring as well as
time consuming. Another alternative the doctor suggested is to wear
prisms. This won't really solve my squint, but it will make reading
more comfortable and since I do so much close work, i feel I really
need help to make the lazy eye focus, it often drifts off and I skip
lines and depend too much on my good eye.

Would patching the good eye help while doing close work? Or would a
prism be of real benefit?

Also, should I wear a weaker rx for close work? I can actually see ok
without my glasses for computer work, but get headaches after a while
(astigmatism) so I have to wear the glasses, but i feel i don't need to
be corrected for myopia for near work.

My eye squints more when trying to focus in the distance rather than
near.

I am mildly myopic (approx. -2) and have some astigmatism (-1  to
-1.50).

Any medical professionals out there please help! I'm at my wits ends
trying to find a solution to my problem.

Thank you.
CatmanX - 11 Jun 2006 02:03 GMT
Ha, Ha, Ha. This makes me want to laugh so much.

Your problem is so easy to fix. It takes around 5 minutes per day for
the exercises in addition to wearing the right prescription.

Your orthoptist and eye surgeon are total idiots and will not fix your
problrem. The second doctor will also not fix your problem as you will
not be fixed using prism.

You now have accommodative insufficiency as well as CI. This is why
the new glasses are hard to wear for close work.

Both issues need to be addressed.

dr grant
acemanvx@yahoo.com - 12 Jun 2006 00:02 GMT
> Ha, Ha, Ha. This makes me want to laugh so much.
>
[quoted text clipped - 11 lines]
>
> dr grant

Yea its funny how dumb some doctors are. Strong glasses are very bad
for your eyes and will make them worse, more myopic and give you nasty
headaches. For close work, its best to take your glasses off but
because you have astigmastim, consider wearing a pair of glasses that
ONLY corrects astigmastim and wear those for reading.
Neil Brooks - 12 Jun 2006 00:48 GMT
>> Ha, Ha, Ha. This makes me want to laugh so much.
>>
[quoted text clipped - 13 lines]
>
>Yea its funny how dumb some doctors are.

But dramatically more funny is how dumb some people are who are NOT
doctors, but like to pretend that they are ;-)
Dr Judy - 11 Jun 2006 17:53 GMT
> the orthoptist did various tests, and I have something called
> convergence insufficiency. I got some eye exercises to do to get my
[quoted text clipped - 12 lines]
> (astigmatism) so I have to wear the glasses, but i feel i don't need to
> be corrected for myopia for near work.

Convergence insufficiency responds well to exercises, but if you find
them too time consuming then prism will work.  Patching either eye will
eliminate the binocular demand and may help but reading with a patch on
can be very annoying.

Wearing weaker or no glasses at near will decrease accommodative
convergence thus creating a larger amount of convergence insufficiency,
so read with your glasses on (unless you are approaching or over 40).

Dr Judy
engel2star@gmail.com - 12 Jun 2006 02:49 GMT
> > the orthoptist did various tests, and I have something called
> > convergence insufficiency. I got some eye exercises to do to get my
[quoted text clipped - 23 lines]
>
> Dr Judy

Thank you very much for your reply. Wearing a patch has helped me in
the past and I din't find reading with it a burden at all, in fact I
felt quite comfortable with it as i could focus better.

The exercises should solve my problem, but I'm not that motivated to
spend half an hour a day on them. Perhaps I will ask again about the
prisms, although I've read that a lazy eye can become too dependent on
them. I suppose every case is different though.

Thanks once again for such an intelligent reply.
CatmanX - 12 Jun 2006 03:29 GMT
You don't need to spend 1/2 hour per day on it. If you do it right, it
takes 5 minutes.

dr grant
Anon E. Muss - 12 Jun 2006 05:08 GMT
[snp]

>the orthoptist did various tests, and I have something called
>convergence insufficiency. I got some eye exercises to do to get my
[quoted text clipped - 4 lines]
>need help to make the lazy eye focus, it often drifts off and I skip
>lines and depend too much on my good eye.

[snip]

>Any medical professionals out there please help! I'm at my wits ends
>trying to find a solution to my problem.

You've already been told solutions.

Convergence insufficiency (CI) is very amenable to vision therapy, and
it is definitely the first option I recommend.  A lot of patients
obtain a lot of relief, in a relatively short amount of time, doing a
minimal amount of work.  Time consuming and very tiring are relative,
but I have found a lot of relief in as little as 5-10 minutes per day
of therapy.

Your second option is prism in your glasses.  This is an option I
rarely recommend or prescribe.  While prism may be a solution, most
people become dependent on them where if they don't have their
glasses, the problem without their glasses is worse than it was before
they started using the glasses.  Also, there is a risk that you may
"eat prism", where at first, 3 prism diopters in each eye may be
enough, but then a year later the problem may return at you now need 6
prism diopters in each eye.

Check out the EMedicine article; it is geared for doctors rather than
laymen, but it is quite good:

    <http://www.emedicine.com/oph/topic553.htm>

It sounds like perhaps the cure(s) is(are) worse than the disease for
you.  I get a lot of that from many of my dry-eyed patients.  They get
prescribed therapy, are poorly compliant because it is overly time
consuming or overly burdensome (it's really not), and they come back
complaining their problem is not better.
klaatubarrata@yahoo.com - 12 Jun 2006 13:13 GMT
Find an OEP fellow OCVD optometrist in your area at OEP.org.I was
diagnosed with a severe binocularity problem.15 minutes a day of each
exercise and visits to vision therapy have yet to cure my convergence
problems or nystagmus from an aniseikonia issue.I am now back in
glasses and have horrible headaches daily.My vision has become very
cloudy in the left eye after a second surgery.This is yet to be
diagnosed.Epithelia ingrowth?
But I may have a decentered ablation and my astigmatisms (thanks
lasik)are increasing steadily 13 months now with a drifting
prescription.My eyes are too dry to tolerate contacts also and they
cannot be fitted on my damaged corneas.In fairness the macrolenses have
yet to be tried.Go lasik.Did I mention the floaters?
Now get in in your neighbors garage for 299.lol
http://lasikvision.imswebmktg.com/lasikvision/unique/87012.php?GCID=S15543x028&K
EYWORD=lasik%2Bvision

Good luck,welcome to lasik.
k8yl05@yahoo.com - 15 Jun 2006 22:41 GMT
I am having the same problem and the dr. gave me reading glasses, but
he said I didnt need to do exercises, he thinks the glasses will
correct it. Could someone please describe some of the exercises besides
pencil pushups that can correct my problem?
 
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