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Convergence Insufficiency Workup

  • Author: Michael J Bartiss, OD, MD; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Oct 14, 2015
 

Laboratory Studies

Usually, no laboratory studies are indicated.

Tensilon testing, acetylcholine receptor antibody titers, and single fiber electromyography (EMG) testing can be performed to differentiate convergence insufficiency from ocular myasthenia.

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Other Tests

Cover testing and accommodation testing are the basic tests used to help diagnose this condition.

Measurement of fusional convergence amplitudes at near is also helpful.

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Contributor Information and Disclosures
Author

Michael J Bartiss, OD, MD Medical Director, Ophthalmology, Family Eye Care of the Carolinas and Surgery Center of Pinehurst

Michael J Bartiss, OD, MD is a member of the following medical societies: American Academy of Ophthalmology, North Carolina Medical Society, American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

J James Rowsey, MD Former Director of Corneal Services, St Luke's Cataract and Laser Institute

J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Sigma Xi, Southern Medical Association, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Richard W Allinson, MD Associate Professor, Department of Ophthalmology, Texas A&M University Health Science Center; Senior Staff Ophthalmologist, Scott and White Clinic

Richard W Allinson, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

References
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  2. Khawam E, Abiad B, Boughannam A, Saade J, Alameddine R. Convergence Insufficiency/Divergence Insufficiency Convergence Excess/Divergence Excess: Some Facts and Fictions. Case Rep Ophthalmol Med. 2015. 2015:680474. [Medline].

  3. Danchaivijitr C, Kennard C. Diplopia and eye movement disorders. J Neurol Neurosurg Psychiatry. 2004 Dec. 75 Suppl 4:iv24-31. [Medline].

  4. Harrison RL. Loss of fusional vergence with partial loss of accommodative convergence and accommodation following head injury. Binoc Vis. 1987. 2:93.

  5. Brown B. The convergence insufficiency masquerade. Am Orthoptic J. 1990. 40:94-7.

  6. Clark TY, Clark RA. Convergence Insufficiency Symptom Survey Scores for Reading Versus Other Near Visual Activities in School-Age Children. Am J Ophthalmol. 2015 Aug 12. [Medline].

  7. Master CL, Scheiman M, Gallaway M, Goodman A, Robinson RL, Master SR, et al. Vision Diagnoses Are Common After Concussion in Adolescents. Clin Pediatr (Phila). 2015 Jul 7. [Medline].

  8. Sreenivasan V, Bobier WR. Increased onset of vergence adaptation reduces excessive accommodation during the orthoptic treatment of convergence insufficiency. Vision Res. 2015 Jun. 111 (Pt A):105-13. [Medline].

  9. Scheiman M, Rouse M, Kulp MT, Cotter S, Hertle R, Mitchell GL. Treatment of convergence insufficiency in childhood: a current perspective. Optom Vis Sci. 2009 May. 86(5):420-8. [Medline]. [Full Text].

  10. Pediatric Eye Disease Investigator Group. Effectiveness of Home-Based Therapy for Symptomatic Convergence Insufficiency. pedig.jaeb.org. Available at http://pedig.jaeb.org/Studies.aspx?RecID=205. Accessed: April 18, 2013.

  11. Hermann JS. Surgical therapy of convergence insufficiency. J Pediatr Ophthalmol Strabismus. 1981 Jan-Feb. 18(1):28-31. [Medline].

  12. Nemet P, Stolovitch C. Biased Resection of the Medial Recti: A New Surgical Approach to Convergence Insufficiency. 1990. Vol 5: 213.

  13. Alvarez TL. A pilot study of disparity vergence and near dissociated phoria in convergence insufficiency patients before vs. after vergence therapy. Front Hum Neurosci. 2015. 9:419. [Medline].

  14. Wallace DK. Treatment options for symptomatic convergence insufficiency. Arch Ophthalmol. 2008 Oct. 126(10):1455-6. [Medline].

  15. Borsting EJ, Rouse MW, Mitchell GL, Scheiman M, Cotter SA, Cooper J, et al. Validity and reliability of the revised convergence insufficiency symptom survey in children aged 9 to 18 years. Optom Vis Sci. 2003 Dec. 80(12):832-8. [Medline].

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