Having Trouble Seeing “Up Close”? Just can’t focus?
Your overall vision may be good or bad. But when it comes to doing “up close” work, you have a problem. Maybe you haven’t even thought about it much. But it could be bringing on unwanted headaches.
Here’s what happens. Normally if you’re looking at something up close, your eyes turn closer together (converge). But some people’s eyes don’t seem to want to converge, or they don’t want to stay that way. So whatever you’re looking at becomes unclear, and/or you start seeing double.
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This is called convergence insufficiency (or convergence disorder), and it’s surprisingly common. It’s considered by some to be a leading cause of eye strain. And guess what? It can also lead to headaches.
Even if you have 20/20 vision, convergence insufficiency (CI) can be an issue. It may not be something that you are tested for at the optometrist. Sometimes there are no other symptoms at all. But sometimes it leads to misdiagnosis, which can be a particular problem in childhood.
Think about how some of these symptoms might be diagnosed: trouble catching balls, tripping and lack of coordination. Obviously, CI is not the first thing you would think of.
How about these symptoms: Difficulty reading, short attention span, trouble remembering what was read. A learning disability comes to mind, doesn’t it? Or perhaps ADHD? But what if it’s CI?
Finally, for our purposes you’ll be familiar with symptoms such as headache, motion sickness, and vertigo, which are common in various headache disorders.
Diagnosis of Convergence Insufficiency
So with all these possible symptoms which could lead to the wrong diagnosis, how do you find out if you (or your child) has CI?
If you’re reading this article and you realize you have vision problems up-close, that’s half the battle. If you’re curious about symptoms in someone else, of course you could ask them. But also watch for things like problems reading, covering or closing one eye when trying to see things up close, or avoidance of activities which require up-close work.
Once CI is suspected, a proper examination is needed. This should include taking a medical history, discussing symptoms, and especially doing tests such as convergence tests (how the eyes work together) and accommodation tests (how the eyes focus). Again, a routine exam may not find the problem.
Treatment
The good news is that proper treatment can usually solve the problem without a need for surgery, drugs, or special glasses.
However, the treatment will take time. A popular home treatment, known as “pencil push-ups”, is generally not recommended today (unless it is very closely monitored by a professional). Instead, a treatment schedule both in the clinic and at home is the first treatment to try.
In very rare cases, special glasses or surgery may be recommended. But because these treatments carry significant problems of their own, they are not used until many weeks of treatment with your doctor and at home are tried.
Remember, this may be one of many things contributing to your headaches. For some, treatment of CI may result in no more headaches. For others, headaches will continue because they are triggered by other issues.
However, because of the possible symptoms of CI and even possible future complications, as well as a possibly underlying disorder, it is wise to be tested as soon as possible if you suspect CI.
For more information:
- Convergence insufficiency article at the Mayo Clinic
- What is Convergence Insufficiency (CI)? (with links to past studies)
- The Ultimate Guide to Convergence Insufficiency (written by an optometry student, more references included)
- If you’re in the United States and have a child with CI, a study offering therapy is currently looking for participants. For more information, see Office-based Vision Therapy for Improving Reading and Attention in Children With Convergence Insufficiency