Convergence insufficiency, ocular surface disease share symptoms

Posted on the PCON Supersite November 18, 2010
SAN FRANCISCO – Treatment of symptomatic convergence insufficiency in presbyopic patients using base-in prism resolved symptoms of ocular surface disease, a study found.

“In convergence insufficiency, there is an overlap of symptoms [with ocular surface disease]. Just because someone complains of burning, dryness and ache does not mean they have ocular surface disease; it could be related to convergence insufficiency,” Bruce A. Teitelbaum, OD, FAAO, told PRIMARY CARE OPTOMETRY NEWS here at Academy 2010.

The randomized, double-masked study enrolled 26 presbyopic patients with symptomatic convergence insufficiency who participated in a previous study to determine the efficacy of base-in prism. Patients were randomly assigned placebo glasses or treatment glasses and quantified the severity of their ocular surface disease symptoms on a scale from 0 to 4.

The ocular surface disease symptoms in the treatment group “dramatically” improved from baseline as compared to the placebo group, the study authors said. The treatment group reported a total symptom score of 2.69 compared to the baseline score of 6.42.

“Many people treat dry eye just by the symptoms. What we’re saying is that some of the symptoms may be driven by a binocular problem,” Dr. Teitelbaum said. “If therapy isn’t working in cases of mild dry eye and objectively a patient does not appear to have a dry eye, perhaps this is something to think about.”

Super Bowl Star Larry Fitzgerald Gives Parents Advice on Vision Therapy

AURORA, OH–(Marketwire – July 24, 2009) – Arizona Cardinals 2008 NFC West Champions’ wide-receiver, Larry Fitzgerald, is helping eye doctors spread the word to parents that vision problems can interfere with a child’s ability to pay attention, read and learn. “Even if you have been told your child has perfect vision or 20/20 vision, your child could still be at-risk of having a learning-related vision problem,” warns Fitzgerald.

Do you have a child who takes forever to do homework? Or hates to read? Learning-related vision problems directly affect how we learn, read, or do close work.

  The College of Optometrists in Vision Development (COVD) launched their annual campaign, August is National Children’s Vision & Learning month, to educate the public on the steps they can take to ensure their children aren’t struggling with reading and learning because of undiagnosed vision problems.

“Parents don’t realize that you need over 15 visual skills to succeed in reading, learning, sports, and in life. Seeing ’20/20′ is just one of those visual skills,” says Fitzgerald.


 During the many pre- and post-Super Bowl press interviews, Fitzgerald explained that one of the keys to his success was having vision therapy as a child. He had a vision problem that was making it difficult to pay attention in school and his grandfather, Dr. Robert Johnson, a developmental optometrist in Chicago, Illinois, diagnosed the vision problem and the appropriate treatment.

 Fitzgerald went through vision therapy under his aunt’s guidance, Dr. Stephanie Johnson-Brown, who is currently the executive director of the Plano Child Development Center, a not-for-profit vision care service corporation which was co-founded by her father, Dr. Johnson, in 1959, which specializes in vision education and the identification and remediation of vision development problems in children and adults.

 According to a report from the New Jersey Commission on Business Efficiency of the Public School, “Undiagnosed and untreated vision related learning problems are significant contributors to early reading difficulties and ultimately to special education classification.”

 Fitzgerald is joining COVD this year to help spread the word that 20/20 is NOT perfect vision and that if your children are struggling with reading you need to take them to see a developmental optometrist. You can visit COVD’s website to find a developmental optometrist near you.

 “Vision problems can have a serious impact on a child’s education. Don’t wait to see if this next school year will be better, take action today!” Fitzgerald encourages parents.

 Convergence insufficiency, one of the most common vision disorders that interferes with reading, was recently the focus of a national study funded by the National Institutes of Health and the National Eye Institute. This is a vision problem where the two eyes don’t work together in unison the way they are supposed to when one is reading. The result can make reading very difficult.

 While at least one out of every 20 school-age children is impacted by convergence insufficiency, there are other visual abnormalities to be considered. It is estimated that over 60% of problem learners have undiagnosed vision problems contributing to their difficulties.

 The good news is the majority of these vision problems can be treated with a program of optometric vision therapy. The study by the NEI found that in-office vision therapy was the best treatment for convergence insufficiency.

 The five most common signs that a vision problem may be interfering with your child’s ability to read and learn are:

1.  Skips lines, rereads lines
2.  Poor reading comprehension
3.  Takes much longer doing homework than it should take
4.  Reverses letters like b's into d's when reading
5.  Has a short attention span with reading and schoolwork
Any one of these symptoms is a sign of a possible vision problem.  

Not all eye doctors test for learning-related vision problems, so it is important for parents to ask the right questions. Call your eye doctor’s office and ask the following two questions:

1.  Do you test for learning-related vision problems?
2.  Do you provide an in-office vision therapy program when indicated, or
     will you refer me to someone who does?