Can anyone help?
A trip to our developmental optometrist last week revealed that my 8 year old son has convergence insufficiency (exophoria), which means that his eyes want to drift outward rather than team up to converge when he views print up close, resulting in blurred vision, eyestrain, double-vision, depending on the size and clarity of the typeface he’s reading.
Exercises will be prescribed in our follow-up appointment, which, due to the doctor’s vacation will not be until Dec. 17. A web search revealed that therapy consists of bringing a pencil forward until just before the point where the pencil splits in two and doing this repeatedly until, gradually, the child reaches his nose while maintaining a single, unblurred image. (Prisms are sometimes used also in assisting with this and it may be that computer programs are available to assist with this therapy.)
I want to get started now. The OD was in a great hurry—leaving for vacation and so is unavailable. (Only two developmental optometrists exist in my area.)
Can anyone who has experience with this therapy tell me if going ahead on my own with this simple exercise is likely to do any good? I don’t want start it and do the wrong thing. His teacher is sympathetic (LD herself and the one who suggested vision testing) and will modify the amount of his work and its physical presentation in the meantime.
(Note: Our experience underlines the importance of getting a good vision assessment done as a preliminary step in identifying LD. My son’s teacher was convinced he was ADD or LD. This condition can be mistaken for either. I was all set to proceed with psychoed. testing but am postponing until after we have results for the vision therapy. An assessment may not then be needed.)
Re: Vision therapy for insufficient convergence
Vision therapy may not have been shown by means of scientific research to improve reading. However, independent scientific research has been conclusive that vision therapy is an effective treatment for convergence insufficiency. The proof is that opthalmologists trained in orthoptics use vision therapy to treat convergence problems.
Since convergence insufficiency means the brain does not receive a clear, single image of letters and words at reading distance, it stands to reason that convergence insufficiency interferes with reading.
How old is the position paper you are talking about? My bet is that it predates the American Academy of Opthalmology’s establishment of orthoptics as a subspecialty, which legitimized vision therapy as a treatment for convergence and accommodative problems.
Nancy
Re: Vision therapy for insufficient convergence
Dear Cathy F.
I think vision therapy is definitely called for first in this case as convergence problems would definitely skew the results of any psychoed. assessment. There are no other apparent reading or learning problems; in fact my son is currently reading (with excellent comprehension) a book that is 3-4 years above his grade level, but which has a boldfaced font. He is highly motivated to read it.
My son’s teacher thinks he is gifted, but targeted the vision problem. Not knowing about the muscular problem that underlies convergence difficulty, she mentioned LDs. The psychologist with whom I had a preliminary consult returned my cheque for the assessment because it is standard to rule out vision/hearing problems first. I will proceed later my son is still having problems but I’m betting he won’t be. (Testing for giftedenss alone would be pointless as it exists as an identified exceptionality only on paper in our district.)
I’m thinking that a lot of people don’t know about this disorder. I certainly didn’t.
Jan
Dear Jan,
Does your child have trouble reading? Vision Therapy has not been shown in scientific research to improve reading. The American Academy of Optholmology and The American Academy of Pediatrics have a joint position paper stating this conclusion. If I were you I would get the LD work-up first before you waste your time and money on Vision Therapy.