Does your head hurt when you look at a book or your phone? Does your eyes get blurry? Could this be Convergence Insufficiency?

Do you get a headache when you read a book or spend a lot of time on your phone? Can you see two or three letters? Or do your eyes feel very tired? Sometimes we think of these things as normal fatigue and put them aside. But in reality, this could be a small problem with the way your eyes work together, that is, with the coordination of the eyes. In medicine, we call this Convergence Insufficiency. Let's talk about this simply today.

Simply put, what is Convergence Insufficiency?

Okay, this is very easy to understand. Imagine you are looking at your finger, and you slowly bring that finger closer to your face. What happens then? Your eyes also turn inward and focus on that finger together, right? To be precise, when we look at something close, our eyes turn inward slightly towards our nose. This process is called 'convergence'.

But when someone with Convergence Insufficiency looks at something close, their eyes don't turn inward exactly. One or both eyes turn outward a little. This means that the brain can't get a clear image. This is not a weakness in the vision of both eyes, but a problem with the coordination of the two eyes working together as a team (binocular vision).

This condition usually begins in childhood, but often goes undiagnosed until children begin to read. It can also occur in adults after a concussion.

What are the symptoms seen in this condition?

These symptoms may appear when you look at something you have, for example, a book, a tablet, or a phone. See if you have one or more of these.

Why is this happening? What is the reason?

The main reason for this is a lack of communication between the nerves and muscles that control your eyes. The important thing is that your eye muscles are healthy and not diseased. However, the muscles are not receiving the correct message from the nerves telling them to "turn inward."

In some cases, Convergence Insufficiency can also be caused by a brain injury or a neurological condition such as Parkinson's disease.

Are there any other problems that this could cause?

In addition to the inconvenience caused by this condition, several other complications can occur.

To avoid double vision, our brain does a very strange thing. The brain suppresses the image coming from one eye. It's like shutting down one eye. Because the two eyes don't work as a team, the brain tries to avoid the problem in this way. If this continues, the two eyes can become further apart and start working independently of each other. Then problems like these can occur:

• Decreased body balance and coordination.
• Inability to accurately estimate distances.
• Difficulty playing sports (especially games that involve catching a ball).
• Difficulty making eye contact when talking to someone.
• Motion sickness when traveling.

How do you find this situation exactly?

To diagnose this, you need to see an ophthalmologist or optometrist.

The important thing is that the eye test we usually do, the 20/20 chart that reads letters, cannot detect this condition of Convergence Insufficiency. Even if a person has this condition, they can still pass that normal test very well.

There is a special test to find this out. It measures how far your eyes converge when an object is brought close to your face.

What are the treatments for this?

The best and most effective treatment for this is eye movement exercises. Just like exercising to build muscles in our bodies, these exercises retrain your nervous system and teach it to keep both eyes focused on the same spot.

These exercises are usually performed in a clinic under the supervision of a specialist, and are also advised to be done at home.

Rarely, some people have to use a special type of glasses called prism glasses . These glasses redirect light rays that enter the eye, doing the job that the nerves cannot do.

In rare cases, surgery may be performed to strengthen the eye muscles. However, keep in mind that wearing regular glasses or eye patches will not cure this condition.

How quickly will I feel better after treatment?

This is not something that happens overnight. It can take three months or more to see results. But the best part is that the results are usually permanent. However, there is a small chance that symptoms may recur in cases like these:

• If you don't get enough sleep.
• If you get sick.
• If you do a lot of close-up work all at once.

Is there a connection between this and ADHD?

This is an important point for many parents. When children are being tested for Attention-Deficit/Hyperactivity Disorder (ADHD), it is recommended that they have an eye exam.

The reason for this is that the symptoms of Convergence Insufficiency (especially difficulty paying attention) and ADHD are very similar.

A study found that Convergence Insufficiency is three times more common in children with ADHD than in the general population. Therefore, it is very important to screen all children diagnosed with ADHD for this condition as well.

When should I see a doctor?

If your child shows any of the symptoms we discussed above while reading a book, studying, or doing other close-up work, be sure to see your doctor . He or she will refer you to an ophthalmologist if necessary. If you have these symptoms as an adult, don't delay in seeking medical advice.

Things to ask your doctor

• Did you perform the special test required to diagnose this condition?
• Can you refer me to someone who can provide this eye exercise treatment?
• How long does treatment take?
• Could this situation happen again?
• What should I do to prevent it from happening again?

Convergence Insufficiency Sinhala, blurred vision, headache, double vision, difficulty reading, eye diseases in children, binocular vision