Convergence insufficiency: When and how to treat

Cheryl Lynn McCarus, Mary Louise Zimmerman Collins

Research output: Contribution to journalArticlepeer-review


Introduction and Purpose: The purpose of this paper is to identify conditions prompting consideration of therapy for convergence insufficiency, to recognize the symptoms of convergence insufficiency and the presenting complaints of adults with asthenopia. The evaluation of the patient with convergence insufficiency and the Convergence Insufficiency Symptom Score (CISS) questionnaire are reviewed. A "Trio for Treatment" is identified. The goals for the classic treatment for convergence insufficiency are highlighted. Method: The ophthalmologic and optometric literature on convergence insufficiency were reviewed including treatment modalities employed from 1850 to the present. A summary of this literature, along with historical data and current multi-centered nationwide randomized studies, provide data that concludes that under certain clinical conditions therapy for convergence insufficiency is both necessary and productive. Results of recent studies show the majority of patients reporting abatement of symptoms and a CISS score less than 16. Conclusion: Treatment of convergence insufficiency is suggested when the patient has symptoms, presents with clinical signs and has a CISS score greater than 16. Goals of treatment are to eliminate and relieve symptoms for comfortable binocular vision at near, improve the near point of convergence, increase fusional amplitudes, increase diplopia awareness, and lower the CISS score to less than 16. Success is achieved when the patient has fewer and less severe symptoms related to reading and near work.

Original languageEnglish (US)
Pages (from-to)10-13
Number of pages4
JournalAmerican Orthoptic Journal
Issue number1
StatePublished - Nov 5 2009


  • Asthenopia
  • Convergence Insufficiency Symptom Survey (CISS)
  • Convergence Insufficiency Treatment Trial (CITT)
  • Fusional amplitudes
  • Near point of convergence and convergence amplitudes

ASJC Scopus subject areas

  • Ophthalmology


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