Renatta wrote:
My 7 yr old son has just had an eye exam where the Dr. said he has convergence excess and needs eye therapy. The treatment is very costly and they also recommended readers as well. The therapy could be as long as 1 yr and I just want to make sure that this is serious enough to make this investment. I will do anything to help my son but I don’t have money to spend on something that doesn’t need to be done or isn’t as big of a concern as they have presented it to be.  Any light you can shed on this would be appreciated.
Thanks

ANSWER

Dear Renetta

You are lucky ! Your optometrist did a very good job considering that convergence excess is rarely diagnosed on time and represents the  no. 1 reason for school drop-out. Convervence excess means that your son’s eyes cross too shortly before the text he has to read. This leads to a reduced distance for reading (25 cm vs 40-50 cm). A shorter distance is very disturbing and demanding to the visual system. Imagine  seeing a computer screen at 25 cm as opposed to 60 cm where it is supposed to be. At 60 cm, a patient that suffers form convergence excess will see 2 screens (double vision). Ocular fatigue, migraine, headaches, nausea, loss of binocular vision could develop over time. It is not rare to see this condition, left untreated to lead to school failure. Most often, the student quits before graduation because their visual system cannot handle the demand.

This is why it is crucial to treat convergence excess. This treatment includes not onlyt the prescription of reading glasses (convex lenses help to reduce convergence excess) but also on orthoptics training. The visual system has to learn how to function properly even with the presence of glasses. Namely, with exercises the eyes will “learn” to converge less and to diverge more, making reading, computer work and any near visual tasks not only more comfortable but also for prolonged hours. The future at school of your son depends on the accuracy of this treatment.  Ask yourself how much money you would spend to assure a future to your chilldren and you will be able to balance  the value of the treatment that is proposed to you.

Thanks for your interest.

Dr. Langis Michaud, OD, MSc, FAAO
Associate Professor
Université de Montréal, School of Optometry

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