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Convergence insufficiency occurs when a child is unable to keep both eyes working together at a near distance 2. Children with convergence insufficiency usually have one eye turn outward while trying to focus on a word or object closer than a certain distance 2. Convergence insufficiency symptoms include double vision, headaches when reading, squinting, problems concentrating on near work and blurred vision during longer periods of reading or when tired 2. Children suspected of having convergence insufficiency should be examined by an eye doctor to assess if further treatment is necessary 2. Practicing convergence through exercises can often treat convergence insufficiency, says the American Association for Pediatric Ophthalmology and Strabismus 2.
This exercise requires a 15 foot-long piece of string and three buttons. Tie the string to a doorknob and bead the three buttons onto it so that they lie 6 inches, 18 inches and 4 feet from the untied end of the string. Have the child hold the end of the string up tight against the tip of her nose and look at the closest buttonhole. If the child’s eyes are working together correctly, she should see two strings crossing right at the opening of the first button. When the child sees the strings crossing at the buttonhole, she should keep her eyes focused there for 10 counts. She should then complete the same process for the next two buttons, repeating the entire cycle five times.
Have the child focus on one of the small letters on the side of a pencil while moving it closer to her nose. She should stop advancing the pencil once she starts to experience double vision. Pencil push-ups should be done for 15 minutes daily, at least five days a week. During one session, she should expect to repeat the exercise at least 100 times. AdvanceMed Hanford Occupational Health Services suggests adding an additional step: Have her imagine there is a tic-tac-toe board in front of her, then bring the pencil in from each box using only her eyes.
Focal Flexibility Exercise
Have the child hold her index finger close to the tip of her nose and fix her gaze on her fingertip. Next, while continuing to look at her fingertip, have her move her hand away until her arm is fully extended, then bring it back in to her nose. Repeat this exercise 20 times. This exercise can be helpful by improving the flexibility of the eye’s crystalline lenses. The eyes must shift their focus from near to far easily in order for vision to be clear. An inflexible crystalline lens can lead to eye strain and affect the eyes' ability to focus.
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