Convergence Insufficiency Symptom Severity Associated With Reading Function QOL

Doctor Doing an Eye Exam on His Senior Patient
Mature Gray Hair Doctor Doing an Eye Exam on His Senior Patient at the Clinic
A team of investigators assessed adults with symptomatic convergence insufficiency treated with vision therapy/exercises or base-in prism.

In adults with convergence insufficiency, worse symptom severity is associated with worse reading function quality of life, according to a study published in Optometry and Vision Science. 

Researchers enrolled 57 adults with symptomatic convergence insufficiency who were treated with vision therapy or exercises (n=35) or base-in prism (n=22). They used spearman correlation coefficients (R) to evaluate associations among clinical measures and patient-reported outcome measures (Convergence Insufficiency Symptom Survey [CISS], Diplopia Questionnaire, Adult Strabismus-20 questionnaire [AS-20]) before treatment (baseline) and at 10 weeks and 1 year after treatment. Associations were interpreted to exist only when the lower limit of the 95% confidence interval (CI) showed a moderate to strong association [R ≥0.4].

In the multiple exploratory analysis, the only moderate-to-strong baseline association was between worse CISS scores and worse AS-20 reading function scores (R =0.62; 95% CI, 0.43-0.76). A moderate-to-strong association was noted between improved CISS scores and improved AS-20 reading function scores for prism at 10 weeks (R =0.78; 95% CI, 0.52-0.91) and 1 year (R =0.85; 95% CI, 0.65-0.94), and for vision therapy or exercises at 1 year (R =0.78; 95% CI, 0.57-0.89).

“Improvements in symptoms and quality of life with base-in prism appeared to be evident sooner, reflected in gains at 10 weeks (and sustained at 1 year), whereas improvements with vision therapy/exercises appeared to continue after 10 weeks and be more apparent at the 1-year follow-up visit,” according to the researchers. “The present study confirms that adult convergence insufficiency predominantly impacts reading function quality of life (assessed using the AS-20 questionnaire), unlike other, more visually obtrusive types of strabismus that may also impact social and interaction domains.” 

Study limitations include a small sample size, inclusion of a majority of participants younger than 35 years in the vision therapy/exercise group, the absence of a control group, and failure to measure treatment compliance. 


Lorenzana IJ, Leske DA, Hatt SR, et al. Relationships among clinical factors and patient-reported outcome measures in adults with convergence insufficiency. Optom Vis Sci. Published online August 1, 2022. doi:10.1097/OPX.0000000000001929