Convergence insufficiency is associated most commonly with an exophoria binocular posture at near, but patients with this disorder may demonstrate orthophoria or even mild esophoria at the time of their examination. The reasons for this variability are described in the following sections. In the past, many ophthalmologists considered convergence insufficiency and its associated symptoms to be a neurotic manifestation of nonrelated psychologic problems best dealt with by a psychiatrist. However, it is now clear that convergence insufficiency is a legitimate, problematic binocular dysfunction. The clinician must consider whether the behavioral manifestations displayed by patients really result from the frustration caused by their inability to perform desired near visual tasks.
Incidence increases with additional near work demand.
The most common presentation encountered by a clinician is that of a high school or college student who develops symptoms when excessive demands are placed on the visual system during extended periods of studying. Lack of sleep, illness, and anxiety are known to aggravate the problem. Headaches, fatigue, frequent loss of place when reading, and frank binocular diplopia associated with near point tasks are among the symptoms associated with this condition. No racial predilection exists for convergence insufficiency. No sexual predilection exists.