The contribution of rehabilitation in the therapeutic management of convergence insufficiency
The contribution of rehabilitation in the therapeutic management of convergence insufficiency
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Date
2025-06-02
Auteurs
DJAOUI Asma
BELHADJ Maroua
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Résumé
Convergence insufficiency is one of the most commonly encountered binocular vision disorders in ophthalmologic consultations. It is characterized by an inability to maintain adequate convergence during near vision tasks, which can disrupt sensory fusion and lead to intermittent diplopia, eyestrain (asthenopia), visual fatigue, headaches, and difficulties with near work.
Rapid screening is possible using simple tests such as the near point of convergence (NPC) test or the Convergence Insufficiency Symptom Survey (CISS). However, a comprehensive binocular vision examination is recommended if convergence insufficiency is suspected. Certain factors, such as traumatic brain injury or other neurological disorders, may be associated with this condition.
The rehabilitation of convergence insufficiency relies on a combination of convergence exercises “both home-based and office-based” that target the eye muscles coordination and strength. These methods improve clinical signs such as NPC and PFV and reduce patient symptoms. Office-based orthoptic therapy, often augmented with prisms and lenses, tends to yield better clinical improvements, though home-based exercises remain valuable, especially when combined with other therapies. The overall goal is to restore comfortable, sustained binocular vision during near tasks, enhancing patients' quality of life and reading performance
As part of this study, several clinical cases were analyzed based on individualized vision therapy programs. The main objective is to observe the progression of clinical signs and symptoms throughout the rehabilitation process and to better understand the potential role of vision therapy in the management of convergence insufficiency. Specifically, four cases were examined: one case of pseudo-convergence insufficiency and three cases of convergence insufficiency associated with accommodative excess. This analysis highlights the diversity of clinical presentations encountered in practice and underscores the value of a personalized approach to vision therapy.