In some circumstances, individuals with convergence insufficiency will also suffer from high exophoria or exotropia, meaning the eyes like to sit in an outward position. 127. 126. More advanced exercises for vergence insufficiencies include. Rutar T, Demer JL. Extraocular muscles (EOM) are surrounded by connective tissue that serve as a functional support and a mechanical pulley. They tend to be older pediatric or adult patients with new-onset or decompensated strabismus. . Sagging Eye Syndrome. Temporal GVRT was chosen for the IR and nasal GVRT for the SR. Clinical management of strabismus. Bedrossian Therapists can make this activity more advanced by increasing the amount the cards are moved (i.e. An affected patient experiences double vision when viewing distant objects, but not when viewing objects up close. However, it seems unlikely, since divergence insufficiency resolved in all 4 patients and no other neurologic problems developed during the time of each patient's follow-up of 1 month, 5.5 months, 34 months, and 44 months, respectively. will be pushed inward, making the image smaller, will be pulled outward, making the image larger, Increasing or decreasing the distance between the two. Between the polarizing glasses and the patients fusional vergence system, he or she will be asked to either converge or diverge to fuse the two partial images into one 3-D image. These patients often present with horizontal and vertical deviations. Vectograms use an approach called the SILO affect to work on increasing divergence or convergence ranges. Information obtained from direct telephone interviews with the patients and review of office records of referring physicians who continued to follow up some patients were included in the determination of follow-up. Of the 15 patients with secondary divergence insufficiency, an underlying neurologic or systemic disorder was either known or initially suspected in all based on the initial history and physical examination. Actually it's not synonymous with divergence paralysis, but it is a separate clinical entity if you would like to learn more about convergence and divergence insufficiency. In this exercise, the patient is asked to wear a pair of red/green glassesone eye sees red and the other eye sees green. The patient is also instructed to keep the words around the lines clear to control accommodation. Patients with divergence insufficiency may complain of intermittent double vision (diplopia) when looking at something in the distance, frequent "wandering" of the eyes, headaches, motion sickness, and eye fatigue that comes and goes and can vary from day-to-day depending on how tired the individual is.

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