While not uncommon, convergence insufficiency (CI) isn’t well defined and is associated with many near-vision symptoms, making it a challenge to diagnose. In an effort to assess the uniformity of diagnostic criteria, researchers found that practitioners were using a range of criteria to diagnose CI, making it more important than ever to establish an evidence-based definition of the disease for more accurate and consistent diagnoses.1

This retrospective study evaluated the age, sex, race, age at diagnosis, past medical and family history, relevant symptoms, visual acuity, near point-of-convergence (NPC), strabismus measurements and fusional amplitudes at distance with base-out and base-in prisms of 387 CI patients.1

The team did not observe any uniformity across clinicians in the evaluation and diagnosis of patients with CI. They note that the amplitudes of NPC measurements were highly variable, and most clinicians did not assess the quality of the convergence movement or perform convergence fusional amplitude testing to diagnose CI.1

“Perhaps it is time to embrace the fact that simple CI isn't so simple, and the apparent inconsistencies in diagnostic criteria reflect different subtypes,” says Leonard J. Press, OD, the author of the study. 

1. Press LJ. Inconsistent diagnostic criteria for convergence insufficiency. JAAPOS. January 23, 2019. [Epub before print].
2. Inconsistent diagnostic criteria for convergence insufficiency. Practice Update. January 23, 2019.