obsolete convergence insufficiency or palsy

Convergence Insufficiency or Palsy: An Obsolete Term

Convergence insufficiency or palsy was an outdated term used to describe a condition where the eyes had difficulty converging, resulting in symptoms such as double vision, eye strain, and blurred vision when looking at nearby objects. This condition was characterized by a tendency of the eyes to drift outward, making it difficult for the brain to fuse the images from each eye.

Symptoms

• Double vision (diplopia)
• Eye strain (asthenopia)
• Blurred vision
• Headaches
• Movement of print while reading
• Difficulty with reading comprehension

Causes and Risk Factors

The exact cause of convergence insufficiency or palsy was not well understood, but it was believed to be related to a combination of factors, including:

• Weak eye muscles
• Psychological issues
• Presbyopia (age-related decline in vision)
• Delayed development
• Neurological anomalies

Diagnosis and Treatment

Convergence insufficiency or palsy was typically diagnosed by an ophthalmologist or orthoptist through a series of tests, including:

• Asking about symptoms
• Testing for double vision
• Using prism lenses to measure eye misalignment

Treatment involved eye movement exercises that retrained the nerves to aim the eyes properly. These exercises improved the ability of the eyes to move inward together by focusing on objects at different distances.

Note

Convergence insufficiency or palsy is no longer a commonly used term in modern ophthalmology, and the condition is now referred to as convergence insufficiency (CI). The symptoms and treatment options remain largely the same.

Convergence Insufficiency (CI) was once referred to as Convergence Palsy, but it is no longer considered an obsolete term. However, I will provide information on the signs and symptoms that were associated with this condition in the past.

The signs and symptoms of convergence insufficiency or palsy are similar to those experienced today. They include:

• Diplopia (Double Vision): People with CI may experience double vision when looking at objects close-up, such as books or smartphones [10].
• Asthenopia (Eye Strain): CI can cause eye strain and fatigue, especially after prolonged reading or near work [4].
• Headaches: Headaches are a common symptom of CI, often occurring after prolonged periods of near work [11].
• Blurred Vision: People with CI may experience blurred vision when looking at objects close-up [10].
• Movement of Print while Reading: CI can cause the print to appear to move or wobble while reading [11].
• Difficulty with Reading Comprehension: Some people with CI may experience difficulty concentrating and understanding written material [11].

It's essential to note that these symptoms are still relevant today, and convergence insufficiency is a recognized binocular vision disorder. If you're experiencing any of these symptoms, it's crucial to consult an eye care professional for proper diagnosis and treatment.

References:

[4] Symptoms of convergence excess include diplopia, headache, asthenopia (eye strain)... [10] Convergence insufficiency (CI) is a binocular vision disorder characterized by difficulty maintaining fusion while looking at a near target due to a tendency of the eyes to drift outwards. [11] What are the symptoms of convergence insufficiency? People with convergence insufficiency may experience several symptoms when reading or looking at objects close-up...

Convergence insufficiency (CI) was previously referred to as convergence palsy, but this term is now considered outdated and replaced with CI.

In the past, several diagnostic tests were used to identify convergence palsy, which are still relevant today for diagnosing convergence insufficiency. These include:

• Cover-uncover test: This test involves covering one eye while the other eye looks at a distant object, then uncovering the first eye and having it look at the same object. A significant difference in the position of the uncovered eye between near and far vision may indicate convergence palsy.
• Exodeviation test: This test measures the extent of outward deviation (exodeviation) of the eyes when looking at a near object compared to a distant object. Convergence insufficiency is characterized by increased exodeviation for near objects.
• Accommodation test: This test assesses the ability to shift focus from distant objects to near objects. Individuals with convergence insufficiency may exhibit difficulty in accommodating or focusing on near objects.

These tests were used to diagnose convergence palsy, but they are still relevant today as diagnostic tools for convergence insufficiency. However, it's essential to note that a comprehensive evaluation by an eye care professional is necessary for accurate diagnosis and treatment of CI.

References:

• [3] describes the exodeviation test as a method to determine the extent of outward drift (exodeviation) in individuals with convergence insufficiency.
• [13] mentions the cover-uncover test, exodeviation test, and accommodation test as diagnostic tools for convergence insufficiency.
• [14] discusses the incidence and prevalence of convergence insufficiency, which is a common nonstrabismic binocular visual dysfunction.

Based on the provided context, it appears that there are limited options for drug treatment of convergence insufficiency (CI) or convergence palsy.

• According to search result [7], multiple injections over several months of botulinum toxin into the medial rectus muscle have been used to reduce contracture due to a weak lateral rectus in patients with convergence palsy. However, this treatment is not specifically mentioned for convergence insufficiency.
• There is no mention of any other drug treatments for convergence insufficiency or convergence palsy in the provided search results.

It's worth noting that the majority of the search results focus on non-pharmacological treatments such as eye movement exercises, vision therapy, and orthoptic training for convergence insufficiency. These treatments are considered more effective than pharmacological interventions.

Therefore, it can be concluded that:

• There is limited evidence for drug treatment of convergence insufficiency or convergence palsy.
• Botulinum toxin injections may be used in some cases to treat convergence palsy, but this is not a standard treatment for convergence insufficiency.
• Non-pharmacological treatments such as eye movement exercises and vision therapy are considered more effective for treating convergence insufficiency.

References:

[7] Multiple injections over several months of botulinum toxin into the medial rectus muscle reduce contracture due to a weak lateral rectus from a [7].

Based on the provided context, it appears that differential diagnosis for obsolete convergence insufficiency or palsy involves several conditions. Here are some possible differentials:

• Convergence paralysis: This is a condition where there is a total lack of ability to converge the eyes, even with the use of base-out prisms (12). It can be differentiated from convergence insufficiency by the immediate onset of diplopia when using base-out prisms (14).
• Pseudo-INO: This refers to a condition that mimics internuclear ophthalmoplegia, often seen in established cases of myasthenia gravis or Guillain-Barré syndrome (5).
• Third nerve palsy: This is a condition where the third cranial nerve is affected, leading to difficulties with eye movement and convergence (5).
• Dorsal midbrain syndrome: This is a rare condition that affects the dorsal midbrain, leading to difficulties with eye movement and convergence (11).
• Internuclear ophthalmoplegia: This is a condition where there is a disruption in the connection between the two eyes, leading to difficulties with eye movement and convergence (11).

It's worth noting that these differentials may not be directly applicable to modern cases of convergence insufficiency or palsy, as the context suggests that these conditions are obsolete. However, they may still provide some insight into the underlying mechanisms and potential causes of similar conditions.

References:

• [12] Convergence paralysis can be differentiated from functional convergence insufficiency by use of base out prisms.
• [14] A patient with convergence paralysis will immediately have diplopia, while in convergence insufficiency several dioptres of convergence amplitude can be demonstrated.
• [5] Pseudo-INO: This is usually seen in established cases of myasthenia gravis, and Guillain-Barré syndrome.
• [11] Differential Diagnosis · Pseudo-INO: This is usually seen in established cases of myasthenia gravis, and Guillain-Barré syndrome. · Third nerve ...