• Reference Number: HEY977/2026
• Departments: Orthoptic
• Last Updated: 30 September 2026

Introduction

This leaflet has been produced to give you general information about you / your child’s treatment. Most of your questions should be answered by this leaflet. It is not meant to replace the discussion with the orthoptist but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the health care team.

What is Convergence Insufficiency and Accommodative Weakness?

These conditions are linked and may exist independently or together. Convergence is the ability to move both eyes inwards together to look at a near object, for example print in a book. Accommodation is the focusing response that helps you see near objects clearly.

Convergence Insufficiency is when you are unable to bring your eyes together sufficiently for near vision, or are unable to maintain this comfortably without effort.

Accommodative Weakness is when the eyes are unable to produce or maintain the amount of focusing effort expected for your age, particularly during close work.

Your orthoptist will assess how well your eyes work together and focus at near. If exercises are appropriate, they are designed to improve your ability to converge and/or accommodate and to maintain clear, comfortable vision for close work.

Why do I need Orthoptic Exercises?

In some cases, Convergence Insufficiency or Accommodative Weakness can cause symptoms such as headaches, eye strain, blurred vision, double vision and difficulty or fatigue with reading and other prolonged close work. Symptoms may become more noticeable after periods of close work. Orthoptic exercises may be prescribed to improve control of your eyes and reduce these symptoms. Depending on your individual assessment, your orthoptist or eye care professional will advise whether any other management is appropriate.

What are the possible complications or risks?

The risk of long-term harm from these exercises is very low as long as you follow the instructions given by your orthoptist. Doing the exercises for longer or more often than advised, or not allowing your eyes to relax afterwards, may increase discomfort.

Temporary symptoms can occur during treatment, particularly when you first start the exercises. These may include:

• Headaches
• Eye strain
• Nausea in some people
• A temporary increase in your usual symptoms during the early stages of treatment

These symptoms are usually most noticeable in the early stages of treatment and should reduce as you progress. After completing your exercises, relax your eyes by looking into the distance or closing your eyes for a couple of minutes. If symptoms are severe, persist, or you are concerned, stop the exercises and contact the Orthoptic Department for advice.

What would I expect to happen?

Before undertaking the exercises, it is important to understand that treatment requires commitment both in attending appointments with the Orthoptic Department and carrying out the exercises at home as instructed.

You will usually need to attend the Orthoptic Department approximately once every 2 to 4 weeks. Exercises are generally carried out in short, frequent sessions. Your orthoptist will tell you how often and for how long to practise. Do not increase the frequency or duration unless advised.

The types of exercises given will depend on the type and severity of the problem. Your orthoptist will demonstrate the exercises that are appropriate for you and explain how to do them. They will also advise whether you should wear your glasses during the exercises. The aim is to improve the control and coordination of your eyes and/or focusing ability. Most patients experience an improvement in their symptoms when the exercises are performed regularly as advised.

How long will I have to do the exercises?

This depends on how severe the problem is to begin with and how well you respond to the exercises, so treatment length varies from one patient to another. Your orthoptist will review your progress and advise when the exercises can be reduced or stopped.

Maintenance exercises may be prescribed after treatment has ceased to help prevent recurrence of symptoms. If your symptoms return after stopping the exercises, or if your symptoms change or worsen, please contact the Orthoptic Department for advice before changing your exercise programme.

Should you require further advice on the issues contained in this leaflet, have difficulty carrying out your exercises, or have concerns about your symptoms, please contact the Orthoptic Department on Tel: 01482 816605.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.