• Reference Number: HEY-977/2024
• Departments: Orthoptic
• Last Updated: 1 February 2024

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 heath care team.

What is Convergence Insufficiency and Accommodation Weakness?

These conditions are linked and may exist independently or together.

Convergence Insufficiency is defined as the inability to focus an object less than 10 cm from you, or the inability to do this and maintain it without effort.

Accommodative Weakness is defined as the inability to exert the correct amount of focusing effort expected for someone of your age or the inability to maintain the correct focusing effort due to fatigue.

Your ability to converge or accommodate is controlled by muscles. The treatment available for the condition is made up of exercises to improve your ability to converge and/or accommodate by exercising these specific muscles.

Why do I need orthoptic exercises?

In some cases convergence insufficiency or accommodation weakness can cause symptoms such as headaches, eye strain and difficulty with prolonged close work. The only proven way to alleviate these symptoms is to do these exercises.

What are the possible complications or risks?

The risks of doing these exercises and causing any long term damage are very limited as long as you follow the instructions given. Overdoing or failing to relax your eyes following the exercises may lead to further complications.

Side effects during the treatment are more likely and are expected due to the nature of the problem and its subsequent treatment. These may include:

• Severe headaches
• Eye strain
• Some patients complain of nausea
• You may also feel that your symptoms are getting worse in the early stages of your treatment

These side effects in the majority of cases are only noted at the early stages of treatment. As you progress through the exercise regime the side effects fade.

What would I expect to happen?

Before undertaking the exercises it is important to understand it will take some commitment both with attendance for appointments to the Orthoptic Department and in carrying out the exercises on a daily basis as instructed.

You will need to attend the Orthoptic Department approximately once every 2 to 4 weeks and the exercises must be carried out several times a day, but for only a few minutes at a time. The emphasis is on little but often.

The types of exercises given will depend on how severe the condition is initially and the type of problem you are having. The aim of the exercises will be to improve on the amount of control you are able to exert over your eyes. It has been shown that by undertaking these exercises most patients appreciate an improvement in their symptoms.

How long will I have to do the exercises?

This is dependent on how severe the problem is to begin with and how well the exercises are done so it can vary from one patient to another. If you follow the instructions given and comply with treatment it is possible to complete the treatment regime within two months. Maintenance exercises may be prescribed after treatment has ceased to prevent recurrence of symptoms.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the Orthoptic Department 01482816605.

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.