Accommodative Vergence Dysfunction

Often referred to as accommodative convergence excess (ACE) or accommodative esotropia, is a vision disorder characterized by an imbalance between the eyes' focusing (accommodation) and converging (vergence) mechanisms. This condition typically occurs when the accommodative system overcompensates during near vision tasks, leading to excessive convergence of the eyes and resulting in various symptoms and visual issues. Here are some key characteristics and symptoms associated with accommodative vergence dysfunction

Excessive Convergence

During close-up tasks like reading, the eyes naturally converge to focus on the near object. In accommodative vergence dysfunction, the eyes converge more than necessary, leading to an esotropia, which is an inward turning of one or both eyes

Symptoms

Common symptoms of accommodative vergence dysfunction may include eye strain, double vision (diplopia), headaches, and difficulty with sustained near tasks like reading or using electronic devices. Age of Onset: Accommodative vergence dysfunction often appears in childhood, and it can persist into adulthood if not properly managed.

Causes

The exact cause of this condition can vary, but it is often associated with an imbalance between the accommodative and vergence systems. Factors that contribute to this imbalance can include a high accommodative convergence to accommodation (AC/A) ratio, uncorrected hyperopia (farsightedness), or other visual anomalies.

Diagnosis

Diagnosis is typically made through a comprehensive eye examination by an optometrist or ophthalmologist. Testing may include assessing near point of convergence (NPC), assessing the AC/A ratio, and determining the refractive error.

Treatment

Management of accommodative vergence dysfunction may involve prescription glasses or contact lenses to correct any refractive errors, such as hyperopia. Vision therapy, which includes exercises and activities to improve eye coordination and focusing, is often a primary treatment option. In some cases, prismatic lenses or prisms incorporated into glasses may be used to alleviate symptoms and encourage more balanced convergence.

It's important to seek professional care from an eye care specialist if you or your child experiences symptoms of accommodative vergence dysfunction. With the appropriate diagnosis and treatment, this condition can often be managed effectively, reducing symptoms and improving visual comfort during near tasks.