Do you answer “no” to the questions on vision screening forms that ask if you ever experience double vision or words moving on the page when reading? If you are like me, you’ve never experienced these symptoms that are common among patients with a binocular dysfunction. Not being able to experience this myself, I found it difficult to explain why this occurs to patients who actually have these symptoms. One of the factors to consider when educating and managing patients with binocular dysfunctions is to accurately and effectively convey what condition the patient has, how it affects their vision, and how lenses or vision therapy can help their visual quality of life. Below are a list of common binocular dysfunctions with their definition and a guide on how to explain these to your patients.
CONVERGENCE INSUFFICIENCY
- What it really means: CI involves eye movements in which the visual axes move toward each other causing the inability of the eyes to fixate accurately and stabilize a retinal image. (1)
- In layman’s terms: There is a problem with eye teaming where your eyes are not working together when looking close up. When looking up close to read, your eyes have to move inward to be able to see single.
ACCOMMODATIVE INSUFFICIENCY
- What it really means: AI interferes with the ability of the eyes to focus clearly on objects at various distances, resulting in the lack of clear retinal images. (1)
- In layman’s terms: Your eyes have a built-in focusing system that focuses in and out, similar to a camera. With this condition, there is a problem with this focusing system that causes blurred images when reading.
OCULOMOTOR DYSFUNCTION
- What it really means: Inability to perform accurate ocular pursuits, duction, version, saccades, and/or fixational eye movement patterns. (2)
- In Layman’s terms: There is a problem with your eye tracking and both eyes aren’t able to work together making it difficult to read across the page.
It’s easy to get wrapped up in the technical definitions that, in our heads, seems easy to understand because of our extensive education on binocularity. However, patients do not know the difference between convergence and accommodation, therefore, putting these terms into words they can understand is crucial to patient education and management outcomes.
(1) Care of the Patient with Accommodative and Vergence Dysfunction. American Optometric Association. [http://www.aoa.org/documents/QRG-18.pdf]
(2) Ocular Motor Dysfunction Abnormal Oculomotor Studies. College of Optometrists in Vision Development.
