convergence

**This post is mainly for family, or those of you who love our Grantster.  It’s an explanation of some of the vision problems he has, as well as a description of what we’re going to do about them.

We’ve known Grant’s eyesight was poor since his kindergarten screening, right before he turned 5.  It’s been almost 3 years since he got his first pair of glasses.  Unfortunately, until today, I haven’t really felt satisfied with any eye doctor we’ve seen.  And until today, we’ve never really had a full explanation for Grant’s poor eyesight.   I am feeling incredibly blessed with the doctor we now have, and excited that there is a plan to help Grant see 20/20!

Grant’s first issue is that he has pretty severe astigmatism in both eyes. A person’s eye is naturally spherical in shape. Under normal circumstances, when light enters the eye, it refracts evenly, creating a clear view of the object. But in the eye of a person with astigmatism, it is shaped more like a football or the back of a spoon. So for Grant, when light enters his eye it is refracted more in one direction than the other, allowing only part of the object to be in focus at one time. Objects at any distance can appear blurry and wavy.  We’ve known about this issue since Grant was 5 and he’s always worn glasses to correct this problem.

The new issue, that we found out about today, is that Grant struggles using both eyes as a team.  He does not have adequate convergence.  His right eye is so poor that when he focuses on something, the left eye zooms in, while the right eye goes just a bit off to the side.  Basically, the brain has been trained not to use the right eye much, if at all, when Grant is looking at something closely.  The ability to use both eyes simultaneously is one of the most critical visual skills.  Most likely this issue goes back to when Grant was a baby.  There was just no way for us to know that then.  This issue can cause problems with coordination and depth perception and, usually, causes children to struggle with reading.  Amazingly, Grant is a great reader!  (I am really looking forward to what he will be able to do when this problem is solved!)  Here is some information about how convergence usually affects reading skills:

  • During the act of reading, the demand is for the two eyes to turn inward so that they are aimed at the reading task. If the eyes have a tendency to deviate outward, the child must use excess effort and energy to maintain fixation on the reading task. Most studies have shown that the greater the amount of effort involved in reading, the lower will be the comprehension and the lower will be the performance. When reading, the eyes do not move smoothly over a line of print. Rather, they make a series of fixations looking from word to word. When an exophoria exists, each time fixation is broken and moved to the next word, the eyes will tend to deviate outwards and they must be brought back in to regain fixation. Human nature being what it is, the child generally has an avoidance reaction to the reading task. This is compounded by the fact that anything the child doesn’t do well, he would rather not do. This is the child who looks out the window rather than paying visual attention. He is commonly given labels. He is often accused of having a short attention span and not trying. He is told that he would do better if he tried harder, but he has tried harder to no avail. He is often labeled as having dyslexia. Commonly, he loses his place while reading and/or uses his finger or a marker to maintain his place. While making the eye movements during the act of reading, he might not land on the next word, but rather land a few words further on. Consequently, he commonly omits small words or confuses small words. Often, he just adds a word or two to make the sentence make sense. Don’t expect a child to tell you that his vision isn’t clear. He has no yardstick of comparison to inform him that his vision differs from the vision of anyone else.

Although Grant reads well, I do see signs of his convergence issue when he reads.  He has to mark words/lines with his finger or a bookmark, and often looses his place or skips words.  He will also add words to make sentences complete.  Grant has also struggled with writing letters and numbers backwards.  We think this could be a symptom of his vision problems as well.

So the course of action we’ve chosen is to put him in a new pair of glasses, with a bi-focal for the right eye.  We will also do eye exercises to improve Grant’s convergence.  In 3 months he will be evaluated again to see if more needs to be done.  Because Grant is already almost 8, there is a chance his brain is so trained to “turn off” his right eye that we won’t be able to get him seeing 20/20.  But the doctor did say there is a good chance this can be reversed with the right glasses and exercises.  I was pleased to hear the doctor say that his goal is to have Grant seeing 20/20 (with glasses)  in the next year.

I can’t wait to see how Grant’s life is going to improve!  Imagine living 8 years with terrible vision and then suddenly being able to see the world in all it’s glory!  It is going to be wonderful for him.  I’m so thankful that the issue has been identified and that we are with this particular doctor.  God is so good!

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5 thoughts on “convergence

  1. The good thing is that you are on top of this and are catching it while he is young. Sounds like your new doctor has a good understanding and plan as to what’s going on. Amazing what the human body does to compensate for weaknesses in one area of the body. I will be waiting to hear about his progress!

  2. What a relief to know what is going on! I’m so glad you found an optometrist you like and trust. Praying for Grant’s progress! God IS good. 🙂

  3. I am so thankful as well. I hope he takes well to the exercises and also notices an immediate improvement with the new glasses.

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