Vision Library

How Convergence Insufficiency Can Sometimes Act Like ADHD

If your child has trouble focusing on reading, writing, or a homework assignment for more than 15 minutes at a time, you have probably been told that his or her symptoms suggest Attention Deficit Hyperactivity Disorder (ADHD) as the underlying cause. However, with symptoms that often are similar to each other, vision disorders in children may sometimes be misdiagnosed as ADHD.

Convergence insufficiency is a common visual disorder which affects the coordination of the eyes. An estimated 1 in 20 children suffer from convergence insufficiency. But, what is convergence insufficiency? First, let me explain the concept of convergence: When reading, writing, drawing, or doing other work that requires up-close attention, a person’s eyes must turn in, or converge, in order for the image of the work to be clear.

Convergence happens smoothly and subconsciously in those without convergence insufficiency. However, those who suffer from the disorder have difficulty turning their eyes inward. As a result, conscious effort must be made to focus on close objects, which is very tiring.

Have you ever crossed your eyes? Imagine feeling like you had to do that in order to read, and imagine being expected to maintain that focus for minutes or even hours at a time. This is how reading feels to those with convergence insufficiency. It’s no wonder they have difficulty focusing on their work!

This extra exertion, naturally, causes a number of uncomfortable symptoms, such as eyestrain, headaches and blurred vision. Children with convergence insufficiency may experience difficulty concentrating, read slowly, read the same line repeatedly, have trouble remembering what they read, or frequently lose their place. This may result in inattentiveness at school and while completing homework, or a general avoidance of such close work.

Here’s the problem: To a parent, or even a medical practitioner, all of these symptoms suggest ADHD. Those with convergence insufficiency may even have 20/20 vision, further complicating diagnoses. In a 2000 study, it was demonstrated that children diagnosed with ADHD are three times more likely to have convergence insufficiency than children who have not been so diagnosed. Clearly, there is reason to believe that some of those children would not need ADHD medications if their struggle with convergence insufficiency was to be fully addressed and treated.

This is why we recommend the following: If your child has been diagnosed with ADHD, or is exhibiting some of the signs of convergence insufficiency or ADHD, a thorough developmental vision exam by a developmental optometrist should be your first step in treating the disorder. It’s a decision that could save your child the stigma of being diagnosed with ADHD, and save you money on medications.


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