Table of Contents
Convergence
Convergence Amplitudes
Near Point of Convergence
Prince Rule
Convergence
Both eyes adduct independent with each other
Accompanies accommodation (
AC/A ratio
)
Used to maintain fixation on near targets
Quantified by measuring convergence amplitudes and near point of convergence
Dysfunctional convergence is seen in Exophoria and Exotropia
When accompanies exophoria, sensory fusion may be able to be strengthened by convergence exercises
Convergence insufficiency
can occur without strabismus
Convergence Amplitudes
Testing requires sensory fusion
With a fixation target at near and distance, look through progressively larger base out prisms until diplopia occurs.
The break point is the prism value where diplopia occurs
The recovery point is the prism value where sensory fusion is re-established
Normal measurements for break point:
Near: 30Δ to 40Δ
Distance: 20Δ to 30Δ
Near Point of Convergence
Point in space directly in front of the eyes where maximal convergence is used
Practically defined as the distance from nose where diplopia occurs
Can use a Prince rule or any ruler with an accommodative target to measure
Normal near point:
4cm to 10cm
Prince Rule
Photo courtesy
AAO
strabismus