Apart from visual observation of the tendency of the eyes to drift outward, symptoms are frequently absent [1], but when it is a constitutive feature of convergence insufficiency (CI), defined as inability to preserve normal eye alignment at near, it can present with symptoms such as eye fatigue, headaches, and double vision when attempting to perform activities that require near sight, for e.g. reading [2] [3]. CI, apart from exophoria, can be accompanied by a remote near point of convergence or decreased positive fusional vergence [3] [4]. Other symptoms that are reported in patients suffering from exophoria are the frequent loss of place when reading, print moving on the page, difficulty concentrating and a short attention span [2]. In some cases, hyperphoria - a permanent upward deviation of the visual axis of the eye, was described as well [5]. Some authors consider that severe exophoria progressively leads to intermittent exophoria, a type of strabismus and that it may develop as early as infancy [1].

• Weakness

  Rarely, this is also found to be weak. If both accommodation and convergence are weak, reading glasses, sometimes with prism added, may be a great option for these patients. It is very difficult to improve accommodation with exercises. Updated 7/2017 [aapos.org]

  In such case suppression is weak and can be usually broken in a short time. If the child has intensively trained the amblyopic eye, visual acuity may become normal within a month. [smart-optometry.com]

  However, the primary issue of exophoria is a weakness in the eye muscles. This muscle weakness causes difficulty in what is called eye-teaming, or the ability to get the eyes to work together. This generally happens in childhood. [healthline.com]

• Pain

  Closing my eyes almost always works to stop pain. But lately I have been waking with pain. Doctor DanB : K [justanswer.com]

  Certainly the muscular inconvenience can be severe and the pain may be hard to stand. With the use of lenses that correct the hypermetropiatheis unbalance is virtually eliminated and there will be a tendency to return to the original conditions. [giarre.com]

  We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: January 31, 2019 [patientslikeme.com]

• Surgical Procedure

  The most common surgical procedure performed to treat intermittent exodeviation are either bilateral lateral rectus recession or unilateral lateral rectus recession and medial rectus resection. [9] Additional Resources AAPOS website - frequently asked [eyewiki.aao.org]

• Diarrhea

  […] accommodative and convergence spasm (so-called divergence insufficiency), the general examination, including a good history, will reveal one or more of the following: irregular flushing; irregular blood pressures; nail biting; spastic colon; constipation or diarrhea [healio.com]

• Constipation

  […] findings of accommodative and convergence spasm (so-called divergence insufficiency), the general examination, including a good history, will reveal one or more of the following: irregular flushing; irregular blood pressures; nail biting; spastic colon; constipation [healio.com]

• Nausea

  Lorazepram helps to minimize and occasionally eliminate nausea. Can use odancetron if needed for nausea. Closing my eyes almost always works to stop pain. But lately I have been waking with pain. Doctor DanB : K [justanswer.com]

  Nausea and headaches are reported to be uncommon among patients with the primary form of DI, as are any history of head trauma or intracranial pathology. 8 The pattern of gradual onset is an important distinction from usually more sudden sixth-nerve palsy [reviewofophthalmology.com]

• Vomiting

  Clinical features of strabismus History-taking Red flags Recent trauma Symptoms of raised intracranial pressure (e.g. morning headaches, vomiting) New strabismus in a school-age child History of presenting complaint Onset (e.g. dependent on the direction [geekymedics.com]

• Flushing

  In many patients with the findings of accommodative and convergence spasm (so-called divergence insufficiency), the general examination, including a good history, will reveal one or more of the following: irregular flushing; irregular blood pressures; [healio.com]

• Macula

  The eye processes central vision primarily through an area called the macula located in the retina and seeing clearly is mainly through this system. However, one can also see receive visual information with their peripheral vision. [braininjuries.org]

• Muscle Weakness

  However, the primary issue of exophoria is a weakness in the eye muscles. This muscle weakness causes difficulty in what is called eye-teaming, or the ability to get the eyes to work together. This generally happens in childhood. [healthline.com]

• Neck Pain

  […] or as neck pains; inability to stay awake; and/or photophobia-burning and smarting. [healio.com]

• Strabismus

  Types of exotropia There are different forms of exotropia, let's know below what they are: congenital exotropia Congenital exophoria or divergent strabismus congenital is the one affects from birth causing childhood strabismus. [areaoftalmologica.com]

  H50.61 Brown's sheath syndrome H50.69 Other mechanical strabismus H50.8 Other specified strabismus Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes. [icd10data.com]

  Exophoria Synonym for Exophoria H00-H59 Diseases of the eye and adnexa (H00-H59)|H49-H52 Disorders of ocular muscles, binocular movement, accommodation and refraction (H49-H52)|H50 Other strabismus|H50.5 Heterophoria Results for Exophoria and additional [averbis.com]

  J Am Assoc Pediatr Ophthalmol Strabismus 1997; 1:134-137. ‎ [books.google.ro]

• Diplopia

  […] exotropes, even when they do not experience diplopia. [bjo.bmj.com]

  Sensory testing revealed uncrossed diplopia beyond 6 feet and normal correspondence. [reviewofoptometry.com]

  Active anti-suppression and diplopia awareness techniques may be used in cases of suppression. [aimu.us]

  Convergence Insufficiency (CI) is the leading cause of eyestrain, blurred vision, double vision (diplopia), and/or headaches. 1 HIGHLIGHTS: Convergence insufficiency is a common near vision problem that -- due to recent scientific research -- is gaining [convergenceinsufficiency.org]

• Esotropia

  Pagina 16 - Pediatric Eye Disease Investigator Group: The clinical spectrum of early-onset esotropia: experience of the Congenital Esotropia Observational Study. Am J Ophthalmol 133:102-108, 2001 3. ‎ [books.google.ro]

  Divergent, non-paralytic squint is less common than esotropia, particularly in infancy and childhood, and increases with age. Amblyopia is rare. [gpnotebook.co.uk]

  Consecutive Exotropia Exotropia following surgical overcorrection of esotropia called consecutive exotropia. Treatment 1.Wait atleast for six month if deviation is not much. 2. [squintmaster.com]

  Otherwise, bimedial recession is usually the procedure of choice for a consecutive esotropia, especially if the esotropia is greater at near. [eyerounds.org]

• Photophobia

  It has blurred vision and / or photophobia. In case of suspicion of exotropia, it is essential to take the child to an ophthalmologic consultation so that the pediatric ophthalmology and strabismus examine the structure deeply. [areaoftalmologica.com]

  […] amaurosis Diplopia Scotoma Color blindness Achromatopsia Dichromacy Monochromacy Nyctalopia Oguchi disease Blindness / Vision loss / Visual impairment Anopsia Hemianopsia binasal bitemporal homonymous Quadrantanopia subjective Asthenopia Hemeralopia Photophobia [worldlibrary.org]

  […] eyes; pain in or around the eyes or near use; trouble in focusing (inability to maintain near work); headache on near use and on viewing television; headache most frequently described as postoccipital or as neck pains; inability to stay awake; and/or photophobia-burning [healio.com]

  Exophoria (tendency for the eyes to turn out) Convergence Insufficiency Accommodative Insufficiency Oculomotor dysfunction Increased myopia Common Symptoms Diplopia (double vision) Blurred near vision Perceived movement of print Asthenopia Headaches Photophobia [braininjuries.org]

• Visual Impairment

  TVI's Guide to the ECC Product details · Digital pdf download: 346 pages (11 pt font) · Publisher: Teaching Students with Visual Impairments · Author: Carmen Willings · Language: English Visual Efficiency & Near Magnifier Fluency Worksheets: TVI's Guide [teachingvisuallyimpaired.com]

  impairment Anopsia Hemianopsia binasal bitemporal homonymous Quadrantanopia subjective Asthenopia Hemeralopia Photophobia Scintillating scotoma Pupil Anisocoria Argyll Robertson pupil Marcus Gunn pupil Adie syndrome Miosis Mydriasis Cycloplegia Parinaud's [worldlibrary.org]

  Sensory Exotropia • Sensory exotropia occurs as a result of unilateral or bilateral serve visual impairment. Consecutive Exotropia Exotropia following surgical overcorrection of esotropia called consecutive exotropia. [squintmaster.com]

  Goodrich, “Visual impairment and dysfunction in combat-injured servicemembers with traumatic brain injury,” Optometry and Vision Science, vol. 86, no. 7, pp. 817–825, 2009. View at: Publisher Site | Google Scholar J. A. Stelmack, T. Frith, D. [hindawi.com]

• Suggestibility

  Interpretation The uncovered eye moves inward - suggests an exophoria (i.e. the covered eye transiently moves outward when covered then corrects inward on uncovering) The uncovered eye moves outward - suggests an esophoria (i.e. the covered eye transiently [medschool.co]

  Suggest your own translation to Longdo [dict.longdo.com]

  I suggest you see an strabismus-pediatric ophthalmologist. Either ask the Eye MD you saw for a referral or go to www.aao and find one near you. [medhelp.org]

• Short Attention Span

  Other symptoms that are reported in patients suffering from exophoria are the frequent loss of place when reading, print moving on the page, difficulty concentrating and a short attention span. [symptoma.com]

  A child with undiagnosed exophoria may be diagnosed with other conditions including: ADHD learning disabilities short attention span issues dyslexia Children with undiagnosed exophoria may also be perceived as not trying in school or when reading. [healthline.com]

• Dyslexia

  A child with undiagnosed exophoria may be diagnosed with other conditions including: ADHD learning disabilities short attention span issues dyslexia Children with undiagnosed exophoria may also be perceived as not trying in school or when reading. [healthline.com]

• Headache

  Symptoms of basic esophoria include: eyestrain, headaches, blurred or double vision, apparent movement of print, and difficulty concentrating on and comprehending reading material. [naturaleyecare.com]

  Symptoms of Convergence Insufficiency (Headaches, Eyestrain, Anxiety, etc.) [convergenceinsufficiency.org]

  Symptoms of basic esophoria include: eyestrain, headaches, blurred or double vision, apparent movement of print difficulty concentrating on and comprehending reading material. [2020detroit.com]

  […] tendency of the eyes to drift outward, symptoms are frequently absent, but when it is a constitutive feature of convergence insufficiency (CI), defined as inability to preserve normal eye alignment at near, it can present with symptoms such as eye fatigue, headaches [symptoma.com]

• Difficulty Concentrating

  Symptoms of basic esophoria include: eyestrain, headaches, blurred or double vision, apparent movement of print, and difficulty concentrating on and comprehending reading material. [naturaleyecare.com]

  Symptoms of basic esophoria include: eyestrain, headaches, blurred or double vision, apparent movement of print difficulty concentrating on and comprehending reading material. [2020detroit.com]

  Other symptoms that are reported in patients suffering from exophoria are the frequent loss of place when reading, print moving on the page, difficulty concentrating and a short attention span. [symptoma.com]

  Many patients will complain that they have difficulty concentrating on near work (computer, reading, etc.) and that the written words will move around and become blurry after prolonged periods of reading. [aapos.org]

  "Convergence insufficiency (CI) is a common binocular vision disorder that is often associated with a variety of symptoms, including eyestrain, headaches, blurred vision, diplopia [double vision], sleepiness, difficulty concentrating, movement of print [convergenceinsufficiency.org]

• Vertigo

  Eyes Vision Symptoms, Testing & Treatment for ADHD, Vertigo, Anxiety, Migraines, etc. [convergenceinsufficiency.org]

  […] spilling or knocking over of objects Bumping into doors, furniture and other stationary objects Sports accidents Avoidance of eye contact Poor posture while doing activities requiring near vision Frequent head tilt Problems with motion sickness and/or vertigo [optometrists.org]

  Often movement in a crowded environment becomes quite disturbing and may cause symptoms of vertigo. This can be extremely debilitating to the patient. [braininjuries.org]

• Paresis

  Postures and Treat ments Head Posture Condition Possible Cause(s) Treatment Left head turn Right gaze preferred Left lateral rectus (LR) paresis Right medial rectus (MR) paresis Yoked prism base left Right head turn Left gaze preferred Right LR paresis [reviewofoptometry.com]

  […] diopters at distance, but only 4 to 18 prism diopters at near. 4 The importance of measuring the magnitude of alignment defect in different directions of gaze was underscored in a 1947 study, 5 allowing clinicians to distinguish between external rectus paresis [reviewofophthalmology.com]

• Dizziness

  […] result of CI— these are the most common: Eyestrain Headaches or muscle tension Blurred or double vision Difficulty reading and concentrating Uses finger or ruler when reading Avoidance of close work Poor hand-eye coordination Anxiety Motion sickness/dizziness [optometrists.org]

Physicians can make a preliminary diagnosis just by close inspection of the eyes during the physical examination, while patient history can reveal signs and symptoms that indicate problems with near vision. Some tests, however, may be employed to confirm exophoria as the cause of symptoms. Firstly, simple cover testing and evaluation of accommodation can be performed, which will provoke the outward movement of the eye in virtually all cases. The Snellen chart should not be used as a sole diagnostic method, since it may reveal completely normal findings in patients suffering from exophoria. The severity of prism diopter (PD) deviation should be examined by skilled ophthalmologists, in order to evaluate the need for correction [3].

Treatment of Convergence Insufficiency Treatments for CI can be categorized as active or passive: Active treatment : A multi-site randomized clinical trial funded by the National Eye Insitute has proven that the best treatment for convergence insufficiency [convergenceinsufficiency.org]

Treatment options. Vision therapy is an effective treatment option. [naturaleyecare.com]

In the case of reoccurrence, treatments will again correct the condition. [healthline.com]

Tenacious proximal fusion is an indicator of a good surgical prognosis. [eyewiki.aao.org]

The conclusions drawn from his data are: A high AC/A is an indicator of a poor surgical prognosis and most of these patients have a consecutive esotropia at near. Tenacious proximal fusion is an indicator of a good surgical prognosis. [eyerounds.org]

The article on "Muscle Imbalance in Myopia" by Marlow 1 in the April issue of the Archives of Ophthalmology stressed an element in the etiology of progressive myopia which has been too long overlooked. [jamanetwork.com]

Keywords: accommodation • vergence • strabismus: etiology © 2011, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. [iovs.arvojournals.org]

[…] myopia as the sole cause of exophoria Baum [8] also reported that myopia cannot be held responsible for exophoria Pascal [9] was of the view that exophoria is almost always secondary to myopia Recently Burian [10] stated that the role of myopia in the etiology [ijo.in]

Etiology The etiology of exotropia is unknown, but on a rudimentary level there is impaired ability to maintain fusion and alignment. In the case of sensory exotropia, the poor acuity of one eye is the cause of the inability to maintain alignment. [eyewiki.aao.org]

All the statistical and epidemiologic analysis was performed using the statistical software SPSS 15.0 for Windows and the EPIDAT 3.1 program. 3. [hindawi.com]

Secondary Form The epidemiology of primary and secondary form appears similar, with highest incidence among adults, but pediatric cases are reported sporadically as well. [reviewofophthalmology.com]

hyper- Upwards-deviating hypo- Downwards-deviating cyclo- Tilted or torsed about an eye’s visual axis comitant Ocular deviation present in all directions of gaze incomitant Ocular deviation only present in specific directions of gaze Aetiology and epidemiology [geekymedics.com]

EPIDEMIOLOGY Variable incidence Affects 2.25-8.3% of population Bimodal peak incidence at High school or college age, when there is an increased demand for near work Early middle age, secondary to initiation of bifocal use and decreased accommodative [webeye.ophth.uiowa.edu]

Pathophysiology of exodeviation. In: symposium on horizontal ocular deviation. St. Louis, Ed. Manley DR. 1971 Mosby-Year Book, Inc., pg 119 ↑ 9.0 9.1 Costenbader FD. The physiology and management of divergent strabismus. [eyewiki.aao.org]

Pathophysiology of exodeviation. In: symposium on horizontal ocular deviation. St. Louis, Ed. Manley DR. 1971 Mosby-Year Book, Inc., pg 119 Costenbader FD. The physiology and management of divergent strabismus. [eyerounds.org]

CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. [pointsdevue.com]

Latent vs Manifest The correct alignment of the eyes is guaranteed by normally functioning sensory and motor fusion mechanisms If sensory fusion is artificially prevented, by occlusion, distortion etc. motor fusion will be prevented and a measurable degree [slideshare.net]

Neuro-ophthalmological examination at an earlier stage could have prevented unnecessary neuroimaging and botulin injections. [bjo.bmj.com]

The symptoms I have obviously bother me, and I would consider this option to rid myself of them if therapy/prevention did not work. [medhelp.org]

1. Jung JW, Lee SY. A Comparison of the Clinical Characteristics of Intermittent Exotropia in Children and Adults. Korean J Ophthalmol. 2010;24(2):96–100.
2. Saunte JP, Holmes JM. Sustained improvement of reading symptoms following botulinum toxin A injection for convergence insufficiency. Strabismus. 2014;22(3):95-99.
3. Bade A, Boas M, Gallaway M, et al. Relationship between Clinical Signs and Symptoms of Convergence Insufficiency. Optom Vis Sci. 2013;90(9):988-995.
4. Scheiman M, Gwiazda J, Li T. Non-surgical interventions for convergence insufficiency. Cochrane Database Syst Rev. 2011;(3):CD006768.
5. Gupta NC, Narang RK, Khurana AK, Parmar IP, Ahluwalia BK. Exophoria and refractive errors-evaluation of 250 cases. Indian J Ophthalmol. 1987;35(4):204-206.