Oxford University Hospitals
NHS Trust
Oxford Eye Hospital
Convergence Weakness
Eye exercise programme
Information for patients
This leaflet explains the problems associated with a weakness
of convergence and how it can be helped with a course of
eye exercises.
Convergence is the ability to direct both eyes at a near target
as it approaches. Good convergence is important for all
near tasks (such as computer work) and enables us to read
comfortably. If you have reduced convergence you may have
symptoms such as:
• blurred vision
• headaches after reading or other close work
• jumbling of print
• double vision for near tasks.
Weakness of convergence can be improved by exercises.
There are 3 stages to the exercises.
Stage 1 – Smooth convergence
• Choose a detailed target (the Orthoptist may have given
you a stick for you to attach a small picture or some
magazine print). Hold this at eye level in front of you,
at arms-length distance.
• The aim is to keep the target as one image for as long as
possible, as you bring it gradually closer.
• Slowly move the target towards your nose.
• When you see two images this means your convergence
has failed and your eyes have stopped working together.
You should try hard to join the two images by intensely
focusing. Once they have become one image again continue
bringing the target closer.
• When you are unable to join the images together for a second
time, move the target back to arms-length and
start again.
• You should aim to be able to keep a target as a single image
until it is at a minimum distance of 10cm away from your nose
– this is the normal convergence range.
• The Orthoptist may give you a ‘Dot Card’ to enhance this
exercise. They will explain how to use this.
Stage 2 – Jump convergence
This exercise helps with your ability to change focus from
a target near you to a distant target and back again.
When your smooth convergence has improved you need to move
to this exercise.
• Start with the near target at about 20cm away from your
nose. Look at this target for about 5-6 seconds. Then look at a
target in the distance for about 2-3 seconds. This target should
be about 3 metres away (on the other side of the room or out
of a window). Then look back to the near target.
• Move the near target gradually closer until you can change
focus from a near distance of around 10cm.
Stage 3 – Voluntary convergence
This is the final stage of the convergence exercises and it
teaches you to ‘cross your eyes’! This is to help you to be able to
converge your eyes without the aid of a near stimulus (target).
The Orthoptist will guide you on how to do this and may give you
one or two ‘stereogram’ cards to help you master this exercise.
You will be advised by the Orthoptist how often to carry out
the exercises. ‘Little but often’ is the best regime; practising 4-6
times a day for 1-2 minutes at a time. If you have forgotten to do
the exercises during the day, do not be tempted to ‘make up’ for
this by doing 10-15 minutes of practise in the evening – if you
do this you are likely to give yourself a headache and make your
eyes feel very uncomfortable.
Stage 3 – Voluntary convergence
Remember that, as with any form of new exercise, your eyes may feel
more tired or uncomfortable at first. This is because you are using
muscles that are not used to working as hard as they should be.
With all the above forms of convergence exercises it is important
that you relax the eye muscles you have been working at the end of
exercising by closing your eyes or looking into the far distance for a
moment or two.
Remembering to do the exercises can be more difficult than the
exercises themselves! Try to find ways of reminding yourself, for
example, leaving a note on the fridge door or setting aside time to
practise them at meal times.
If you have any problems please discuss these with the Orthoptist at
your next visit, or telephone us on 01865 234 742.
If you have a specific requirement, need an interpreter,
a document in Easy Read, another language, large print,
Braille or audio version, please call 01865 221 473
or email PALSJR@ouh.nhs.uk
Authors: Claire MacIntosh, Orthoptist
Head of Department: Stella Czypionka
February 2015
Review: February 2018
Oxford University Hospitals NHS Trust
Oxford OX3 9DU
www.ouh.nhs.uk/patient-guide/leaflets/library.aspx
OMI 11095P
