Documenta Ophthalmologica

, Volume 111, Issue 2, pp 65–72 | Cite as

Asthenopia in Schoolchildren, Orthoptic and Ophthalmological Findings and Treatment

  • Saber AbdiEmail author
  • Agneta Rydberg


The aim of this study was to describe the orthoptic and ophthalmological findings in schoolchildren with asthenopia, to correlate them with asthenopic symptoms and to evaluate the effect of treatment. One hundred and twenty schoolchildren, aged 6–16 years, were included in the study. They were all referred by school nurses, for asthenopic symptoms. An orthoptic and ophthalmological assessment was performed. The main diagnoses were accommodative insufficiency, convergence insufficiency, refractive errors, and latent strabismus. Reading glasses could help 98% of the schoolchildren with reduced accommodation, and 94% of the children with refractive errors and heterophorias were helped with appropriate spherical, cylindrical and prism correction. Convergence exercise reduced the symptoms in all patients with convergence insufficiency. Ninety-three percent of all 120 schoolchildren were symptom free 3–6 month after treatment had started. By an orthoptic and ophthalmological examination abnormalities in schoolchildren with asthenopia related to visual problems can be identified. Most of the children were relieved from their symptoms by giving adequate glasses, convergence exercises and surgery.

Key words

Asthenopia accommodation convergence heterophoria and refractive errors 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    von Noorden G, Campos E. Binocular Vision and Ocular Motility, Theory and Management of Strabismus. St. Louis. The Mosby, 2002: 85–100, 150–157.Google Scholar
  2. 2.
    Mein, J, Harcourt B. Diagnosis and management of ocular motility disorders. Blackwell Scientific Publications Press, 1986: 241–53.Google Scholar
  3. 3.
    Goss, D 1986Ocular accommodation, convergence, and fixation disparityProfessional PressFairchild New York12021Google Scholar
  4. 4.
    Cooper, J, Selenow, A, Ciuffreda, KJ, Feldman, J, Faverty, J, Hokoda, SC, Silver, J 1983Reduction of asthenopia in patients with convergence insufficiency after fusional vergence trainingAm J Optom Physiol Opt609829PubMedGoogle Scholar
  5. 5.
    Sheedy, JE, Saladin, JJ 1977Phoria vergence, and fixation disparity in oculomotor problemsAm J Optom Physiol Opt544748PubMedGoogle Scholar
  6. 6.
    Sheedy, JE, Saladin, JJ 1978Association of symptoms with measures of oculomotor deficienciesAm J Optom Physiol Opt556706PubMedGoogle Scholar
  7. 7.
    Gil-Gouveia, R, Martins, IP 2003Headaches Associated with Refractive Errors: Myth or Reality?J Head and Face Pain4225662Google Scholar
  8. 8.
    Cooper, J, Feldman, J, Selenow, A, Fair, R, Buccerio, F, Macdonald, D, Levy, M 1987Reduction of asthenopia after accommodative facility trainingAm J Optom Physiol Opt644306PubMedGoogle Scholar
  9. 9.
    Sterner, B, Abrahamsson, M, Sjöström, A 1999Accommodative facility training with a long term follow up in a sample of school aged children showing accommodative dysfunctionDoc Ophthalmol9993101PubMedCrossRefGoogle Scholar
  10. 10.
    Pantano, R 1982Orthoptic treatment of convergence insufficiency: A two year follow up reportAm Orthoptic J577380Google Scholar
  11. 11.
    Bobier, WR, Sivak, JG 1983Orthoptic treatment of subjects showing slow accommodative responsesAm J Optom Physiol Opt6067887PubMedGoogle Scholar
  12. 12.
    Rouse, MW 1987Management of binocular anomalies: efficacy of vision therapy in the treatment of accommodative deficienciesAm J Optom Physiol Opt6441520PubMedGoogle Scholar
  13. 13.
    Shorter, AD, Hatch, SW 1993Vision therapy for convergence excessN Engl J Optom45513Google Scholar
  14. 14.
    Gallaway, M, Scheiman, M 1997The efficacy of vision therapy for convergence excessJ Am Optom Assoc68816PubMedGoogle Scholar
  15. 15.
    Birnbaum, MH, Soden, R, Cohen, AH 1999Efficacy of vision therapy for convergence insufficiency in an adult male populationJ Am Optom Assoc7022532PubMedGoogle Scholar
  16. 16.
    Brodney, AC, Pozil, R, Mallinson, K, Kehoe, P 2001Vision therapy in a school settingJ Behav Optom1299103Google Scholar
  17. 17.
    Borsting, E, Rouse, MW, Mitchell, GL,  et al. 2003Validity and Reliability of the Revised Convergence Insufficiency Symptoms Survey in Children Aged 9 to 18 YearsAm Aca Optom808328Google Scholar
  18. 18.
    Moutakis, K, Stigmar, G, Hall-Lindberg, J 2004Using the KM visual acuity chart for more reliable evaluation of amblyopia compared to the HVOT methodActa Ophthalmologica Scand8254751Google Scholar
  19. 19.
    Caloroso, EE, Rouse, MW 1993Clinical Management of StrabismusButterworth-HeinemannUSA14856Google Scholar
  20. 20.
    Cooper, J, Duckman, R 1978Convergence Insufficiency: Incidence, diagnosis, and treatmentAm J Optom Assoc496739Google Scholar
  21. 21.
    Mazow, ML, France, TD, Finkleman, S 1989Acute accommodative and convergence insufficiencyAm Ophthalmol Soc8715868Google Scholar
  22. 22.
    Daum, KM 1983Accommodative insufficiencyAm J Optom Physiol Opt603529PubMedGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  1. 1.Karolinska InstitutetSt. Erik’s Eye HospitalStockholmSweden
  2. 2.St. Erik’s Eye HospitalStockholmSweden

Personalised recommendations