Follow-up results of a combination of accommodation and convergence insufficiency in school-age children and adolescents

A follow-up over a period of 1-4.7 years was done on nine patients between the ages of 9-16 years, who had a combination of accommodation and convergence insufficiency without any known history of head trauma, febrile illness or drug use. The initial examinations disclosed exophoria and/or exotropia in near fixation, markedly low amplitudes of accommodation in both eyes, and remote near points of convergence in all patients. There was no correlation between the severity of convergence insufficiency and that of accommodative insufficiency. The extent of convergence insufficiency remained unchanged except for one patient who had a gradual and complete recovery and two other patients who underwent resection of both medial rectus muscles. The amplitude of accommodation recovered in varying degrees in six patients, while it decreased further in two other patients during the follow-up period. On initial examination, these two patients had the most remote near point of convergence (20 cm) and the lowest accommodative amplitude (less than 2 D) in common.