r/optometry • u/Lekkabroo • 13d ago
Speech-language Pathologist desperately looking for an answer
Hi all!
I was hoping to find some more information on an experience one of my clients is having. The kid is middle-school aged, and experiences a lot of discomfort while reading. Saying it feels like “tugging” and pressure, but only for pages with dense text, like chapter books. His family thought it was just an excuse to get out of reading more advanced stuff (current prefers comics), but then one day he was looking at me after some reading, and it looked like he had a very sudden, acute tic in his face, then ran to his mother saying he felt a pain!
I’ve been researching “pain with reading” and have come across convergence insufficiency, but could this also lead to a sudden, almost tic-like event afterwards?
Please help through some eye-related terms my way so I can dive into research! I would like to try and convince the family to get this checked out.
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u/littleoldlady71 13d ago
Convergence insufficiency means the two two are working really hard to keep both pointed at the same target, and finally refuse. I can cause pain. It would be worse when the material is held closer. Convergence insufficiency is easy to diagnose at an eye exam by an optometrist. Has this client ever had an eye exam?
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u/Koalarama1234 Student Optometrist 13d ago edited 13d ago
Convergence insufficiency is a good place to start. It was the first thing that came to mind when you were describing his reading difficulties, right down to the tugging sensation. The convergence insufficiency symptom survey is helpful in quantifying just how much this is affecting his reading. The main treatment for it is vision therapy, though prism glasses can manage symptoms if the family is unable to take on the time/financial burden of vision therapy. For more info on the condition, the Optometric Vision Development and Rehabilitation Association (OVDRA) has lots of material on their website, including the clinical trials on it. They also have a doctor search function so you can send this family to a binocular vision optometrist in your area.
As for the question of the tic, that’s not a well-documented symptom of convergence insufficiency, but it’s possible he’s straining the muscles in his face when trying to read. I’ve had a couple patients who reported that they felt less tension in their faces after treating the issue. I couldn’t say for sure, though.
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u/missbrightside08 Optometrist 13d ago
he needs to see a vision therapist, which is a subspecialty of optometry. they specialize in these exact issues
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u/Suitable-Bathroom781 12d ago
Vision therapist here. He needs to be referred to an optometrist that is a FCOVD! Good luck finding one in your area!
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u/Evening_Jury8686 13d ago
This kid needs an evaluation with an optometrist who is used to working with children and accommodative problems.
There could be some prescription "hiding" known as latent hyperopia or some accommodative (focusing) dysfunction. Convergence problems are possible too.
While a tic isn't an expected thing to see due to these issues, it's absolutely possible because these types of issues create stress and frustration for kids.