Effectiveness of Vision Therapy for Divergence Insufficiency: A Case Series.

Background: When base-out prism glasses are not successful in maintaining binocularity and eliminating symptoms in divergence insufficiency, vision therapy serves as a viable non-surgical treatment option. We report three cases of patients with divergence insufficiency who improved negative fusional...

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Published in:Optometry & Visual Performance Vol. 13; no. 4; pp. 252 - 261
Main Authors: Chhetri, Santosh, Belbase, Umesh, Cantó-Cerdán, Mario, Shah, Aashish Kant
Format: case study tables/charts Journal Article
Published: Optometric Extension Program Dec2025
Online Access:View this record in EBSCOhost
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      dt: Dec2025
      vid: 13
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      pub: Optometric Extension Program
      place: Lutherville Timonium, Maryland
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        atl: Effectiveness of Vision Therapy for Divergence Insufficiency: A Case Series.
      aug:
        au:
          Chhetri, Santosh
          Belbase, Umesh
          Cantó-Cerdán, Mario
          Shah, Aashish Kant
        affil: Metro Eye Care & Shrawan Autism Center • Butwal, Nepal
      sug:
        subj:
          Strabismus Diagnosis
          Strabismus Rehabilitation
          Therapeutic Exercise Methods
          Eye Movements Physiology
          Treatment Outcomes
          Male
          Female
          Child
          Adolescence
          Adult
          Headache Etiology
          Vision Disorders Etiology
          Diplopia Therapy
          Eyeglasses
          Stereopsis
          Magnetic Resonance Imaging
          Child: 6-12 years
          Adolescent: 13-18 years
          Adult: 19-44 years
          Male
          Female
      ab: Background: When base-out prism glasses are not successful in maintaining binocularity and eliminating symptoms in divergence insufficiency, vision therapy serves as a viable non-surgical treatment option. We report three cases of patients with divergence insufficiency who improved negative fusional vergence, eliminated symptoms, maintained binocularity, and achieved stereopsis through vision therapy. Case one: An 18-year-old female student presented with complaints of an occipital headache and occasional double vision, which was more pronounced at a distance and in the evening for the past four years. Orthoptic evaluation led to a diagnosis of divergence insufficiency. She was treated with base-out prism glasses and vision therapy. Over five months, the prism glasses were gradually weaned off, and the patient became asymptomatic with well-controlled deviation. Case two: A 35-year-old male driver had to leave his job due to double vision. He had been using prism glasses for the past ten years. However, his negative fusional vergence and prism glasses were insufficient to control the deviation. After several sessions of vision therapy, his double vision was eliminated, and he was able to resume driving. Case 3: A 12-year-old female student had headaches, usually while focusing on the board at school. She was diagnosed with left eye suppression and divergence insufficiency. After several sessions of office and home-based vision therapy, she experienced relief from symptoms and achieved binocularity and stereopsis. Conclusion: Vision therapy is a non-surgical treatment approach for divergence insufficiency and offers an effective and promising alternative to surgical intervention. These three cases highlight successful and positive outcomes in patients with divergence insufficiency.
      pubtype: Academic Journal
      doctype:
        case study
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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