Q: I just read a letter in Dear Abby about a lady with problems reading comfortably, and it sounded just like me. How common is this, and is age a factor?
A: I also read those advice columns, you could not make this stuff up! The case you mention is relatively common and not “age-related.” Many people find reading for a long time tiresome or uncomfortable. Some people even have double vision while reading. Some researchers believe that underlying eye problems may cause “reading avoidance” and learning problems.
We commonly see patients whose glasses prescription is correct for each eye, but there has been no testing or prescribing for how your two eyes work together. This “eye teaming” or binocularity is critical for effortless and comfortable reading. The specific condition you mention is called “convergence insufficiency.” When we read, our eyes automatically do three things: turn inward ( convergence ) to align on a letter or word at a close distance, and our internal eye muscles contract or “work” to change our focus from distance to near.
( accommodation ), and our pupils constrict a little ( miosis ). Only the first two affect our reading skills.
A thorough eye examination should include testing to determine if your eyes converge and align as a precise team for close work. We can measure how much your eyes converge or turn inward to align for reading correctly. Deficiencies in your binocularity can be compensated by using “prism” lenses. These contain your Rx for seeing clearly and additional corrections to make your eye alignment accurate and easy.
Then step two is to be sure that your eyeglass lens lab fabricates your lenses to match your eye alignment measurements exactly. I suppose this is commonly missed these days by optical laboratories due to cost time or lack of care. Having the right prescription for each lens is only part of restoring clear and comfortable vision.
While we do find these binocularity disorders in patients of any age, they are more likely found in children because it has been noted they are not keeping up with the other children in reading speed or comprehension. Usually, a teacher or parent will bring the child in because of this reading problem. No one is checking for adults, so it would be up to you to ensure your eye exam is thorough enough to find binocularity disorders.
Lastly, I should add that over-the-counter “readers” never include prism correction. Readers always have the same Rx in each lens ( while real people are usually not identical ) and never include correction for astigmatism, the most common vision disorder of all. So be sure you get a comprehensive vision exam and that your glasses are made accurately. Reading should be easy and enjoyable!
