Clinical Features of Patients with Convergence Spasm

Purpose: The purpose of this study is to report clinical features of patients with convergence spasm. Methods: Four patients with convergence spasm were included in this retrospective case series. Measurements of deviation angles at near and far, ocular motility, refractive errors and best-corrected visual acuity (BCVA) were done at each visit. Results: None of the patients included in this study demonstrated any organic causes of convergence spasm, however, all of them turned out to have psychiatric problems. Mean age of patients was 8.5 years and 3 patients were male and 1 patient was female. Mean deviation angle at near was 25 prism diopter of esodeviation and the average BCVA measured by logMAR chart was 0.6 at the time of diagnosis. Mean value of refractive errors measured by auto-refraction was -6.9 diopter (spherical equivalent, SE), however, mean value of refractive errors measured by cycloplegic refraction was +1.8 D (SE). Mean duration between the time of diagnosis and achieving 20/20 of BCVA was 49 days, and the mean time of resolution of esodeviation was 53 days after the initiation of atropinization. The cessation of atropinization of the eyes was achieved at 7.5 months. Conclusions: Therapy consisted of prolonged atropinization of the eyes and plus lenses prescribed as reading glasses gave symptomatic relief in all patients of convergence spasm in this study. We recommend active referral and collaboration with psychiatrists when treating patients with convergence spasm whose disease may be functional in origin.