Convergence Insufficiency
About 10 years ago while I was building out HelpSpot I started experiencing intermittent dizzy spells. Dizzy isn’t even the correct word, but it’s the best word I have for it. It’s somewhere between a ‘pang’ going through my eyes and feeling off balance. Not room spinning vertigo, but definitely uncomfortable.
I was working 12-16 hours a day at the time coding HelpSpot and just pushed through it. After that, there was always some reason to not deal with it. Babies, new releases, etc.
Over the past year I started to experience far more headaches than I ever had in the past, general anxiety and other physical symptoms. Driving became extremely difficult as feeling pangs of dizziness at high speed makes driving… uncomfortable :)
I have been seen by numerous doctors, ENTs, and optometrists over the years with nobody ever finding anything unusual. As I started to feel worse over the past year I became determined to figure out what was going on.
After seeing a bunch more doctors, I decided to try and find a more specialized optometrist who might be able to find something off with my eyes that all the others had missed.
It felt like a bit of a long shot, but I know I work my eyes really hard with all this close up computer work and as the more serious potential issues had been ruled out it seemed worthwhile. I ended up finding the Bernstein Center for Visual Performance in White Plains, NY about an hour from where I live.
The center specializes in weird eye stuff (my own words), unlike your local optometrist who is really only checking for your basic vision clarity (they do that also at Bernstein). In fact, even when I asked local optometrists if anything with my vision could cause these things I was always told my eyes were fine.
So, I went to the Bernstein Center somewhat desperate as I was basically out of ideas after them. After a thorough evaluation (when was the last time you spent an hour and a half with an optometrist?) it was determined I have Convergence Insufficiency along with a misalignment of my eyes.
Convergence Insufficiency is the inability of your eyes to converge together consistently. If one or both eyes move too far in/out they’re unable to focus properly on the correct place in space. This causes increased strain on your eyes, muscles, brain, etc.
Convergence Insufficiency is normally found in children as it often presents as learning disabilities. Sometimes even being misdiagnosed as ADHD or similar. But the child is not able to focus not because they have a chemical imbalance but because they literally aren’t seeing correctly.
My eyes are also about ¼ inch off from each other vertically. Nobody had ever noticed this. Not other optometrists, not my wife, not even me!
The eye level difference and the Convergence Insufficiency could cause many of the symptoms I was experiencing. That, along with an improper vision correction prescription (too strong) and bad glasses (the online store you all probably buy your glasses from) made things worse.
Having a convergence issue doesn’t mean you necessarily can’t see clearly. Optometrists who don’t detect the Convergence Insufficiency can often keep you seeing “clearly” by increasing your prescription strength, but that only further strains your eyes, brain, etc making other problems worse.
So, how to fix this? First, in the office during that first visit the doctor put me in contacts. I used to always wear contacts before starting the business at which point I went to glasses full time (the same time I started experiencing these visual issues suspiciously). Instantly, in the office that second I felt better. Not 100% better, but a noticeable difference immediately.
To actually fix the issue would require 24-44 in office visits to go through vision therapy as well as homework each night at home. I spent a lot of time looking at a pencil :)
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Yesterday I finished my 24th session and am done for now. Each one requiring a 1 hour drive back and forth to White Plains along with the 40 minute session. It’s one of those times where having a bit of flexibility in your job and an amazing team to cover your absence pays off in far more than dollars.
Those early drives down were borderline terrifying as I mentioned above, driving was a bit scary. Now, I’m able to make the drive without even thinking about it. It’s one of the more pronounced differences for me. It’s also nice to be able to do my work without constant pangs of dizziness while on the screen.
I’m still not 100% done. I do get an occasional pang, but my eyes will continue to strengthen over time. We’ll be giving it 3 months to see how things go, it’s possible I could need another round of therapy but hopefully things continue to improve just through eye use with the proper prescriptions going forward.
It’s an amazing feeling when you find out something actually is wrong with you after you’ve always been told you’re fine. That’s one of the main reason I wanted to write this post.
If you or someone you know has dizziness, headaches, trouble reading or remembering what you’ve read you may have a vision issue. Your local optometrist probably won’t find this, especially if you’re an adult. Try and find a specialist, an optometrist that offers vision therapy as a service is likely a good sign. The one at the mall isn’t going to cut it in most cases.
I also want to again point out the impact Convergence Insufficiency has on kids. By impacting their ability to read, to pay attention, even their balance systems, it can often be misdiagnosed.
In fact, the vast majority of the people I was going through vision therapy with were kids between 7-12. It was great being around them and I loved the occasional “what is that adult doing in here?” question.
I suspect this condition is under diagnosed in adults, especially knowledge workers who spend 8+ hours a day looking at a fixed distance.
If you’re seeing any of these symptoms yourself definitely find a proper optometrist and get checked out. Those of you in the NYC metro area I can’t recommend the Bernstein Center for Visual Performance enough. It’s been truly a life changing experience working with them.