Review Article

A review exploring convergence insufficiency in younger populations and e-devices in the digital era

Renaishia Pillay, Alvin J. Munsamy
African Vision and Eye Health | Vol 80, No 1 | a623 | DOI: | © 2021 Renaishia Pillay, Alvin J. Munsamy | This work is licensed under CC Attribution 4.0
Submitted: 17 October 2020 | Published: 14 June 2021

About the author(s)

Renaishia Pillay, Discipline of Optometry, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Alvin J. Munsamy, Discipline of Optometry, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa


Background: The advancement of the fourth industrial revolution has increased the penetrance of e-devices among younger populations, particularly with e-learning technology which has become widespread due to special circumstances such as the coronavirus disease 2019 (COVID-19) pandemic.

Aim: The purpose of this review is to explore the prevalence of convergence insufficiency (CI) in younger populations and to map any associations between CI, near work and e-device usage.

Method: A comprehensive literature search was conducted using Elsevier, PubMed, Medline and Ebscohost databases. The literature search used the following keywords in various combinations: ‘Convergence Insufficiency’, ‘Binocular vision status of primary school children’, ‘E-learning’, ‘M-learning’, ‘Computer vision syndrome’, ‘Digital eye syndrome’, ‘E-devices and children’.

Results: The observed prevalence of CI ranges from 5.46% to 13.00% among non-clinical studies and from 3.50% to 18.00% among clinical studies. The prevalence among primary school children ranges from 6.80% to 31.40% whilst CI among high school children may be as prevalent as 32.60%, depending on the diagnostic criteria employed. There is mixed evidence showing the association between screen time and myopia. No studies were identified showing a direct association between CI and e-device use.

Conclusion: Convergence insufficiency has proven to be a prevalent condition among both young children and young adult populations. There is a need for studies to investigate the prevalence of CI in younger populations who learn in a digital environment. This may highlight exposure to the modifiable factor of screen time in managing the condition in the context of a tech-infused lifestyle.


convergence insufficiency; binocular vision disorders; e-learning; digital eye strain; computer vision syndrome; primary school children


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