Original Research

Evaluation of convergence, accommodation and fusional vergence in pre-presbyopes with asthenopia

Saif H. Alrasheed, Saeed Aljohani
African Vision and Eye Health | Vol 83, No 1 | a863 | DOI: https://doi.org/10.4102/aveh.v83i1.863 | © 2024 Saif H. Alrasheed, Saeed Aljohani | This work is licensed under CC Attribution 4.0
Submitted: 05 May 2023 | Published: 16 April 2024

About the author(s)

Saif H. Alrasheed, Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia; and Department of Binocular Vision, Faculty of Optometry and Visual Sciences, Al-Neelain University, Khartoum, Sudan
Saeed Aljohani, Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia


Background: Pre-presbyopes may suffer from ocular symptoms such as asthenopia of near work.

Aim: This study aimed to evaluate near points of convergence, amplitudes of accommodation, and fusional vergence among pre-presbyopes with asthenopia symptoms.

Setting: The study was conducted at El-Walidain Eye Hospital, Khartoum, Sudan in 2022.

Methods: The study was a hospital-based prospective, including 107 pre-presbyopes aged 35–40 years who complained of asthenopia symptoms. Clinical examinations included an assessment of amplitude of accommodation, near point of convergence and fusional vergence.

Results: The findings showed receded in near points of convergence and a decrease in the accommodation was highly significantly associated with increased age among emerging presbyopes with asthenopia symptoms (p = 0.0001). Conversely, positive and negative fusional vergence amplitudes were not significantly correlated with age with p = 0.109 and p = 0.355, respectively. Positive and negative fusional amplitudes were not significantly different between males and females (p ˃ 0.05). Esophoria was more common in pre-presbyopia 62 (57.4%) and exophoria 45 (43.6) with p = 0.503.

Conclusion: The pre-presbyopes presented with low accommodation amplitude and receded near point of convergence, but without significant changes in positive and negative fusional vergence amplitudes.

Contribution: This study added by demonstrating how early presbyopia altered accommodation amplitude and near point of convergence significantly while having no significant impact on amplitudes of positive and negative fusional vergence.


presbyopia; accommodation anomalies; symptoms; insufficiency; fusional vergence; esophoria.

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