Eye coordination challenges can indicate a vision disorder called convergence insufficiency (CI) that may be common among people living with ADHD.

Attention deficit hyperactivity disorder (ADHD) refers to ongoing patterns of inattention, hyperactivity, and impulsivity that can cause challenges in everyday function.

The prominent symptoms of ADHD are behavioral, but living with ADHD may increase the chances of experiencing conditions that have nothing to do with your mannerisms.

Convergence insufficiency (CI) is one example of a physical condition that may be more prevalent among people living with ADHD.

Convergence insufficiency (CI) is a vision disorder of improper eye coordination when focusing on something up close.

The nearer an object is to you, the more inward your eyes need to turn (converge) to focus on it. In convergence insufficiency, one of your eyes turns out instead of in.

CI symptoms

When your eyes can’t coordinate at a comfortable level, it can result in a number of symptoms, such as:

People living with ADHD may be more likely to experience CI.

In 2005, a landmark retrospective study found that children living with ADHD experienced CI at three times the rate of neurotypical children. Researchers also noted that people living with CI had a three-fold greater incidence of ADHD.

Since that time, research has continued to find a correlation between CI and ADHD.

A 2020 case-control study assessing common vision challenges found children living with ADHD showed significant near-point convergence issues compared to neurotypical children.

In 2022, a systematic review and meta-analysis of more than 70 studies with over 3 million participants concluded that the existing evidence supports an association between ADHD and CI.

How common is CI in ADHD?

The exact rate of CI among people with ADHD is unknown. Research suggests prevalence may range from 15.9% to 41.9% or higher.

Among the general population, the prevalence of CI among school-age children is between 2% and 13%, with slightly higher rates for those over the age of 19 years.

Can CI lead to ADHD?

There’s no evidence that shows CI causes ADHD.

Currently, ADHD is believed to be related to alterations in brain structures and neural pathways responsible for your executive functions.

While the exact cause of convergence insufficiency is unknown, it may also be linked to changes in the brain and is commonly seen following brain injury or concussion.

ADHD and CI may share underlying pathology, but they’re not currently believed to be causes of one another.

The symptoms of CI can look like signs of inattention or distraction, particularly in young children who aren’t capable of communicating vision challenges.

Blurred vision, eyestrain, and poor concentration from CI, for example, can cause children to want to walk away from tasks, avoid certain activities, or let their attention wander.

These behaviors mirror those seen in ADHD, but they ultimately stem from visual discomfort, not a neurodevelopmental disorder.

If you live with ADHD and CI, convergence insufficiency discomfort may make ADHD symptoms appear worse.

Why is an eye exam part of an ADHD diagnosis?

In addition to specific patterns of inattention, hyperactivity, and impulsivity, ADHD is diagnosed when no other condition can explain your symptoms.

An eye exam is part of an ADHD diagnosis because it helps rule out conditions like CI that may cause ADHD-like symptoms.

In order to receive an ADHD diagnosis, you’ll likely experience a variety of exams, lab work, and tests to rule out other possible conditions.

As a visual disorder, CI is treated through specialized visual exercises. Your eye doctor will teach you convergence exercises that you can do at home to help retrain the muscles of your eyes.

Many people who stick to their eye exercise program experience permanent convergence improvement after about 12 weeks.

While you progress through your visual exercises, specialized lenses called prism glasses can help compensate for the vision differences in your eyes.

In rare cases, surgery may be necessary to correct ineffective eye muscles.

ADHD is not treated using convergence exercises. As a condition widely regarded to be a type of neurodivergence rather than a disorder, ADHD treatment is focused on providing support and teaching skills that can help improve overall function.

ADHD treatment may include medications to help relieve distressing symptoms, but these are almost always used in conjunction with psychosocial methods such as:

If you live with ADHD and CI, your treatment will involve methods specific to each condition.

Living with ADHD may increase the chances of living with convergence insufficiency, a visual disorder affecting your eye coordination.

While CI won’t cause ADHD, it may be misdiagnosed as ADHD due to visual discomfort that’s perceived as inattention or distraction.

If you’ve been diagnosed with CI, visual exercises can help. They can be done alongside ADHD treatment which typically involves medication and psychosocial therapies.