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

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.