Dr. Shalu Pal

  • "If you want quality and wonderful service, please go to Dr. Shalu Pal! The patience, care, and true concern that Dr. Pal has for her clients is wonderful. "

    --Seleena J
  • " I was pleasantly surprised by finding a hidden gem within Dr. Pal's office"

  • "Finally a doctor who is extremely knowledgeable, patient and explains things clearly. She is a wonderful human being who really takes the time to care for your needs. The office has a wonderful atmosphere and the staff are just as helpful as Dr. Pal. "

  • "I couldn't ask for a better Optometrist. She is a delight to deal with, very patient, helpful and extremely knowledgeable. She was very good with my kids who can be very fussy at times.. And who could ask for a more beautiful location. Highly Recommend! "

    --Natalie M.
  • "My wife and I, highly recommend Dr. Pal. The staff, the service, the merchandise, are all top notch. They really make you feel welcomed. It has been several years since I have been able to see this well !!! You and your staff are the best !!!! "

    --Steve and Maria L.
  • "We barely go to optometrists so when we do, we should look for the best! I am super pleased I chose Dr. Pal\'s office. They were helpful from beginning to end, from booking on the phone to my actual visit. Dr. Pal was very detailed and went in-depth about my eye health. She is very patient and made me feel calm. The optician helped me pick a great pair of glasses, they were genuinely friendly which is a huge bonus."

    --Ahmad S
  • "I have been going to Dr. Pal for several years now. My most recent visit on June 6, 2016 was the best experience there that I have ever had. Firstly, the women on the desk were friendly and efficient - a very good prelude to my examination. Dr. Pal, herself, was, as usual, very thorough and encouraging in her examination. And she puts you at ease before we get into the eyes examination by discussing other things in life. That helps to ease any stress I may have. And they now have a man in the office who does that difficult examination (name of which I do not know!). He is so patient and encouraging and made the exam not so difficult for me this time. After all that, I saw Dr. Pal again before I left and she told me my eyes were good! Even had the news been not so good, I believe that I would be able to handle it because I truly believe that Dr. Pal and her staff would have taken good care of me. I will always go back to Dr. Pal and members of her team because I truly believe"

    --A. Howlett
  • " I have been to a few appointments at Dr. Pal\'s office over the last year for dry eye issues and every time it has been a very positive experience. The 3 receptionists at the front desk are warm and friendly. They are attentive and provide a very high level of customer service. I appreciate that they call me by name and remembered conversations we had at previous visits. I find Dr. Pal to be an excellent practitioner who is very thorough with her exams, has a lovely personality and takes the time to answer any and all questions that may arise. I am happy with the computer glasses I purchased and value the honest opinions I received from the staff when selecting frames. It was refreshing to have multiple opinions on styles and I felt they truly wanted me to walk out with a frame that was best suited to me. I highly recommend Dr. Pal \'s office! As a health care practitioner myself, I think all health care experiences should be this personilzed and friendly!"

    --A. Mclean
Convergence Insufficiency


Convergence Insufficiency


There are six muscles attached to each eye that control movement of the eyes in all directions. When these extra-ocular muscles are working in perfect harmony, it is comfortable and easy to perform visual tasks at any distance and at any direction of gaze. (Right: a diagram of the six muscles.)

Convergence may be thought of as the ability to cross the eyes; as funny as this may sound, we do need this ability every time we perform tasks like reading or using a computer. This is because when we are looking straight ahead and far away, the eyes should be in essentially parallel alignment; when the target gets closer, the eyes must turn inward to keep each of them aimed correctly right where it should be. Another name for inadequate convergence is exophoria. (Small amounts of exophoria are expected, especially for close vision, but when we cannot converge enough to maintain single vision, we can experience a variety of symptoms.)

However, we must also increase the focusing power to keep this single image clear; this is called accommodation. Ideally, when we are looking at an object in the distance, our eyes should not have to focus at all, and when that object comes closer, we automatically accommodate to maintain clarity.

To make our lives easier, these two systems are linked in the brain so that when we shift from distance to near, they each reinforce the other and keep the image both single and clear without either of them needing extra help in doing so.

Mismatching Systems

When our eyes focus correctly but don’t aim properly, we must add more convergence, but doing so also increases the amount of accommodation. When our eyes aim correctly but are out of focus we must add accommodation, but doing that also increases the amount of convergence.

This can be thought of as the feedback loop between the amount of convergence and accommodation being out of balance. The results can include eye fatigue, headaches, double vision, pulling sensations, poor reading skills and other symptoms of eye strain. In mild cases, it doesn’t usually cause a lot of problems, but when the imbalance increases, so does the visual stress. In more severe cases, where the brain can no longer overcome it, one eye may drift away from the target so we have episodes of double vision or even the type of strabismus called exotropia. Exotropia can involve the same eye being turned outward or alternate between the two; it can also occur only some of the time or be present constantly.

Parents should watch for several factors when their child reads:

  • A tendency to hold reading material either too close or too far away
  • Comments the child may make regarding “seeing two” of anything
  • A tendency to turn the head when reading
  • Using one hand to cover an eye when reading
  • Avoiding reading or other similar activities
  • Poor hand-to-eye coordination
  • Excess blinking or eye watering

Additionally, they should make sure that the child has a well-lighted and comfortable place to read, and that the child isn’t using poor posture. Discourage reading while lying on the floor and if he or she wants to read in bed that they should sit up to do so. (This is because reading material is held too closely in these situations.) Frequent breaks to re-focus and relax are a good idea as well. Parents should also keep in mind that children don’t usually complain about their vision because they think everyone else’s vision is like theirs.

In practical terms, we should be able to converge our eyes to within only a few inches from our noses; this is not because we should hold things that close to us, (or to amuse our friends) but rather to have more ability than we actually need, so that even when the muscles begin to tire out we still have enough left to avoid double vision. If the eyes can only converge to 40 cm (about 16 inches), then we have none in reserve and begin to experience those symptoms of eyestrain again.


Your eyecare practitioner will first want to discover if there is a refractive error present that is not currently corrected. Sometimes just correcting undiagnosed near- or far-sightedness can reduce or even eliminate a mismatch between the convergence and accommodative systems and bring immediate relief of eyestrain symptoms.

It may be necessary, too, to add prism to the eyeglass prescription. Vision therapy (VT) exercises to strengthen the convergence system using a variety of techniques, can be very effective, especially for children. VT has the ultimate goal of improving binocular vision skills to make it easy to read or use a computer without fatigue

Successful Outcomes

Generally, VT is quite effective at reinforcing the ability of the extra-ocular muscles to perform as they should. In a perfect visual world, we should all be able to drive, read, use a computer, and play both indoor and outdoor games as long and as easily as we breathe. Unfortunately, sometimes we need a little help to make things easier.

Fortunately, lenses and prisms can help us in increasing the abilities we need for extended tasks that we so often need to perform in today’s busy world.

See an eyecare practitioner for a comprehensive vision examination if either you or your child doesn’t seem to use your eyes efficiently, because we should all have the opportunity to see well and without undue fatigue.

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