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A randomized clinical trial of treatments for convergence insufficiency in children

Mitchell Scheiman1, G Lynn Mitchell, Susan Cotter

  • 1Eye Institute, Pennsylvania College of Optometry, Philadelphia 19141, USA. mscheiman@pco.edu

Archives of Ophthalmology (Chicago, Ill. : 1960)
|January 12, 2005
PubMed

Insights

Vision therapy/orthoptics significantly improved symptoms and clinical signs of convergence insufficiency in children. Pencil push-ups and placebo treatments were ineffective for convergence insufficiency.

Area of Science:

  • Ophthalmology
  • Pediatric Eye Care
  • Vision Science

Background:

  • Convergence insufficiency (CI) is a common binocular vision disorder affecting children.
  • Symptomatic CI can negatively impact reading and academic performance.
  • Effective treatment options for pediatric CI are crucial.

Purpose of the Study:

  • To compare the efficacy of vision therapy/orthoptics, pencil push-ups, and placebo vision therapy/orthoptics for treating symptomatic convergence insufficiency in children aged 9-18.
  • To evaluate the impact of these treatments on CI symptoms and clinical signs.

Main Methods:

  • A randomized, multicenter clinical trial involving 47 children (9-18 years) with symptomatic CI.
  • Participants were assigned to 12 weeks of office-based vision therapy/orthoptics, placebo vision therapy/orthoptics, or home-based pencil push-ups.
  • Primary outcome: Convergence Insufficiency Symptom Survey score. Secondary outcomes: near point of convergence and positive fusional vergence.

Main Results:

  • Vision therapy/orthoptics significantly reduced CI symptoms (mean score from 32.1 to 9.5) and improved clinical measures (near point of convergence from 13.7cm to 4.5cm; positive fusional vergence from 12.5Δ to 31.8Δ).
  • Pencil push-ups and placebo treatments showed no significant improvement in symptoms or clinical signs.
  • Statistically and clinically significant changes were observed only in the vision therapy/orthoptics group.

Conclusions:

  • Office-based vision therapy/orthoptics is an effective treatment for symptomatic convergence insufficiency in children.
  • Pencil push-ups and placebo vision therapy/orthoptics are not effective for treating pediatric convergence insufficiency.
  • Vision therapy/orthoptics offers a superior treatment approach for improving both subjective symptoms and objective measures of CI in pediatric patients.
Abstract

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