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Randomized clinical trial of treatments for symptomatic convergence insufficiency in children

1

  • 1Pennsylvania College of Optometry, 1200 W Godfrey Ave, Philadelphia, PA 19141, USA.

Archives of Ophthalmology (Chicago, Ill. : 1960)
|October 15, 2008
PubMed

Insights

Office-based vergence therapy significantly improved convergence insufficiency symptoms in children. This treatment showed superior results compared to home-based therapies and placebo over 12 weeks.

Area of Science:

  • Ophthalmology
  • Pediatric Optometry
  • Vision Therapy

Background:

  • Symptomatic convergence insufficiency (CI) is a common condition affecting children's visual function.
  • Current treatments vary in approach and efficacy, necessitating comparative studies.

Purpose of the Study:

  • To compare the effectiveness of four treatment protocols for symptomatic convergence insufficiency in children.
  • Evaluate home-based pencil push-ups (HBPP), home-based computer vergence/accommodative therapy with pencil push-ups (HBCVAT+), office-based vergence/accommodative therapy with home reinforcement (OBVAT), and office-based placebo therapy with home reinforcement (OBPT).

Main Methods:

  • A randomized clinical trial involving 221 children aged 9-17 years with symptomatic CI.
  • Participants were assigned to one of the four treatment groups for 12 weeks.
  • Primary outcome measure was the Convergence Insufficiency Symptom Survey score; secondary measures included near point of convergence and positive fusional vergence.

Main Results:

  • The OBVAT group showed a statistically significant lower mean Symptom Survey score (15.1) compared to HBCVAT+ (21.3), HBPP (24.7), and OBPT (21.9) (P < .001).
  • OBVAT also resulted in significantly improved near point of convergence and positive fusional vergence compared to other groups (P <= .005).
  • Success rates were highest in the OBVAT group (73%) compared to HBPP (43%), HBCVAT+ (33%), and OBPT (35%).

Conclusions:

  • Twelve weeks of office-based vergence accommodative therapy (OBVAT) with home reinforcement is significantly more effective than HBPP, HBCVAT+, and OBPT for treating symptomatic convergence insufficiency in children.
  • OBVAT leads to greater symptom improvement and better clinical outcomes in near point of convergence and positive fusional vergence.
  • Office-based vergence accommodative therapy is an effective clinical treatment for pediatric symptomatic convergence insufficiency.
Abstract

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