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Vision therapy/orthoptics for symptomatic convergence insufficiency in children: treatment kinetics

Mitchell Scheiman1, Marjean Taylor Kulp, Susan Cotter

  • 1Pennsylvania College of Optometry, Salus University, Elkins Park, Pennsylvania 19141, USA. mscheiman@salus.edu

Optometry and Vision Science : Official Publication of the American Academy of Optometry
|June 15, 2010
PubMed

Insights

Office-based vergence/accommodative therapy (OBVAT) offers faster symptom and sign improvement for convergence insufficiency (CI) in children. This vision therapy regimen leads to better outcomes compared to home-based or placebo treatments.

Area of Science:

  • Ophthalmology
  • Optometry
  • Pediatric Vision

Background:

  • Convergence insufficiency (CI) is a common binocular vision disorder affecting children.
  • Effective treatment is crucial for visual comfort and academic performance.

Purpose of the Study:

  • To compare the effectiveness of different vision therapy regimens for treating symptomatic CI in children.
  • To evaluate the kinetics of symptom and sign changes over 12 weeks of treatment.

Main Methods:

  • A randomized clinical trial involving 221 children (aged 9-17) with symptomatic CI.
  • Comparison of home-based pencil push-ups (HBPP), home-based computer vergence/accommodative therapy plus pencil push-ups (HBCVAT+), office-based vergence/accommodative therapy with home reinforcement (OBVAT), and office-based placebo therapy (OBPT).
  • Outcome measures included the CI Symptom Survey (CISS), near point of convergence (NPC), and positive fusional vergence (PFV) at 4, 8, and 12 weeks.

Main Results:

  • The OBVAT group showed significant symptom improvement at each visit, unlike other groups.
  • All groups improved between weeks 8 and 12, but OBVAT had fewer symptoms by week 8.
  • OBVAT demonstrated the most significant improvements in NPC and PFV, particularly within the first 4 weeks, and continued to improve PFV at weeks 8 and 12.

Conclusions:

  • Clinical signs (NPC, PFV) improve faster than symptoms in children treated for CI.
  • OBVAT is superior to HBPP, HBCVAT+, and OBPT in accelerating symptom and sign improvement and achieving treatment success criteria.
Abstract

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