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Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
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Related Experiment Video

Updated: Nov 27, 2025

Quantification of Oculomotor Responses and Accommodation Through Instrumentation and Analysis Toolboxes
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Interventions for convergence insufficiency: a network meta-analysis.

Mitchell Scheiman1, Marjean T Kulp2, Susan A Cotter3

  • 1Salus University, Elkins Park, Pennsylvania, USA.

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|December 2, 2020
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Summary
This summary is machine-generated.

Office-based vision therapy with home reinforcement is more effective for treating convergence insufficiency in children than home-based exercises or placebo. Evidence for adult effectiveness is less clear.

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Area of Science:

  • Ophthalmology and Vision Science
  • Evidence-Based Medicine
  • Clinical Trials Analysis

Background:

  • Convergence insufficiency (CI) is a common binocular vision disorder characterized by outward eye drift (exophoria) and difficulty converging eyes for near tasks.
  • Effective non-surgical interventions are crucial for managing CI, impacting reading and close work performance.

Purpose of the Study:

  • To systematically review and perform a network meta-analysis (NMA) on non-surgical interventions for convergence insufficiency.
  • To compare the relative effectiveness and ranking of various CI treatments in children and adults.

Main Methods:

  • Systematic literature search of multiple databases (CENTRAL, MEDLINE, Embase, PubMed) up to September 2019.
  • Inclusion of randomized controlled trials (RCTs) comparing non-surgical interventions against placebo, sham, or other non-surgical treatments.
  • Network meta-analyses were conducted separately for pediatric and adult populations, assessing treatment success and specific clinical outcomes.

Main Results:

  • In children, high-certainty evidence shows office-based vergence/accommodative therapy with home reinforcement significantly increases successful outcomes compared to home-based computer therapy, home-based pencil/target push-ups, and placebo.
  • Moderate-certainty evidence indicates this therapy is over 5 times more likely to result in treatment success than placebo in children.
  • Evidence for the effectiveness of home-based therapies compared to placebo or each other in children was low-certainty. Prism reading glasses showed no significant benefit in children. Adult data was limited, with some evidence suggesting office-based therapy improved positive fusional vergence compared to placebo.

Conclusions:

  • Office-based vergence/accommodative therapy combined with home reinforcement is the most effective non-surgical treatment for convergence insufficiency in children.
  • The effectiveness of other non-surgical interventions, including home-based therapies and prism glasses, is less certain or not supported by current evidence.
  • Evidence regarding the comparative effectiveness of non-surgical interventions for convergence insufficiency in adults remains less clear and requires further investigation.