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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Effectiveness of vergence/accommodative therapy for accommodative dysfunction in children with convergence insufficiency
Ophthalmic & physiological optics, v 41(1), pp 21-32
Jan 2021
PMID: 33119180
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: To determine the effectiveness of office-based vergence/accommodative therapy for improving accommodative amplitude and accommodative facility in children with symptomatic convergence insufficiency and accommodative dysfunction.
Methods: We report changes in accommodative function following therapy among participants in the Convergence Insufficiency Treatment Trial - Attention and Reading Trial with decreased accommodative amplitude (115 participants in vergence/accommodative therapy; 65 in placebo therapy) or decreased accommodative facility (71 participants in vergence/accommodative therapy; 37 in placebo therapy) at baseline. The primary analysis compared mean change in amplitude and facility between the vergence/accommodative and placebo therapy groups using analyses of variance models after 4, 8, 12 and 16 weeks of treatment. The proportions of participants with normal amplitude and facility at each time point were calculated. The average rate of change in amplitude and facility from baseline to week 4, and from weeks 4 to 16, were determined in the vergence/accommodative therapy group.
Results: From baseline to 16 weeks, the mean improvement in amplitude was 8.6 dioptres (D) and 5.2 D in the vergence/accommodative and placebo therapy groups, respectively (mean difference = 3.5 D, 95% confidence interval (CI): 1.5 to 5.5 D; p = 0.01). The mean improvement in facility was 13.5 cycles per minute (cpm) and 7.6 cpm in the vergence/accommodative and placebo therapy groups, respectively (mean difference = 5.8 cpm, 95% CI: 3.8 to 7.9 cpm; p < 0.0001). Significantly greater proportions of participants treated with vergence/accommodative therapy achieved a normal amplitude (69% vs. 32%, difference = 37%, 95% CI: 22 to 51%; p < 0.0001) and facility (85% vs. 49%, difference = 36%, 95% CI: 18 to 55%; p < 0.0001) than those who received placebo therapy. In the vergence/accommodative therapy group, amplitude increased at an average rate of 1.5 D per week during the first 4 weeks (p < 0.0001), then slowed to 0.2 D per week (p = 0.002) from weeks 4 to 16. Similarly, facility increased at an average rate of 1.5 cpm per week during the first 4 weeks (p < 0.0001), then slowed to 0.6 cpm per week from weeks 4 to 16 (p < 0.0001).
Conclusion: Office-based vergence/accommodative therapy is effective for improving accommodative function in children with symptomatic convergence insufficiency and coexisting accommodative dysfunction.
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Details
- Title
- Effectiveness of vergence/accommodative therapy for accommodative dysfunction in children with convergence insufficiency
- Creators
- Angela M. Chen - Marshall B. Ketchum UniversityTawna L. Roberts - Stanford UniversitySusan A. Cotter - Marshall B. Ketchum UniversityMarjean T. Kulp - The Ohio State UniversityLoraine T. Sinnott - SUNY College of OptometryEric J. Borsting - Marshall B. Ketchum UniversityYin C. Tea - Nova Southeastern UniversityLisa A. Jones-Jordan - The Ohio State UniversityRichard Hertle - Akron Children's HospitalG. Lynn Mitchell - SUNY College of OptometryL. Eugene Arnold - The Ohio State UniversityChristopher Chase - Western University of Health SciencesMitchell M. Scheiman - Salus UniversityConvergence Insufficiency Treatmen
- Publication Details
- Ophthalmic & physiological optics, v 41(1), pp 21-32
- Publisher
- Wiley
- Number of pages
- 12
- Grant note
- 5U10EY022599; 5U10EY022601; 5U10EY022595; 5U10EY022592; 5U10EY022586; 5U10EY022600; 5U10EY022587; 5U10EY022596; 5U10EY022594; 5U10EY022591 / National Eye Institute of National Institutes of Health, Department of Health and Human Services; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Eye Institute (NEI)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pennsylvania College of Optometry (PCO)
- Web of Science ID
- WOS:000584638100001
- Scopus ID
- 2-s2.0-85094676839
- Other Identifier
- 991021900019704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Ophthalmology