Journal article
Office-based Vergence and Accommodative Therapy for the Treatment of Intermittent Exotropia: A Pilot Study
Optometry and vision science, v 96(12), pp 925-933
01 Dec 2019
PMID: 31834152
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
PURPOSE This study was designed to evaluate changes in the office control score after office-based vergence/accommodative therapy for intermittent exotropia. METHODS This was a prospective, unmasked pilot study. Fourteen Chinese participants aged 6 to 18 years with intermittent exotropia (excluding the convergence insufficiency type) were enrolled. All participants received 60 minutes of office-based vergence/accommodative therapy with home reinforcement once per week for 12 weeks. Therapy included vergence, accommodation, saccades and pursuits, antisuppression, and monocular fixation in binocular field techniques. The primary outcome measure was the change in the office control score from the baseline visit to the 13-week outcome visit. RESULTS All participants completed the study. The office control score at distance changed by -1.0 (95% confidence interval [CI] = -1.6 to -0.4; P = .005; Cohen's d effect size, 0.93). The distant Look And Cover, then Ten seconds Observation Scale for Exotropia score and distant Newcastle control score total score changed by -0.7 (95% CI, -1.2 to -0.2; P = .02; Cohen's d effect size, 0.55) and -1.9 (95% CI, -2.8 to -1.0; P < .001; Cohen's d effect size, 1.37), respectively. Although there was no significant change in the angle of distance exodeviation (-1.8 prism diopter [Delta] less exodeviation; 95% CI, -3.74 to 0.14 Delta; P = .11), a significant change was observed in the near angle (-4.4 Delta less exodeviation; 95% CI, -7.3 to -1.5 Delta; P = .01; Cohen's d effect size, 0.79). There was no significant change in stereopsis or the Chinese Intermittent Exotropia Questionnaire score. CONCLUSIONS In this select group of children with intermittent exotropia, 12 weeks of office-based vergence/accommodative therapy with home reinforcement resulted in a statistically and clinically significant improvement in the distance control of exodeviation and the near exodeviation magnitude. These results suggest that there is a need for a randomized clinical trial designed to determine the effectiveness of vision therapy as a treatment modality for intermittent exotropia.
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Details
- Title
- Office-based Vergence and Accommodative Therapy for the Treatment of Intermittent Exotropia: A Pilot Study
- Creators
- Martin Ming-Leung Ma - Sun Yat-sen UniversityYing Kang - Sun Yat-sen UniversityMitchell Scheiman - Salus UniversityXiang Chen - Sun Yat-sen University
- Publication Details
- Optometry and vision science, v 96(12), pp 925-933
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pennsylvania College of Optometry (PCO)
- Web of Science ID
- WOS:000504871500007
- Scopus ID
- 2-s2.0-85076453730
- Other Identifier
- 991021900187804721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Ophthalmology