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Treatment of Convergence Insufficiency in Childhood: A Current Perspective
Journal article   Open access   Peer reviewed

Treatment of Convergence Insufficiency in Childhood: A Current Perspective

Mitchell Scheiman, Michael Rouse, Marjean Taylor Kulp, Susan Cotter, Richard Hertle and G. Lynn Mitchell
Optometry and vision science, v 86(5), pp 420-428
01 May 2009
DOI: https://doi.org/10.1097/OPX.0b013e31819fa712
PMID: 19319008
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc2821445View
Accepted (AM)Open Access (License Unspecified),  Open

Abstract

Life Sciences & Biomedicine Ophthalmology Science & Technology
Purpose. To provide a current perspective on the management of convergence insufficiency (CI) in children by summarizing the findings and discussing the clinical implications from three recent randomized clinical trials in which we evaluated various treatments for children with symptomatic Cl. We then present an evidence-based treatment approach for symptomatic Cl based on the results of these trials. Finally, we discuss unanswered questions and suggest directions for future research in this area. Methods. We reviewed three multi-center randomized clinical trials comparing treatments for symptomatic (CI) in children 9 to 17 years old.(one study 9 to 18 years old). Two trials evaluated active therapies for Cl. These trials compared the effectiveness of office-based vergence/accommodative therapy, office-based placebo therapy, and home-based therapy [pencil push-ups alone (both trials), home-based computer vergence/accommodative therapy, and pencil push-ups (large-scale study)]. One trial compared the effectiveness of base-in prism reading glasses to placebo reading glasses. All studies included well-defined criteria for the diagnosis of Cl, a placebo group, and masked examiners. The primary outcome measure was the Convergence Insufficiency Symptom Survey score. Secondary outcomes were near point of convergence and positive fusional vergence at near. Results. Office-based vergence/accommodative therapy was significantly more effective than home-based or placebo therapies. Base-in prism reading glasses were no more effective than placebo reading glasses for the treatment of symptomatic Cl in children. Conclusions. Recent clinical trials showed that office-based vision therapy was successful in about 75% of patients (resulting in normal or significantly improved symptoms and signs) and was the only treatment studied which was more effective than placebo treatments for children with symptomatic Cl. Eye care providers who do not currently offer this treatment may consider referring these patients to a doctor who provides this treatment or consider expanding the treatment options available within their practice to manage this condition. (Optom Vis Sci 2009;86:420-428)

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34 citations in Web of Science
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Collaboration types
Domestic collaboration
Web of Science research areas
Ophthalmology
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