Journal article
Treatment of Convergence Insufficiency in Childhood: A Current Perspective
Optometry and vision science, v 86(5), pp 420-428
01 May 2009
PMID: 19319008
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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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Details
- Title
- Treatment of Convergence Insufficiency in Childhood: A Current Perspective
- Creators
- Mitchell Scheiman - Fundação Armando Alvares PenteadoMichael Rouse - So Calif Coll Optometry, Optometry Study Ctr Vis Therapy, Fullerton, CA USAMarjean Taylor Kulp - The Ohio State UniversitySusan Cotter - So Calif Coll Optometry, Ctr Vis Res, Fullerton, CA USARichard Hertle - University of PittsburghG. Lynn Mitchell - The Ohio State University
- Publication Details
- Optometry and vision science, v 86(5), pp 420-428
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 9
- Grant note
- National Eye Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Eye Institute (NEI) U10EY014713 / NATIONAL EYE INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Eye Institute (NEI) National Institutes of Health, Department of Health and Human Services; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pennsylvania College of Optometry (PCO)
- Web of Science ID
- WOS:000265810800003
- Scopus ID
- 2-s2.0-67651173078
- Other Identifier
- 991021900610604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Ophthalmology