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Journal article
Vergence/accommodative therapy for symptomatic convergence insufficiency in children: Time course of improvements in convergence function
Ophthalmic & physiological optics, v 43(1), pp 105-115
Jan 2023
PMID: 36271753
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To evaluate the time course of improvements in clinical convergence measures for children with symptomatic convergence insufficiency treated with office-based vergence/accommodative therapy.
We evaluated convergence measures from 205, 9- to 14-year-old children with symptomatic convergence insufficiency randomised to office-based vergence/accommodative therapy in the Convergence Insufficiency Treatment Trial - Attention and Reading Trial (CITT-ART). Near-point of convergence (NPC) and near-positive fusional vergence (PFV) were measured at baseline and after 4, 8, 12 and 16 weeks of therapy; mean change in NPC and PFV between these time points were compared using repeated measures analysis of variance. Rates of change in NPC and PFV from: (1) baseline to 4 weeks and (2) 4-16 weeks were calculated. For each time point, the proportion of participants to first meet the normal criterion for NPC (<6 cm), PFV blur (break if no blur; >15Δ and >2 times the exodeviation) and convergence composite (NPC and PFV both normal) were calculated.
The greatest change in NPC and PFV (7.6 cm and 12.7 Δ) and the fastest rate of improvement in NPC and PFV (1.9 cm/week and 3.2 Δ/week, respectively) were both found during the first 4 weeks of therapy, with both slowing over the subsequent 12 weeks. After 12 weeks of therapy, the NPC, PFV and convergence composite were normal in 93.2%, 91.7% and 87.8% of participants, respectively, and normalised with another 4 weeks of therapy in 4.4%, 2.0% and 4.4% of participants, respectively.
Although the greatest improvements in NPC and PFV occurred in the first 4 weeks of therapy, most participants had weekly improvements over the subsequent 12 weeks of treatment. While most children with convergence insufficiency obtained normal convergence following 12 weeks of therapy, an additional 4 weeks of vergence/accommodative therapy may be beneficial for some participants.
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- Title
- Vergence/accommodative therapy for symptomatic convergence insufficiency in children: Time course of improvements in convergence function
- Creators
- Erin C Jenewein - Salus UniversitySusan Cotter - Marshall B. Ketchum UniversityTawna Roberts - Stanford UniversityMarjean Kulp - SUNY College of OptometryG Lynn Mitchell - SUNY College of OptometryLisa A Jones-Jordan - The Ohio State UniversityAngela M Chen - Marshall B. Ketchum UniversityKristine Hopkins - University of Alabama at BirminghamKristine Huang - Marshall B. Ketchum UniversityDeborah Amster - Nova Southeastern UniversityGregory Fecho - Nova Southeastern UniversityJulie Tyler - Nova Southeastern UniversityShivakhaami Meiyeppen - Salus UniversityMitchell Scheiman - Salus UniversityConvergence Insufficiency Treatment Trial - Attention and Reading Trial (CITT-ART) Investigator Group
- Publication Details
- Ophthalmic & physiological optics, v 43(1), pp 105-115
- Publisher
- Wiley
- Grant note
- U10 EY022592 / NEI NIH HHS U10 EY022587 / NEI NIH HHS U10 EY022586 / NEI NIH HHS U10 EY022599 / NEI NIH HHS U10 EY022596 / NEI NIH HHS U10 EY022595 / NEI NIH HHS U10 EY022594 / NEI NIH HHS U10 EY022601 / NEI NIH HHS U10 EY022591 / NEI NIH HHS U10 EY022600 / NEI NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pennsylvania College of Optometry (PCO)
- Web of Science ID
- WOS:000870976200001
- Scopus ID
- 2-s2.0-85140256934
- Other Identifier
- 991021900609604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Ophthalmology