A Randomized Clinical Trial of Vision Therapy/Orthoptics versus Pencil Pushups for the Treatment of Convergence Insufficiency in Young Adults

Abstract

: In this study, vision therapy/orthoptics was the only treatment that produced clinically significant improvements in the near point of convergence and positive fusional vergence. However, over half of the patients in this group (58%) were still symptomatic at the end of treatment, although their symptoms were significantly reduced. All three groups demonstrated statistically significant changes in symptoms with 42% in office-based vision therapy/orthoptics, 31% in office-based placebo vision therapy/orthoptics, and 20% in home-based pencil push-ups meeting our criteria for elimination of symptoms.

Vergence in mild traumatic brain injury: A pilot study

“…Thus, reduction in the number of symptoms and their intensity should be correlated with improvement in clinical signs [35] and dynamic responses [36].…”

Treatment of symptomatic convergence insufficiency in children with a home-based computer orthoptic exercise program

“…Although the results of 3 rigorously designed comparative treatment studies for convergence insufficiency demonstrated that home-based treatments were not as effective as office-based vergence-accommodative therapy, the studies did show 12 weeks of pencil-push-up alone or in conjuction with home-based computerized therapy to be effective approximately 35% to 40% of the time. [9][10][11] Although the methodological limitations of the study by Serna and colleagues 13 prevent any conclusions to be made regarding the effectiveness of home-based computerized treatment, these results, taken together with those from the CITT, support the need for further investigation of home-based treatments with the objective of determining how their effectiveness can be improved when it is not possible to offer office-based vergence accommodative therapy to children with symptomatic convergence insufficency.…”

“…However, recent randomized clinical trials funded by the National Eye Institute and completed by the Convergence Insufficiency Treatment Trial (CITT) Study Group have shown that 12 weeks of office-based vergence/accommodative therapy with home reinforcement results in a significantly greater improvement in symptoms and clinical signs as compared with placebo therapy and with home-based treatments that use pencil push-up therapy alone or in conjunction with computer vergence/accommodative therapy. [9][10][11] Despite these findings and the conclusion from the recent Cochrane systematic review for convergence insufficiency that "current research suggests that office-based vision therapy/orthoptics is more effective than home-based pencil push-ups or home-based computer vision therapy/orthoptics," 12 some eye-care providers still prescribed home-based treatments as the primary treatment option, presumably because they do not offer office-based vision therapy/orthoptics in their offices or on account of the low cost and ease of use of home-based therapy.…”

Correlation between Convergence Insufficiency with CISS and Attentiveness in Children

“…[6] 폭주부족군을 대상으로 집중력이 떨어지는 어린이는 정 상 어린이와 비교하여 3배 이상의 집중력 저하 현상을 보 인다고 하였다. [7] 특히 어린이의 학습능력과 태도는 주의 집중력과도 서로 상관관계가 있으며, 주의집중의 부족과 제한은 일차적인 학습능력 저하의 원인이 된다고 하였다. [8] 학습을 위한 정보의 수집은 약 80% 정도가 시각기관을 통 해 받아들여지므로 [9] [11] 16점 이 상일 경우에 폭주근점 파괴점이 10 cm 미만인 경우는 제 외하였다.…”