Convergence Insufficiency Clinical Trial
Official title:
Effectiveness of Home-Based Therapy for Symptomatic Convergence Insufficiency
The purpose of this study is to determine the effectiveness of home-based computer therapy for symptomatic convergence insufficiency (CI) compared to traditional home-based near target push-ups and placebo treatment.
Convergence insufficiency (CI) is a common and distinct binocular vision disorder that
affects approximately 4% of school age children and adults in the United States. Convergence
insufficiency is often associated with symptoms such as frequent loss of place while
reading, loss of concentration, having to re-read, reading slowly, poor comprehension,
sleepiness, blurred vision, diplopia, headaches, and/or eyestrain. A recently completed
randomized clinical trial, the Convergence Insufficiency Treatment Trial (CITT),
demonstrated that a 12-week program of office-based vergence/ accommodative therapy with
home reinforcement was more effective than home-based near target pencil push-ups,
home-based computer accommodative therapy plus pencil push-ups, or office-based placebo
therapy in treating the symptoms and signs associated with symptomatic CI in children 9 to
17 years of age.
While the home-based therapies in the CITT were not as effective as office-based
vergence/accommodative therapy there was some improvement noted. Currently, many eye care
professionals only offer home-based therapy, while others suggest passive treatment with
base-in prism. At a Pediatric Eye Disease Investigator Group (PEDIG) meeting (Tampa, January
2009), the results of a poll of attendees indicated that a large majority of pediatric
ophthalmologists continue to recommend home-based near target push-ups as the initial
treatment approach for children with symptomatic CI in spite of the CITT results.
There are significant differences in contact time, complexity, and cost between office-based
and home-based therapy for CI. Many clinicians believe that the less costly and less complex
treatment option should be attempted first. Although home-based therapy using computer
software is becoming more popular, no prospective data are available to demonstrate the
effectiveness of home-based vision therapy using computer software compared to home-based
near target push-ups or home-based placebo computer therapy. A prospective clinical trial is
therefore needed to determine the effectiveness of home-based computer therapy for
symptomatic CI compared to traditional home-based near target push-ups and placebo
treatment.
The current study is a multi-center randomized clinical trial to evaluate the effectiveness
of home-based computer vergence/accommodative therapy and home-based near target push-ups in
children 9 to <18 years of age with symptomatic CI.
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