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Vergence/Accommodative Tx Improves Visual Function

But treatment does not improve reading performance for children with convergence insufficiency

THURSDAY, Oct. 24, 2019 (HealthDay News) — For children with convergence insufficiency, treatment with office-based vergence/accommodative therapy improves near point of convergence but does not improve reading performance, according to two studies published online Oct. 23 in Optometry and Vision Science.

Mitchell M. Scheiman, O.D., Ph.D., from Salus University in Elkins Park, Pennsylvania, and colleagues reported the changes in clinical signs and symptoms of convergence insufficiency in 311 symptomatic children aged 9 to 14 years. Participants were randomly assigned to either 16 weeks of office-based vergence/accommodative therapy or placebo therapy. The researchers found that the mean near point of convergence improved 10.4 and 6.2 cm in the vergence/accommodation and placebo therapy groups, respectively (mean difference, −4.2 cm; 95 percent confidence interval, −5.2 to −3.2; P < 0.001). The mean positive fusional vergence increased 23.2 and 8.8Δ in the groups, respectively (mean difference, 14.4Δ; 95 percent confidence interval, 12.1 to 16.8Δ; P < 0.001).

In a second study, Scheiman and colleagues examined the impact of office-based vergence/accommodative therapy on reading performance in 310 children with symptomatic convergence insufficiency in the same trial. The researchers found adjusted mean improvements on the Wechsler Individual Achievement Test, Third Edition, of 3.7 and 3.8 standard score points in the vergence/accommodative therapy and placebo groups, respectively (adjusted mean difference, −0.12 points; 95 percent confidence interval, −1.89 to 1.66 points).

“While in-office vision therapy can improve visual function for children with convergence insufficiency, this trial indicates that clinicians should not suggest that it will lead to increased reading performance,” Scheiman said in a statement.

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