Children asymptomatic 1 year after cessation of convergence insufficiency therapy

Optom Vis Sci. 2009;86(9):1096-1103.

Children aged 9 to 17 years who were treated for convergence insufficiency showed improvements in symptoms for more than a year after stopping treatment, according to results of the Convergence Insufficiency Treatment Trial.

The study included 79 patients who were shown to be asymptomatic after a 12-week therapy program for convergence insufficiency and followed for at least 1 year. The group included 33 patients in office-based vergence/accommodative therapy (OBVAT), 18 patients in home-based pencil push-ups (HBPP), 12 patients in home-based computer vergence/accommodative therapy and pencil push-ups (HBCVAT+) and 16 patients in office-based placebo therapy (OBPT).

Investigators measured symptoms and clinical signs 6 months and 1 year after completion of therapy. The main outcome measure was the mean change on the Convergence Insufficiency Symptom Survey (CISS). Secondary outcome measures were near point of convergence, positive fusional vergence at near, and proportion of patients who were asymptomatic or deemed successful or improved based on a composite measure of CISS, near point of convergence and positive fusional vergence. The 1-year follow-up completion rate was 89%.

Study data showed no significant changes in CISS scores between any treatment group during the 1-year follow-up interval. Results showed that 84.4% of OBVAT patients, 66.7% of HBPP patients, 80% of HBCVAT+ patients and 76.9% of OBPT patients remained asymptomatic, the authors said.

At 1 year, 87.5% of OBVAT patients, 66.6% of HBPP patients, 80% of HBCVAT+ patients and 69.3% of OBPT patients remained successful or improved, they said.