Effectiveness of VT for CI in Children: Use of Objective Outcome Measures

Title Effectiveness of VT for CI in Children: Use of Objective Outcome Measures
Author, Co-Author Mitchell Scheiman, Tara Alvarez, Henry Talasan
Topic Binocular Vision/Pediatrics
Program Number
Ballroom A-B
Pennsylvania College of Optometry at Salus University

Purpose: To evaluate changes in objective measures of disparity vergence after office-based vision therapy (OBVT) for symptomatic convergence insufficiency (CI) in children 11-17 years old.

Methods: In this prospective, observational trial, we recruited 10 participants with normal binocular vision (NBV) and 13 with symptomatic CI. At baseline all participants received the same testing. CI participants were treated with 12 weeks of OBVT. The primary outcome measure was average peak velocity for 4° symmetrical convergence steps. Other objective outcome measures of disparity vergence included time to peak velocity, latency, accuracy, and settling time. Changes in clinical measures (near point of convergence (NPC), positive fusional vergence at near PFV), Convergence Insufficiency Symptom Survey (CISS) score) were evaluated.

Results: Ten of the 13 participants (mean age 13.1 years) meet clinical success criteria. For the objective measures, we found a statistically significant changes in the mean change in convergence peak velocity (12.84°/sec, p=.001), response amplitude (1.43°, p=.004) and accuracy (1.46°, p=.005). A comparison of peak velocity, response amplitude and accuracy revealed statistically differences at baseline between the NBV and CI subjects. At the outcome visit, however, there were no statistically significant differences between the two groups. There were statistically significant and clinically meaningful changes in all clinical measures (CISS mean change 24.6, p=.001, NPC break mean change 12.9cm, p=.001, PFV mean change 26.6 pd, p=.001)

Conclusions: These results provide additional information about the effectiveness of OBVT that is not accessible with clinical tests. The study results demonstrate that children 11-17 can be successfully evaluated using a protocol that requires about 25 minutes and suggests that these measures could be used in future large-scale randomized clinical trials of binocular vision disorders.

Affiliation of Co-Authors New Jersey Institute of Technology, New Jersey Institute of Technology