Feasibility study for orthoptic treatment of convergence insufficiency in Parkinson's disease

Title Feasibility study for orthoptic treatment of convergence insufficiency in Parkinson's disease
Author, Co-Author Helene Kergoat, Elizabeth Irving, Caroline Law, Estefania Chriqui, Marie-Jeanne Kergoat, Bernard Simon Leclerc, Michel Panisset, Ronald Postuma
Topic Binocular Vision/Pediatrics
Program Number
Ballroom A-B
Univ. of Montreal Ecole D'Opt.

Purpose: Our objective was to evaluate the feasibility of providing orthoptic treatment (OT) for symptomatic convergence insufficiency (CI) in Parkinson's disease (PD).

Methods: We recently conducted a prevalence study of CI in PD including 80 PD and 80 non-PD participants. Of those, all who had symptomatic CI, i.e. 25 individuals with and 6 without PD, were invited to participate in the current study. OT consisted of 8 weeks of visual training performed 30 minutes/day, 5 days/week, with pencil pushups, Brock string and vectogram exercises. Treatment outcomes were based on the changes measured pre- vs post-OT on near point of convergence, positive fusional vergences and CISS-15 scores. Based on these outcomes, a participant who completed OT was considered as "cured", "improved" or "non-responder".

Results: Mean ages were 70.2 ± 8.9 yrs for PD and 61.5 ± 2.9 yrs for non-PD participants. The mean CISS-15 score was 28.2 ± 4.9 for individuals with and 31.8 ± 7.9 for those without PD. Among individuals with PD, 3 refused further evaluation, 19 accepted and 3 were excluded. Among those without PD, 4 accepted further evaluation while 2 were excluded. Finally, 12 of the 19 PD participants and the 4 controls refused OT. Seven participants with PD accepted OT but 3 abandoned and 2 were lost to follow-up. The 2 that completed OT met our criteria for "improved" after therapy and were satisfied with the results.

Conclusions: There is poor uptake and poor compliance to OT in participants with PD. However, results obtained in those completing OT, although limited in number, were positive. Ways to overcome uptake and compliance barriers should be sought, so that studies evaluating OT for symptomatic CI in PD could be pursued. One possibility would be including OT in general PD exercise programs.

Affiliation of Co-Authors School of Optometry & Vision Science, University of Waterloo, School of Optometry, Université de Montréal, School of Optometry, Université de Montréal, Institut Universitaire de Gériatrie de Montreal, École de santé publique de l’Université de Montréal, Centre Hospitalier de l’Université de Montreal, Montreal General Hospital