More Effective Treatment Identified
for Common Childhood Vision Disorder
Scientists have found a more effective treatment for a common
childhood eye muscle coordination problem called convergence insufficiency
(CI). For words on a page to appear in focus a child's eyes must
turn inward, or converge. In CI, the eyes do not converge easily,
and as a result, additional muscular effort must be used to make
the eyes turn in.
While the majority of eye care professionals treat children diagnosed
with CI using some form of home-based therapy, a new study concludes
that office-based treatment by a trained therapist along with at-home
reinforcement is more effective. The research, reported in the
Oct.13 issue of Archives of Ophthalmology, was funded by the National
Eye Institute (NEI), part of the National Institutes of Health.
The 12-week study, known as the Convergence Insufficiency Treatment
Trial (CITT), found that approximately 75 percent of those who
received in-office therapy by a trained therapist plus at-home
treatment reported fewer and less severe symptoms related to reading
and other near work. Symptoms of CI include loss of place, loss
of concentration, reading slowly, eyestrain, headaches, blurry
vision, and double vision.
"This NEI-funded study compared the effectiveness of treatment
options for convergence insufficiency," said Paul A. Sieving,
M.D., Ph.D., director of the NEI. "The CITT will provide eye
care professionals with the research they need to assist children
with this condition."
The CITT, which included 221 children age 9 to 17, is the first
to compare three forms of vision therapy and a placebo therapy
option. The first therapy was the current treatment standard known
as home-based pencil push-up therapy, an exercise in which patients
visually followed a small letter on a pencil as they moved the
pencil closer to the bridge of their nose. The goal was to keep
the letter clear and single, and to stop if it appeared double.
The second group used home-based pencil push-ups with additional
computer vision therapy. The third attended weekly hour-long sessions
of office-based vision therapy with a trained therapist and performed
at-home reinforcement exercises. The last group was given placebo
vision activities designed to simulate office-based therapy.
After 12 weeks of treatment, nearly 75 percent of children who
were given the office-based vision therapy along with at-home reinforcement
achieved normal vision or had significantly fewer symptoms of CI.
Only 43 percent of patients who completed home-based therapy alone
showed similar results, as did 33 percent of patients who used
home-based pencil push-ups plus computer therapy and 35 percent
of patients given a placebo office-based therapy.
"There are no visible signs of this condition; it can only
be detected and diagnosed during an eye examination," said
principal investigator Mitchell Scheiman, O.D., of Pennsylvania
College of Optometry at Salus University near Philadelphia, Pa. "However,
as this study shows, once diagnosed, CI can be successfully treated
with office-based vision therapy by a trained therapist along with
at-home reinforcement. This is very encouraging news for parents,
educators, and anyone who may know a child diagnosed with CI."
A 12-month follow-up study is being conducted to examine the long-term
effects of these CI treatments. Further information about the reported
trial, NCT 00338611, can be found at www.clinicaltrials.gov.
The National Eye Institute (NEI) a component of the National Institutes
of Health is the federal government's lead agency for vision research
that leads to sight-saving treatments and plays a key role in reducing
visual impairment and blindness. For more information, visit the
NEI Web site at www.nei.nih.gov/.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.