Authors
Pediatric Eye Disease Investigator Group

Home-Based Therapy for Symptomatic Convergence Insufficiency in Children: A Randomized Clinical Trial

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Abstract/Introduction

Purpose 

To compare the effectiveness of home-based (HB) computer vergence/accommodative therapy (HB-C) to HB near target push-up therapy (HB-PU) and to HB placebo treatment (HB-P) among children aged 9 to <18 years with symptomatic convergence insufficiency (CI).

 

Methods 

In this multicenter randomized clinical trial, participants were randomly assigned to computer therapy, near target push-ups, or placebo. All therapy was prescribed for 5 days per week at home. A successful outcome at 12 weeks was based on meeting predetermined composite criteria for the CI Symptom Survey, near point of convergence, and positive fusional vergence at near.


Conclusion/Results

Results 

A total of 204 participants were randomly assigned to HB-C (n = 75), HB-PU (n = 85), or HB-P (n = 44). At 12 weeks, 16 of 69 (23%, 95% CI: 14–35%) in the HB-C group, 15 of 69 (22%, 95% CI: 13–33%) in the HB-PU group, and 5 of 31 (16%, 95% CI: 5–34%) in the HB-P group were classified as having a successful outcome. The difference in the percentage of participants with a successful outcome in the HB-C group compared with the HB-PU group was −4% (two-sided 97.5% CI: −19 to +11%; p = 0.56) and with the HB-P group was +5% (two-sided 97.5% CI: −12 to +22%; p = 0.52), adjusted for baseline levels of the composite outcome components.

 

Conclusions 

The majority of participants with symptomatic CI did not have a successful outcome at 12 weeks. Some participants treated with placebo were successful. With recruitment reaching only 34% of that originally planned and differential loss to follow-up among groups, estimates of success are not precise and comparisons across groups are difficult to interpret.


Testimonials


I haven't actually used the optometrist side, so my review is limited to the vision therapy offered.  This office was recommended by my occupational therapist for the treatment of my double vision following a stroke.


Claire A.

Love this location. I had a brain injury accident from day one one. All the team make you feel you still important and hope in the horizon after when the medical system fell you miserably. Dr. Ikeda very professional and very understanding about your issue. Two tombs up.


Jim K.

My husband and I were immediately impressed with Dr Ikeda. I was hit by a car while cycling which caused broken bones and three brain injuries. The brain injuries caused double vision. Dr. Ikeda examined my eyes and got me started on vision therapy with his occupational therapist who specializes in vision therapy.  She (Chris) is absolutely great.  I am impressed with the array of tools used to help recover my binocular vision.  I am doing things I never thought were possible (balance boards etc).  Chris pushes me and keeps me motivated. I really enjoy my sessions with her.  The office staff is always friendly and they have a wonderful appointment reminder tool that makes it easy to keep my calendar up to date. I am happy the rehab center at Little Co. of Mary recommended them!!


Teresa S.

The Vision Therapy is handled in a separate office through a different door from the shared waiting room. Chris, the vision therapist, has a wide and varied assortment of tools, equipment and resources to best evaluate and treat most vision issues. After just a few visits, my double vision became easier to control, using exercises developed during the therapy process. It was time well-spent.


Joe M.

I have been coming here since I can remember. I love it here. The staff is so amazing and nice. They explain everything they gonna do and never make you feel rushed. Dr. Ikeda has always been my doctor and I would never want another one. He is the doctor for my whole family and is always asking how everyone is doing. I am also so crazy about picking out my frames and have to try so many and each person who helps me take the time and lets me try them all on. I would never want to go anywhere else! I definitely would recommend this office to anyone looking for a great eye doctor.


Kayla W.

This is not for the eye exam but for the frames selection portion. I brought my prescription from Kaiser here with my VSP insurance. The reception staff was very polite and professional.  Manny helped me to pick out frames and explain my coverage.  Very helpful and patient not like the individual at the other place I rated here on Yelp.  I was running late and he still helped me and was not bothered at all.  I am so glad I came here ..........very pleased.

Very professional staff and pleasant.


Daniel G.
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