Authors
Ma, Martin Ming-Leung BSc; Kang, Ying MD; Scheiman, Mitchell OD, PhD, FAAO; Chen, Xiang MS, PhD

Office-based Vergence and Accommodative Therapy for the Treatment of Intermittent Exotropia: A Pilot Study

publication date
September 21, 2019
Category
see more

Abstract/Introduction

SIGNIFICANCE 

This study will help to demonstrate the potential value of office-based vergence/accommodative therapy for the treatment of intermittent exotropia and provide data that can be used for planning future clinical trials.

 

PURPOSE 

This study was designed to evaluate changes in the office control score after office-based vergence/accommodative therapy for intermittent exotropia.

 

METHODS 

This was a prospective, unmasked pilot study. Fourteen Chinese participants aged 6 to 18 years with intermittent exotropia (excluding the convergence insufficiency type) were enrolled. All participants received 60 minutes of office-based vergence/accommodative therapy with home reinforcement once per week for 12 weeks. Therapy included vergence, accommodation, saccades and pursuits, antisuppression, and monocular fixation in binocular field techniques. The primary outcome measure was the change in the office control score from the baseline visit to the 13-week outcome visit.


Conclusion/Results

RESULTS 

All participants completed the study. The office control score at distance changed by −1.0 (95% confidence interval [CI] = −1.6 to −0.4; P = .005; Cohen's d effect size, 0.93). The distant Look And Cover, then Ten seconds Observation Scale for Exotropia score and distant Newcastle control score total score changed by −0.7 (95% CI, −1.2 to −0.2; P = .02; Cohen's d effect size, 0.55) and −1.9 (95% CI, −2.8 to −1.0; P < .001; Cohen's d effect size, 1.37), respectively. Although there was no significant change in the angle of distance exodeviation (−1.8 prism diopter [Δ] less exodeviation; 95% CI, −3.74 to 0.14Δ; P = .11), a significant change was observed in the near angle (−4.4Δ less exodeviation; 95% CI, −7.3 to −1.5Δ; P = .01; Cohen's d effect size, 0.79). There was no significant change in stereopsis or the Chinese Intermittent Exotropia Questionnaire score.

 

CONCLUSIONS 

In this select group of children with intermittent exotropia, 12 weeks of office-based vergence/accommodative therapy with home reinforcement resulted in a statistically and clinically significant improvement in the distance control of exodeviation and the near exodeviation magnitude. These results suggest that there is a need for a randomized clinical trial designed to determine the effectiveness of vision therapy as a treatment modality for intermittent exotropia.


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.

Blog

Lighting-Assessment---Intensity-1

Lighting as Part of A Low Vision Evaluation

A low vision evaluation is in some ways similar to a regular eye exam, and in other ways entirely different. […]

Read More
josh-applegate-p_KJvKVsH14-unsplash

Can ADD/ADHD be a Vision Problem?

According to a study, approximately 20% of 4.5 million children currently identified as having ADHD may have been misdiagnosed. Furthermore […]

Read More
pexels-monstera-6186146

Are all magnifiers the same? The difference in optics between handheld magnifiers

Hand magnifiers are hand-held devices that can be placed over an object or text to enlarge or magnify what you […]

Read More
see all blogs

Contact Us To Amplify Your EyeCare

Working Hours

Monday - Thursday
8:00 am - 5:15pm
friday-sunday
Closed
Location
16816 Clark Ave, Bellflower, CA 90706, United States
Website Accessibility Policy
Safety protocols page
phone-handsetarrow-uparrow-right linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram