Authors
Mitchell Scheiman, OD, FAAO, Susan Cotter, OD, MS, FAAO, Marjean Taylor Kulp, OD, MS, FAAO, G. Lynn Mitchell, MAS, FAAO, Jeffrey Cooper, MS, OD, FAAO, Michael Gallaway, OD, FAAO, Kristine B. Hopkins, OD, MPH, FAAO, Mary Bartuccio, OD, and Ida Chung, OD, FAAO

Treatment of Accommodative Dysfunction in Children: Results from an Random Clinical Trial

publication date
2012 Nov 1
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Abstract/Introduction

Purpose

To report the effectiveness of various forms of vision therapy/orthoptics in improving accommodative amplitude and facility in children with symptomatic convergence insufficiency (CI) and co-existing accommodative dysfunction.

Methods

In a randomized clinical trial, 221 children 9 to 17 years with symptomatic CI were assigned to one of four treatments. Of the enrolled children, 164 (74%) had accommodative dysfunction; 63 (29%) had a decreased amplitude of accommodation with respect to age, 43 (19%) had decreased accommodative facility, and 58 (26%) had both. Analysis of variance models were used to compare mean accommodative amplitude and accommodative facility for each treatment group after 4, 8, and 12 weeks of treatment.


Conclusion/Results

Results

After 12 weeks of treatment, the increases in amplitude of accommodation [office-based vergence/accommodative therapy with home reinforcement group (OBVAT) 9.9D, home-based computer vergence/accommodative therapy group (HBCVAT+) 6.7D, home-based pencil push-up therapy group (HBPP) 5.8D] were significantly greater than in the office-based placebo therapy group (2.2D) (p-values ≤ 0.010). Significant increases in accommodative facility were found in all groups (OBVAT: 9cpm, HBCVAT+: 7cpm, HBPP: 5cpm, OBPT: 5.5cpm); only the improvement in the OBVAT group was significantly greater than that found in the OBPT group (p = 0.016). One year after completion of therapy, reoccurrence of decreased accommodative amplitude was present in only 12.5% and accommodative facility in only 11%.

Conclusions

Vision therapy/orthoptics is effective in improving accommodative amplitude and accommodative facility in school-age children with symptomatic CI and accommodative dysfunction. Mitchell Scheiman, OD, FAAO, Susan Cotter, OD, MS, FAAO, Marjean Taylor Kulp, OD, MS, FAAO, G. Lynn Mitchell, MAS, FAAO, Jeffrey Cooper, MS, OD, FAAO, Michael Gallaway, OD, FAAO, Kristine B. Hopkins, OD, MPH, FAAO, Mary Bartuccio, OD, and Ida Chung, OD, FAAO


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.

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