The Convergence Insufficiency Treatment Trial (CITT)

Studies estimate that approximately 10% of the population has a vision deficit called convergence insufficiency (CI). CI makes it difficult to sustain focus when looking at something close. The Convergence Insufficiency Treatment Trial (CITT) is a groundbreaking clinical study that has revolutionized the way we understand and treat convergence insufficiency, a common vision disorder that affects the ability to focus on near objects. As a local optometry clinic in Bellflower, we feel it's crucial to share the groundbreaking findings of this trial with our patients and our community. In this detailed paragraph, we'll explore the trial's background, methodology, and key findings, along with their implications for optometry practices like ours.

The Convergence Insufficiency Treatment Trial (CITT) in Bellflower

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CITT Methodology and Treatment Groups

  • The CITT is a multi-center, randomized clinical trial conducted by the National Eye Institute (NEI) and the Convergence Insufficiency Treatment Trial Investigator Group. This study aimed to evaluate the effectiveness of various treatment methods for convergence insufficiency in children aged 9 to 17 years.
  • The trial comprised 221 participants who were randomly assigned to one of four treatment groups: office-based vergence/accommodative therapy (OBVAT), home-based pencil push-ups (HBPP), home-based computer vision therapy/orthoptics (HBCVTO), and office-based placebo therapy (OBPT).
  • The primary outcome measure of the CITT was the near point of convergence (NPC), a measure of how close a person can focus on an object without experiencing double vision. Secondary outcome measures included positive fusional vergence (PFV), Convergence Insufficiency Symptom Survey (CISS) score, and clinical success rates.

Key Findings from the Convergence Insufficiency Treatment Trial (CITT)

The Convergence Insufficiency Treatment Trial is a scientific research study that has been going on for a while. It has shown that both home-based and in-office vision therapy are effective in treating this condition. However, in-office therapy was found to be more effective than home therapy in dealing with this condition.

  • The CITT study found that 73% of children with symptomatic convergence insufficiency showed significant improvement after receiving 12 weeks of office-based vision therapy.
  • The CITT study demonstrated that children receiving office-based vision therapy for convergence insufficiency experienced a reduction in symptoms by an average of 10.7 points on the Convergence Insufficiency Symptom Survey (CISS).
  • In the CITT study, children who received office-based vision therapy were 3 times more likely to achieve normal convergence function compared to children receiving home-based pencil push-ups.
  • The CITT study found that children receiving office-based vision therapy had a success rate of 73%, compared to only 33% for those receiving home-based computer therapy.
  • According to the CITT study, office-based vision therapy led to significantly improved near point of convergence (NPC) and positive fusional vergence (PFV) compared to home-based treatments.
  • The CITT study reported that the improvements in symptoms and clinical signs of convergence insufficiency were maintained in 79% of children who received office-based vision therapy one year after treatment.
  • In the CITT study, 88% of children who received office-based vision therapy reported that they were either "much better" or "completely better" in terms of their symptoms after treatment.
  • The CITT study found that the mean CISS score decreased from 30.7 to 15.1 in children receiving office-based vision therapy, indicating a significant reduction in symptoms.
  • The CITT study revealed that children receiving office-based vision therapy showed an average improvement of 13.4 prism diopters in their near positive fusional vergence.
  • According to the CITT study, only 5% of children receiving office-based vision therapy reported adverse effects, which were mild and transient, such as headaches or eyestrain.
Key Findings from the Convergence Insufficiency Treatment Trial (CITT)
Implications for Optometry Practices

Implications for Optometry Practices

The findings from the CITT have had a profound impact on the way we approach the treatment of convergence insufficiency. Based on the trial's results, we now have clear evidence that office-based vergence/accommodative therapy is the most effective treatment option for this condition. By incorporating this evidence-based treatment approach into our practice, we can offer our patients the best possible care and help them overcome the challenges associated with convergence insufficiency.

Implications for Optometry Practices

Amplify EyeCare of Greater Long Beach's Collaboration with Local Schools and Community Organizations

At Amplify EyeCare of Greater Long Beach, we are committed to raising awareness of convergence insufficiency by forming partnerships with local schools and community organizations. Our collaborative efforts include providing educational workshops, seminars, and vision screenings to identify children who may be experiencing this condition and ensuring they receive timely intervention.

Amplify EyeCare of Greater Long Beach's Dedication to Continuing Education and CITT-Related Research Updates

Our team at Amplify EyeCare of Greater Long Beach is dedicated to staying current with the latest research and developments concerning the CITT and convergence insufficiency. By actively participating in continuing education and monitoring new studies, we strive to offer the most effective, evidence-based treatments to our patients, ensuring their well-being and satisfaction.

Key Findings from the Convergence Insufficiency Treatment Trial (CITT)
Implications for Optometry Practices

What is Convergence Insufficiency?

Convergence insufficiency is a common vision disorder characterized by the inability to maintain proper eye alignment and focus on near objects. This condition occurs when the eyes struggle to work together while focusing on a nearby object, resulting in one or both eyes drifting outward instead of converging at the desired point. Learn more about convergence insufficiency here.

Symptoms of Convergence Insufficiency

The symptoms of convergence insufficiency can vary between individuals and may affect daily activities, such as reading, computer work, or other tasks that require near vision. Common symptoms include:

  • Difficulty focusing on near objects
  • Eyestrain or eye fatigue when performing close-up tasks
  • Headaches or discomfort around the eyes
  • Blurred or double vision
  • Difficulty concentrating on near tasks, often leading to a short attention span
  • Squinting or closing one eye to focus better
  • Frequent loss of place while reading
  • The need to re-read sentences or passages due to comprehension difficulties

Common Questions

The most effective treatment for convergence insufficiency, as determined by the Convergence Insufficiency Treatment Trial (CITT), is office-based vergence/accommodative therapy (OBVAT). This treatment approach involves personalized vision therapy sessions with a trained eye care professional, focusing on improving the eye muscles' ability to work together while concentrating on near objects. The CITT findings revealed that 73% of participants in the OBVAT group achieved clinical success, demonstrating substantial improvements in near point of convergence and positive fusional vergence. Office-based vergence/accommodative therapy has become the gold standard for treating convergence insufficiency due to its proven effectiveness in addressing the condition's symptoms and improving patients' overall quality of life.
The duration of therapy for convergence insufficiency can vary depending on the individual's needs and the severity of their condition. Typically, office-based vergence/accommodative therapy sessions are conducted once or twice a week, each lasting 45 to 60 minutes. The overall treatment period may range from 12 to 24 weeks or more. During this time, patients often receive supplemental at-home exercises to reinforce the skills and techniques learned during in-office sessions. It is important to note that the exact duration of therapy may differ based on factors such as the patient's progress, compliance with at-home exercises, and response to treatment. Close collaboration with an eye care professional ensures that therapy is tailored to the individual's unique needs, allowing for optimal outcomes and improvements in their quality of life.
The Convergence Insufficiency Treatment Trial (CITT)
Dr. Ikeda cartoon

Schedule a Functional Vision Exam for Convergence Insufficiency

If you or your child is experiencing convergence insufficiency, we recommend exploring the benefits of office-based vergence/accommodative therapy, as supported by the CITT findings. As eye care professionals, we are devoted to maintaining the highest standards of evidence-based treatment methods and delivering the most current care to our patients. Don't hesitate to book an appointment with us to discuss available treatment options and embark on the path towards better vision and an enhanced quality of life. Contact us at (562) 925-6591 to schedule a functional vision exam.

Patients with functional vision issues visit our clinic from all over California, and we are proud to be a leading provider of pediatric and functional vision services for patients from Bellflower, Long Beach, Lakewood, and Los Angeles.


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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