When parents learn their child has convergence insufficiency (CI), the next question is usually: what actually works? You may hear about home exercises, special glasses, apps, or vision therapy.
Fortunately, CI is one of the few vision conditions that has been studied in large, careful clinical trials.
The Convergence Insufficiency Treatment Trial (CITT)
In 2008, the Convergence Insufficiency Treatment Trial published the results of a study funded by the National Eye Institute. Researchers randomly assigned 221 children, ages 9 to 17, to one of four 12-week treatments:
Home-based pencil push-ups
Home-based computer therapy plus pencil push-ups
Office-based vision therapy with home reinforcement
Office-based placebo therapy
The examiners measuring results didn't know which treatment each child received.
What they found
After 12 weeks, children in the office-based vision therapy group did significantly better than every other group, both in symptoms and in clinical measures of eye teaming.
The share of children with a successful or improved outcome was:
73% with office-based vision therapy plus home practice
43% with home pencil push-ups
33% with home computer therapy plus push-ups
35% with office placebo therapy
A later, larger trial
In 2019, a follow-up trial called CITT-ART studied 310 children ages 9 to 14 with CI. Office-based vision therapy again improved eye teaming measurements more than placebo. But children in both groups reported similar improvement in symptoms, and vision therapy was no better than placebo at improving reading test scores or attention.
In other words, vision therapy reliably improves how the eyes work together, but it shouldn't be expected to raise reading scores or improve attention on its own.
What this means for your child
Office-based vision therapy, supported by home practice, is the best-supported treatment for children with symptomatic CI.
Home exercises alone help some children, but far fewer. Therapy treats eye teaming; it isn't a reading or attention treatment.
The study looked at children 9 to 17, so results may differ for younger kids and adults.
How we apply it
Our vision therapy for CI follows the same approach studied in the CITT: weekly one-on-one sessions in the office, with structured activities at home between visits.
Schedule an evaluation in Clermont
Hope Vision Development Center specializes in binocular vision evaluations and vision therapy for convergence insufficiency. Our In-Office Training program is an approved Florida Empowerment Scholarship (FES-UA) service through Step Up For Students.
Call 352-243-4673 or email pcc@hopevdc.com to schedule. We're at 235 Citrus Tower Blvd., Suite 107, Clermont, FL.
Sources: Convergence Insufficiency Treatment Trial Study Group, Archives of Ophthalmology, 2008; CITT-ART Investigator Group, Optometry and Vision Science, 2019 and 2021.