In the News
More Effective Treatment Identified for
Common Childhood Vision Disorder
Scientists have found a more effective treatment for a common childhood
eye muscle coordination problem called
convergence insufficiency (CI).
For words on a page to appear in focus a child's eyes must turn inward, or
converge. In CI, the eyes do not converge easily, and as a result, additional
muscular effort must be used to make the eyes turn in.

While the majority of eye care professionals treat children diagnosed with CI
using some form of home-based therapy, a new study concludes that
office-based treatment by a trained therapist along with at-home
reinforcement is more effective. The 12-week study, known as the
Convergence Insufficiency Treatment Trial (CITT), found that
approximately 75 percent of those who received in-office therapy by a
trained therapist plus at-home treatment reported fewer and less severe
symptoms related to reading and other near work. Symptoms of CI include
loss of place, loss of concentration, reading slowly, eyestrain, headaches,
blurry vision, and double vision.

The CITT, which included 221 children age 9 to 17, is the first to compare
three forms of vision therapy and a placebo therapy option. The first therapy
was the current treatment standard known as home-based pencil push-up
therapy, an exercise in which patients visually followed a small letter on a
pencil as they moved the pencil closer to the bridge of their nose. The goal
was to keep the letter clear and single, and to stop if it appeared double.

The second group used home-based pencil push-ups with additional
computer vision therapy. The third attended weekly hour-long sessions of
office-based vision therapy with a trained therapist and performed at-home
reinforcement exercises. The last group was given placebo vision activities
designed to simulate office-based therapy.

After 12 weeks of treatment, nearly 75 percent of children who were given
the office-based vision therapy along with at-home reinforcement achieved
normal vision or had significantly fewer symptoms of CI. Only 43 percent of
patients who completed home-based therapy alone showed similar results,
as did 33 percent of patients who used home-based pencil push-ups plus
computer therapy and 35 percent of patients given a placebo office-based

"There are no visible signs of this condition; it can only be detected and
diagnosed during an eye examination," said principal investigator Mitchell
Scheiman, O.D., of Pennsylvania College of Optometry at Salus University
near Philadelphia, Pa. "However, as this study shows, once diagnosed, CI can
be successfully treated with office-based vision therapy by a trained
therapist along with at-home reinforcement. This is very encouraging news
for parents, educators, and anyone who may know a child diagnosed with

The National Eye Institute (NEI) a component of the National Institutes of
Health is the federal government's lead agency for vision research that leads
to sight saving treatments and plays a key role in reducing visual
impairment and blindness. For more information, visit the NEI Web site at

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