In 2008, the results of the Convergence Insufficiency Treatment Trial (CITT) were published. That clinical trial left no doubt that optometric vision therapy is the treatment of choice for convergence insufficiency (CI). This landmark study was based upon evidence built over many years that established the following:
- CI is a common binocular vision disorder that is accompanied by symptoms associated with reading and other near work.
- It is possible to measure the severity of these symptoms using a survey instrument.
- The survey can be used as an outcome measure to evaluate treatment of CI.
The CITT Investigator Group continued analysis of the data from the study and 2 additional and very significant papers were published in 2012.
One evaluated the symptoms experienced by these children pre- and post-treatment for the CI. Symptoms were divided into 2 categories: performance-related and eye-related. Performance-related symptoms were reported more frequently before treatment. The 6 most frequently reported symptoms associated with reading and other near work were:
- loss of place
- loss of concentration
- having to reread
- reading slowly
- difficulty remembering what was read
- feeling sleepy
Children with Attention-Deficit-Hyperactivity-Disorder (ADHD) had more symptoms, especially these performance-related symptoms, but symptoms decreased in all children after treatment! In some cases the decrease in symptoms after treatment was quite striking. For example, 50% of patients responded “fairly often” or “always” when asked how often they experience loss of place when reading. After treatment, this dropped to only 10%. The dramatic decrease in performance-related symptoms with treatment of CI suggests that such treatment may have a positive effect on reading performance and attention.
The second study looked specifically at parental reports of academic difficulties in children with CI. When compared to children with normal binocular vision, children with CI are more likely to avoid reading and have difficulty completing their homework and maintaining attention during reading. The parents of these children are also more worried about their child’s academic performance. But after successful treatment of the CI with optometric vision therapy, parents reported fewer and less frequent adverse behaviors and parental concern.
So where are we in 2014?