Evidence map›Paper›PMID 33119180›Full record

Trial reportOphthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)2021

Effectiveness of vergence/accommodative therapy for accommodative dysfunction in children with convergence insufficiency.

Angela M Chen, Tawna L Roberts, Susan A Cotter, Marjean T Kulp, Loraine T Sinnott, Eric J Borsting, Yin C Tea, Lisa A Jones-Jordan, Richard Hertle, G Lynn Mitchell and 4 more

Erratum issuedOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Post-concussion clinical findings of oculomotor function in paediatric patients with persisting symptoms compared to healthy controls.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2025
    Article
  5. Classification of accommodative insufficiency by monocular subjective push-up test is poorly predictive of monocular objective amplitudes in children and young adults.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2025
    Article
  6. Article
  7. Vergence/accommodative therapy for symptomatic convergence insufficiency in children: Time course of improvements in convergence function.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2023
    Article
  8. Effectiveness of vergence/accommodative therapy for accommodative dysfunction in children with convergence insufficiency.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2023
    Article
  9. Observational
  10. Does coexisting accommodative dysfunction impact clinical convergence measures, symptoms and treatment success for symptomatic convergence insufficiency in children?Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2022
    Article
  11. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 1 country.

Angela M ChenSouthern California College of Optometry, Marshall B Ketchum University, Fullerton, USA.ORCID 0000-0002-1227-5672
Tawna L RobertsDepartment of Ophthalmology, Stanford University School of Medicine, Stanford, USA.
Susan A CotterSouthern California College of Optometry, Marshall B Ketchum University, Fullerton, USA.ORCID 0000-0002-8402-0521
Marjean T KulpThe Ohio State University College of Optometry, Columbus, USA.
Loraine T SinnottThe Ohio State University College of Optometry, Columbus, USA.
Eric J BorstingSouthern California College of Optometry, Marshall B Ketchum University, Fullerton, USA.
Yin C TeaNova Southeastern University, Fort Lauderdale, USA.
Lisa A Jones-JordanThe Ohio State University College of Optometry, Columbus, USA.
Richard HertleAkron Children's Hospital, Columbus, USA.
G Lynn MitchellThe Ohio State University College of Optometry, Columbus, USA.
L Eugene ArnoldThe Ohio State University College of Medicine, Columbus, USA.
Christopher ChaseWestern University, Pomona, USA.
Mitchell M ScheimanSalus University Pennsylvania College of Optometry, Pennsylvania, USA.
Convergence Insufficiency Treatment Trial - Attention and Reading Trial (CITT-ART) Investigator Group
The Ohio State University · USMarshall B. Ketchum University · USAkron Children's Hospital · USNova Southeastern University · USSalus University · USStanford University · USWestern University of Health Sciences · US

Funding

Convergence Insufficiency Treatment Trial - Attention and Reading TrialU10EY022599 · NEI · SALUS UNIVERSITY · PI SCHEIMAN, MITCHELL M · 2014 to 2018
$2.2M
Convergence Insufficiency Treatment Trial- Attention and Reading Trial (CITT-ART)U10EY022601 · NEI · OHIO STATE UNIVERSITY · PI MITCHELL, GLADYS L · 2014 to 2018
$1.5M
Convergence Insuffiency Treatment Trial - Attention and Reading TrialU10EY022586 · NEI · STATE COLLEGE OF OPTOMETRY · PI SCHULMAN, ERICA · 2014 to 2018
$791k
Convergence Insufficiency Treatment Trial - Attention and Reading TrialU10EY022595 · NEI · SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY · PI COTTER, SUSAN ANNE · 2014 to 2018
$729k
The Convergence Insufficiency Treatment Trial - Attention and Reading TrialU10EY022600 · NEI · CHILDREN'S HOSPITAL MED CTR OF AKRON · PI HERTLE, RICHARD W · 2014 to 2018
$693k
Convergence Infufficency Treatment Trial - Attention and Reading Trial (CITT-ART)U10EY022592 · NEI · OHIO STATE UNIVERSITY · PI KULP, MARJEAN T · 2014 to 2018
$609k
Convergence Insufficiency Treatment Trial - Attention and Reading TrialU10EY022587 · NEI · SALUS UNIVERSITY · PI GALLAWAY, MICHAEL · 2014 to 2018
$577k
Convergence Insufficiency Treatment Trial - Attention and Reading TrialU10EY022596 · NEI · NOVA SOUTHEASTERN UNIVERSITY · PI COULTER, RACHEL ANASTASIA · 2014 to 2018
$513k
Convergence Insufficiency Treatment Trial Attention and Reading Trial (CITT-ART)U10EY022591 · NEI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI TAMKINS, SUSANNA M · 2014 to 2018
$439k
Convergence Insufficiency Treatment Trial - Attention and Reading TrialU10EY022594 · NEI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI HOPKINS, KRISTINE BECKER · 2014 to 2018
$438k
NEI NIH HHS U10 EY022586NEI NIH HHS U10 EY022587NEI NIH HHS U10 EY022591NEI NIH HHS U10 EY022592NEI NIH HHS U10 EY022594NEI NIH HHS U10 EY022595NEI NIH HHS U10 EY022596NEI NIH HHS U10 EY022599NEI NIH HHS U10 EY022600NEI NIH HHS U10 EY022601
6 · The paper itself

Abstract

purposeTo determine the effectiveness of office-based vergence/accommodative therapy for improving accommodative amplitude and accommodative facility in children with symptomatic convergence insufficiency and accommodative dysfunction.

methodsWe report changes in accommodative function following therapy among participants in the Convergence Insufficiency Treatment Trial - Attention and Reading Trial with decreased accommodative amplitude (115 participants in vergence/accommodative therapy; 65 in placebo therapy) or decreased accommodative facility (71 participants in vergence/accommodative therapy; 37 in placebo therapy) at baseline. The primary analysis compared mean change in amplitude and facility between the vergence/accommodative and placebo therapy groups using analyses of variance models after 4, 8, 12 and 16 weeks of treatment. The proportions of participants with normal amplitude and facility at each time point were calculated. The average rate of change in amplitude and facility from baseline to week 4, and from weeks 4 to 16, were determined in the vergence/accommodative therapy group.

resultsFrom baseline to 16 weeks, the mean improvement in amplitude was 8.6 dioptres (D) and 5.2 D in the vergence/accommodative and placebo therapy groups, respectively (mean difference = 3.5 D, 95% confidence interval (CI): 1.5 to 5.5 D; p = 0.01). The mean improvement in facility was 13.5 cycles per minute (cpm) and 7.6 cpm in the vergence/accommodative and placebo therapy groups, respectively (mean difference = 5.8 cpm, 95% CI: 3.8 to 7.9 cpm; p < 0.0001). Significantly greater proportions of participants treated with vergence/accommodative therapy achieved a normal amplitude (69% vs. 32%, difference = 37%, 95% CI: 22 to 51%; p < 0.0001) and facility (85% vs. 49%, difference = 36%, 95% CI: 18 to 55%; p < 0.0001) than those who received placebo therapy. In the vergence/accommodative therapy group, amplitude increased at an average rate of 1.5 D per week during the first 4 weeks (p < 0.0001), then slowed to 0.2 D per week (p = 0.002) from weeks 4 to 16. Similarly, facility increased at an average rate of 1.5 cpm per week during the first 4 weeks (p < 0.0001), then slowed to 0.6 cpm per week from weeks 4 to 16 (p < 0.0001).

conclusionOffice-based vergence/accommodative therapy is effective for improving accommodative function in children with symptomatic convergence insufficiency and coexisting accommodative dysfunction.

Indexed as

EyeglassesAccommodation, OcularChildConvergence, OcularFemaleFollow-Up StudiesHumansHyperopiaMaleMyopiaOcular Motility DisordersOrthopticsTreatment OutcomeVision, Binocularaccommodative amplitudeaccommodative dysfunctionaccommodative facilityconvergence insufficiencyvergence/accommodative therapy

Identifiers

PMID33119180
PMCPMC10545079
OpenAlexW3097856147

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.