Thursday, February 20, 2014

Vision therapy for vergence and accommodation

Vision therapy success - Dr. M.K. Randhawa
A new case report was published in the latest issue of the Journal Optometry & Visual Performance, which supports the effectiveness of in-office vision therapy for the treatment of vergence and accommodation dysfunctions.

Vergence is the simultaneous movement of both eyes in opposite directions to obtain or maintain single binocular vision.

Accommodation  is the process by which the eye changes its focusing power to maintain a clear focus on an object as its distance from the eye varies.

The case report discussed a patient who was 10-years and 10 months old and underwent 16 visits for vision-based therapy along with home reinforcement (vision therapy homework). The authors used several methods to measure accomodation and vergence before and after therapy, including the Convergence Insufficiency Symptom Survey (CISS), near point of convergence (NPC), positive fusional vergence range at near (PFV), accommodative amplitude, and accommodative facility. The measures taken showed decreased symptom severity following therapy.

The in-office vision therapy program used in the study was identical to that used in the well known Convergence Insufficiency Treatment Trial studies and produced measurable changes in vergence and accommodation in the case subject, who also had convergence insufficiency.

The results not only demonstrate the efficacy of vision therapy but also provide an illustration of the plasticity of the oculomotor system, which is not fully developed at 10 years of age and responds well to interventions like vision therapy.


Optometry & Visual Performance
Objective Assessment of Vergence and Accommodation After Vision Therapy for Convergence Insufficiency in a Child: A Case Report Optometry and visual performance 2014 Feb 04;2(1)7-12, M Scheiman, KJ Ciuffreda, P Thiagarajan, B Tannen, DP Ludlam