An evaluation of clinical treatment of convergence insufficiency for children with reading difficulties

Abstract

Background: The present study investigates two different treatment options for convergence insufficiency CI for a group of children with reading difficulties referred by educational institutes to a specialist eye clinic in Vienna.

Methods: One hundred and thirty four subjects (aged 7-14 years) with reading difficulties were referred from an educational institute in Vienna, Austria for visual assessment. Each child was given either 8Δ base-in reading spectacles (n=51) or computerised home vision therapy (HTS) (n=51). Thirty two participants refused all treatment offered (clinical control group). A full visual assessment including reading speed and accuracy were conducted pre- and post-treatment.

Results: Factorial analyses demonstrated statistically significant changes between results obtained for visits 1 and 2 for total reading time, reading error score, amplitude of accommodation and binocular accommodative facility (within subjects effects) (p<0.05). Significant differences were also demonstrated between treatment groups for total reading time, reading error score and binocular accommodative facility (between subjects effects) (p<0.05).

Conclusions: Reading difficulties with no apparent intellectual or psychological foundation may be due to a binocular vision anomaly such as convergence insufficiency. Both the HTS and prismatic correction are highly effective treatment options for convergence insufficiency. Prismatic correction can be considered an effective alternative to HTS.

Figure 1

Mean spherical equivalent refractive error of subjects with convergence insufficiency.

Figure 2

Box plots of total reading time at first and second visits for each subject group. The top of the box represents the 75^th percentile, the bottom of the box represents the 25^th percentile and the middle line represents the 50^th percentile. The whiskers represent the highest and lowest values (excluding outliers). Outliers are represented by the closed circles. Asterisks represent extreme values.

Figure 3

Box plots of reading error scores at first and second visits for each subject group. The top of the box represents the 75^th percentile, the bottom of the box represents the 25^th percentile and the middle line represents the 50^th percentile. The whiskers represent the highest and lowest values (excluding outliers). Outliers are represented by the closed circles. Asterisks represent extreme values.

Figure 4

Box plots of amplitude of accommodation at first and second visits for each subject group. The top of the box represents the 75^th percentile, the bottom of the box represents the 25^th percentile and the middle line represents the 50^th percentile. The whiskers represent the highest and lowest values (excluding outliers). Outliers are represented by the closed circles. Asterisks represent extreme values.

Figure 5

Box plots of binocular accommodative facility at first and second visits for each subject group. The top of the box represents the 75^th percentile, the bottom of the box represents the 25^th percentile and the middle line represents the 50^th percentile. The whiskers represent the highest and lowest values (excluding outliers). Outliers are represented by the closed circles. Asterisks represent extreme values.

Figure 6

Box plots of vergence facility at first and second visits for each subject group. The top of the box represents the 75^th percentile, the bottom of the box represents the 25^th percentile and the middle line represents the 50^th percentile. The whiskers represent the highest and lowest values (excluding outliers). Outliers are represented by the closed circles. Asterisks represent extreme values.