Danish College of Optometry and Visual Science, 8960 Randers SØ, Denmark.
Department of Ophthalmology, Aarhus University Hospital, 8200 Aarhus N, Denmark.
Invest Ophthalmol Vis Sci. 2021 May 3;62(6):23. doi: 10.1167/iovs.62.6.23.
Convergence insufficiency (CI) is characterized by abnormal vergence eye movement frequently accompanied by abnormal accommodation and subjective symptoms, such as headache, blurred vision, and diplopia. CI is treated with vergence and accommodation exercises that are integrated so that the relative contributions of vergence and accommodation exercises to the outcome are concealed. The purpose of the present study was to determine the individual contributions of vergence and accommodation exercises for the treatment of CI in school children.
In a prospective crossover study 44 children aged 9 to 13 years with CI were randomized to perform either vergence exercises followed by accommodation exercises each for 6 weeks or the 2 treatment regimes in the reverse order. The outcome measures were recovery from CI and the parameters vergence facility, positive fusional vergence, near point of convergence, monocular amplitude, and facility of accommodation.
After the first 6-week period, full recovery from CI was significantly more frequent in the group commencing vergence exercises than in the group commencing monocular accommodation exercises (p = 0.01), whereas there was no significant difference between these proportions after the second 6-week period (p = 0.45). Vergence facility and positive fusional vergence improved significantly more after the period with vergence exercises than after the accommodation exercises, whereas there was no significant difference between the effects of the two types of exercises on the other studied parameters.
Vergence treatment induces a faster recovery of CI than accommodation treatment in school children. This may be used to improve compliance and success rate of the treatment.
集合不足（CI）的特征是异常的聚散眼动，常伴有异常调节和主观症状，如头痛、视力模糊和复视。CI 的治疗方法是融合聚散和调节运动，使聚散运动和调节运动对结果的相对贡献被掩盖。本研究的目的是确定聚散和调节运动对治疗儿童 CI 的单独贡献。
在一项前瞻性交叉研究中，44 名 9 至 13 岁的 CI 儿童被随机分为两组，分别进行 6 周的聚散运动或调节运动，然后两种治疗方案以相反的顺序进行。观察指标为 CI 的恢复情况以及聚散力、正融像性聚散、集合近点、单眼幅度和调节力等参数。
在前 6 周结束时，开始聚散运动的组从 CI 中完全恢复的频率明显高于开始单眼调节运动的组（p = 0.01），而在后 6 周结束时，两组之间的比例没有显著差异（p = 0.45）。聚散力和正融像性聚散在聚散运动期间显著改善，而在调节运动期间没有显著改善，而两种运动类型对其他研究参数的影响没有显著差异。
在儿童中，聚散治疗比调节治疗能更快地恢复 CI。这可以用来提高治疗的依从性和成功率。
