Jeffrey Cooper, Jerome Feldman

Reduction of symptoms in binocular anomalies using computerized home therapy-HTS

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Background: Asthenopic symptoms often are associated with various accommodative/vergence disorders. Recent studies have found that symptoms associated with convergence insufficiency are reduced by in-office vision therapy with supplemental home therapy. No studies have used standardized symptom questionnaires to evaluate the effectiveness of either in-office or home-based vision therapy in binocular anomalies other than convergence insufficiency. This retrospective study was designed to evaluate the changes in symptoms using an automated, home computer vision therapy program (HTS) in accommodative/vergence disorders.

Methods: A retrospective study of 43 prepresbyopic patients who completed the HTS was performed. Before and immediately after treatment all patients in this study completed a 15-question symptom questionnaire (Convergence Insufficiency Symptom Survey). Treatment consisted of various accommodative and vergence activities.


Results: Initial symptoms scores on the scaled questionnaire were 32.8 (SD = 8.1); after therapy they were 20.6 (SD = 11.5). These changes were both clinically and statistically significant. Forty percent were "normalized" and 55% improved. Convergence amplitude improved from 22Delta to 53Delta after treatment, and divergence amplitudes improved from 15Delta to 25Delta. These findings were clinically significant. Lastly, more than 75% of the patients finished the program by 40 sessions (equivalent to 8 weeks).

Conclusion: Automated vision therapy delivered by the HTS system improved convergence and divergence amplitudes with a concomitant reduction in symptoms. The HTS system should be used on those patients with symptoms associated with an accommodative/vergence anomaly when in-office vision therapy supplemented with home therapy is not practical.

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