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Leal-Vega L, Piñero DP, Molina-Martín A, Hernández-Rodríguez CJ, Cuadrado-Asensio R, Martín-Gutiérrez A, Arenillas Lara JF, Coco Martín MB. Pilot Study Assessing the Safety and Acceptance of a Novel Virtual Reality System to Improve Visual Function. Semin Ophthalmol 2024; 39:394-399. [PMID: 38426308 DOI: 10.1080/08820538.2024.2324074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/22/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE To assess the feasibility of the clinical use of a novel Virtual Reality (VR) training software designed to be used for active vision therapy in amblyopic patients by determining its preliminary safety and acceptance on the visual function of healthy adults. METHODS Pilot study enrolling 10 individuals (3 men, 7 women, mean age: 31.8 ± 6.5 years) with a best-corrected visual acuity (BCVA) of ≥ .90 (decimal) in both eyes were evaluated before and after 20 minutes of exposure to the NEIVATECH VR system using the HTC Vive Pro Eye head mounted display. Visual function assessment included near (40 cm) and distance (6 m) cover test (CT), stereopsis, binocular accommodative facility (BAF), near point of convergence (NPC), near point of accommodation (NPA), accommodative-convergence over accommodation (AC/A) ratio and positive and negative fusional vergences. Safety was assessed using the VR Sickness Questionnaire (VRSQ) and acceptance using the Technology Acceptance Model ;(TAM). Changes in all these variables after VR exposure were analyzed. RESULTS Short-term exposure to the NEIVATECH VR system only induced statistically significant changes in distance phoria (p = .016), but these changes were not clinically relevant. No significant changes were observed in VRSQ oculo-motricity and disorientation scores after exposure (p = .197 and .317, respectively). TAM scores showed a good acceptance of the system in terms of perceived enjoyment and perceived ease of use, although some concerns were raised in relation to the intention-to-use domain. CONCLUSION Exposure to the NEIVATECH VR system does not seem to adversely affect the visual function in healthy adults and its safety and acceptance profile seems to be adequate for supporting its potential use in other populations, such as amblyopic patients.
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Affiliation(s)
- Luis Leal-Vega
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
| | - David P Piñero
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
- Clinical Optometry Unit, Department of Ophthalmology, Hospital Vithas Medimar International, Alicante, Spain
| | - Ainhoa Molina-Martín
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Carlos J Hernández-Rodríguez
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Clinical Optometry Unit. Department of Ophthalmology, Centro Médico Virgen de la Caridad Hospital, Cartagena, España
| | | | - Adrián Martín-Gutiérrez
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
| | - Juan Francisco Arenillas Lara
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
- Stroke Unit & Stroke Program, Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - María Begoña Coco Martín
- Group of Applied Clinical Neurosciences, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Valladolid, Spain
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Short-Term Effect of Wearing of Extended Depth-of-Focus Contact Lenses in Myopic Children: A Pilot Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12010431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This pseudo-experimental, prospective, and longitudinal pilot study was conducted to characterize the optical and visual changes occurring in the short-term wear of a hydrophilic contact lens (CL) based on extended focus technology (EDOF). A total of 30 eyes of 15 children (age, 6–16 years) were fitted with the EDOF CL Mylo (Mark’ennovy Care SL), performing an exhaustive follow-up for one month evaluating changes in visual acuity (VA), accommodation, binocularity, ocular aberrometry, visual quality, pupillometry, keratometry and biometry. Far and near VA with the CL improved progressively (p < 0.001), obtaining mean final binocular values of −0.08 ± 0.01 and −0.07 ± 0.01 LogMAR, respectively. There was a mean reduction in the accommodative LAG of 0.30 D (p < 0.001), without associated alterations in the magnitude of the phoria and fusional vergences (p ≥ 0.066). A controlled but statistically significant increase (p ≤ 0.005) of ocular high order aberration (HOA) root mean square (RMS), primary coma RMS, primary spherical aberration Zernike term and secondary astigmatism RMS was found with the CL wear. In conclusion, the EDOF CL evaluated provides adequate visual acuity and quality, with associated increased of several HOAs and a trend to reduction in the accommodative LAG that should be confirmed in future studies.
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Bilbao C, Piñero DP. Distribution of Visual and Oculomotor Alterations in a Clinical Population of Children with and without Neurodevelopmental Disorders. Brain Sci 2021; 11:351. [PMID: 33801948 PMCID: PMC7999547 DOI: 10.3390/brainsci11030351] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/03/2021] [Accepted: 03/06/2021] [Indexed: 12/14/2022] Open
Abstract
A prospective, non-randomized comparative study was conducted to compare the distribution of oculomotor and visual alterations in children with neurodevelopmental disorders and healthy children without such disorders. Sixty-nine children (aged 6-13 years) were enrolled and divided into three groups: a control group (CG) of 23 healthy children; a group of 18 healthy children with oculomotor abnormalities (OAG); and a group of 28 children with a neurodevelopmental disorder (NDDG), with 15 cases of dyslexia, 7 cases of developmental coordination disorder (DCD) and 6 cases of attention deficit/hyperactivity disorder (ADHD). Significantly worse near stereopsis was found in NDDG compared with CG (p < 0.001) and OAG (p = 0.001). Likewise, a significantly lower amplitude of accommodation was found in NDDG compared with CG in both the right (p = 0.001) and left eyes (p < 0.001). No statistically significant differences between groups were found in the measurement of near and distance phoria (p ≥ 0.557), near point of convergence (p = 0.700) and fusional vergences (p ≥ 0.059). Significantly impaired oculomotor test scores were found in NDDG compared with CG (p < 0.001), with no significant differences between OAG and NDDG (p ≥ 0.063). The comparison between the three types of neurodevelopmental disorders included revealed the presence of a significantly lower amplitude of accommodation in children with DCD compared with dyslexics. Furthermore, less exophoria at near was present in children with dyslexia compared with children with ADHD (p = 0.018) and DCD (p = 0.054). In conclusion, children with dyslexia, ADHD and DCD show an altered oculomotor pattern and a more reduced amplitude of accommodation, not always compatible with the diagnostic criteria of an accommodative insufficiency. Accommodative and binocular vision problems are not always present in these children and cannot be considered an etiologic factor.
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Affiliation(s)
- Carmen Bilbao
- Department of Optometry, Policlínica Alto Aragón, 22003 Huesca, Spain;
| | - David Pablo Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain
- Department of Ophthalmology, Vithas Medimar International Hospital, 03016 Alicante, Spain
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Wajuihian SO. Normative values for clinical measures used to classify accommodative and vergence anomalies in a sample of high school children in South Africa. JOURNAL OF OPTOMETRY 2019; 12:143-160. [PMID: 29887298 PMCID: PMC6612036 DOI: 10.1016/j.optom.2018.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 03/05/2018] [Accepted: 03/20/2018] [Indexed: 05/10/2023]
Abstract
AIM To determine normative values for stereoacuity, accommodative and vergence measures for high school populations. METHODS Using a multi-stage random cluster sampling, 1211 children (481 males and 730 females) between 13 and 18 years of age, with a median age of 16 years, were selected. Visual acuity, stereoacuity and suppression, refractive errors, near point of convergence, heterophoria and fusional vergences, as well as, amplitude of accommodation, accommodative response, facility and relative accommodation were evaluated. RESULTS Most data did not have a normal distribution. The range of normality for the vergence measures were: near point of convergence break, 5-10cm, recovery, 6-13cm, near lateral phoria, 2.5-6 prism dioptre (pd) (nasal), near vertical, orthophoria to 0.50pd, negative fusional vergence break, 12-23pd, recovery, 8-17pd, positive fusional vergence break, 16-35 and recovery 11-24pd. For accommodative measures, the range of normality for accommodative measures was: amplitude of accommodation, 12-18pd, accommodative response, plano to +0.75D, binocular accommodative facility, 5-12 cycles per minute (cpm), negative relative accommodation, 1.75-2.50DS, positive relative accommodation, -2.0 to -3.0DS and 17-69s arc for stereoacuity. CONCLUSION This study provides norms for clinical measures which could be used to classify accommodative and vergence parameters for children aged 13-18 years in this population or beyond. Findings should be applied in the context of the measurement techniques and the associated limitations outlined in this report.
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Affiliation(s)
- Samuel Otabor Wajuihian
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa.
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Abstract
Background: Fusional amplitudes are important for clinical practice in diagnosing and managing binocular vision anomalies. Several measurement methods can be used to assess fusional amplitudes. However, those methods are not interchangeable, and measurement repeatability has been questioned. Objectives: To compare the normative values of tests for the measurement of fusional vergence and to investigate sources of heterogeneity of diagnostic accuracy including: age, variation in method of assessment, study design and size, type (convergent, divergent, vertical, cyclo) and severity of strabismus (constant/intermittent/latent). Data sources: Bibliographic databases were searched up to March 2018, including Cochrane registers, PubMed, Web of ScienceTM, Google Scholar and Science Citation Index. Trial registers and conference proceedings were hand searched. Review methods: The review observed and reported according to the PRISMA guidelines and was registered with PROSPERO. The I2 was used to show the percentage of observed total variation across studies that is due to real heterogeneity rather than chance. The results of the different studies and the overall effect (meta-analysis under the random effects model) are shown. Results: Eighty-one studies were included in the review. Heterogenous information about break vergence amplitudes is reported for the step vergence method (I2 > 50%; p < 0.05) in children. Four parameters were reported consistently to affect measurements; age, method of assessment, order of testing and target size. For the smooth vergence technique break vergence values heterogeneity was not present in children and adults (I2 = 0%; p > 0.05). Limitations: The results are based on cross-sectional studies that were performed independently of each other, with different examiners, methods of examination and different populations. Conclusions: The source of heterogeneity between studies for vergence break points measured with the step vergence method seems to be linked with age. Normal vergences reported in children had considerable heterogeneity compared with adults. In clinical practice, the population-based vergence ranges measured with the step vergence method in children should not be used as one single criterion. For the smooth vergence technique, normative population data can be used.
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Affiliation(s)
| | - Fiona J Rowe
- b Department of Health Services Research, University of Liverpool , Liverpool
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Yekta A, Khabazkhoob M, Hashemi H, Ostadimoghaddam H, Ghasemi-Moghaddam S, Heravian J, Doostdar A, Nabovati P. Binocular and Accommodative Characteristics in a Normal Population. Strabismus 2017; 25:5-11. [DOI: 10.1080/09273972.2016.1276937] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- AbbasAli Yekta
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Hassan Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Hadi Ostadimoghaddam
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Javad Heravian
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asgar Doostdar
- Department of Optometry, Iran University of Medical Sciences, Tehran, Iran
| | - Payam Nabovati
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
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Wajuihian SO, Hansraj R. Vergence anomalies in a sample of high school students in South Africa. JOURNAL OF OPTOMETRY 2016; 9:246-57. [PMID: 26750804 PMCID: PMC5030317 DOI: 10.1016/j.optom.2015.10.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 10/05/2015] [Accepted: 10/05/2015] [Indexed: 05/21/2023]
Abstract
AIM To study the prevalence of nearpoint vergence anomalies (convergence insufficiency, convergence excess and fusional vergence dysfunction) and association with gender, age groups, grade level and study site (suburban and rural). METHODS The study design was cross sectional and data was analyzed for 1201 high school students aged 13-19 years who were randomly selected from 13 high schools in uMhlathuze municipality. Of the total sample, 476 (39.5%) were males and 725 (60.5%) were females. The visual functions evaluated included refractive errors, heterophoria, near point of convergence, accommodative functions and fusional vergences. Possible associations between vergence anomalies and demographic variables (gender, age groups, school grade levels and study site) were explored. RESULTS Prevalence estimates were 11.8%, 6% and 4.3% for low suspect, high suspect and definite convergence insufficiency, and 1.9% for the pseudo convergence insufficiency. Convergence excess prevalence was 5.6%, and fusional vergence dysfunction was 3.3%. The prevalence of low suspect CI was significantly higher in suburban than in rural participants (p=0.01), the reverse was the case for pseudoconvergence insufficiency while the prevalence of convergence excess was significantly higher in the younger than in the older age group (p=0.02). No other category showed any statistically significant associations with vergence anomalies. CONCLUSION The prevalence estimates for vergence anomalies in a sample of black high school students in South Africa were relatively low. Only study location and age influenced some vergence anomalies. Identification and referrals are important steps toward diagnosis and treatment for vergence anomalies. Further studies to compare vergence anomalies in various racial populations will be relevant.
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Affiliation(s)
- Samuel Otabor Wajuihian
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal (UKZN), Private Bag X54001, Durban 4000, South Africa.
| | - Rekha Hansraj
- Discipline of Optometry, School of Health Sciences, University of KwaZulu-Natal (UKZN), Private Bag X54001, Durban 4000, South Africa
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Characterization of Visual Symptomatology Associated with Refractive, Accommodative, and Binocular Anomalies. J Ophthalmol 2015; 2015:895803. [PMID: 26351575 PMCID: PMC4553196 DOI: 10.1155/2015/895803] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 07/20/2015] [Accepted: 07/26/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose. To characterize the symptomatology of refractive, accommodative, and nonstrabismic binocular dysfunctions and to assess the association between dysfunctions and symptoms. Methods. 175 randomised university students were examined. Subjects were given a subjective visual examination with accommodative and binocular tests, evaluating their symptomatology. Accommodative and binocular dysfunctions (AD, BD) were diagnosed according to the number of existing clinical signs: suspect AD or BD (one fundamental clinical sign), high suspect (one fundamental + 1 complementary clinical sign), and definite (one fundamental + 2 or more complementary clinical signs). A logistic regression was conducted in order to determine whether there was an association between dysfunctions and symptoms. Results. 78 subjects (44.6%) reported any kind of symptoms which were grouped into 18 categories, with “visual fatigue” being the most frequent (20% of the overall complaints). Logistic regression adjusted by the presence of an uncorrected refractive error showed no association between any grade of AD and symptoms. Subjects with BD had more likelihood of having symptoms than without dysfunction group (OR = 3.35), being greater when only definite BD were considered (OR = 8.79). Conclusions. An uncorrected refractive error is a confusion factor when considering AD symptomatology. For BD, the more the number of clinical signs used the greater the likelihood suffering symptoms.
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Cacho-Martínez P, García-Muñoz Á, Ruiz-Cantero MT. Is there any evidence for the validity of diagnostic criteria used for accommodative and nonstrabismic binocular dysfunctions? JOURNAL OF OPTOMETRY 2014; 7:2-21. [PMID: 24646897 PMCID: PMC3938740 DOI: 10.1016/j.optom.2013.01.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 12/21/2012] [Accepted: 12/21/2012] [Indexed: 05/22/2023]
Abstract
PURPOSE To analyze the diagnostic criteria used in the scientific literature published in the past 25 years for accommodative and nonstrabismic binocular dysfunctions and to explore if the epidemiological analysis of diagnostic validity has been used to propose which clinical criteria should be used for diagnostic purposes. METHODS We carried out a systematic review of papers on accommodative and non-strabic binocular disorders published from 1986 to 2012 analysing the MEDLINE, CINAHL, PsycINFO and FRANCIS databases. We admitted original articles about diagnosis of these anomalies in any population. We identified 839 articles and 12 studies were included. The quality of included articles was assessed using the QUADAS-2 tool. RESULTS The review shows a wide range of clinical signs and cut-off points between authors. Only 3 studies (regarding accommodative anomalies) assessed diagnostic accuracy of clinical signs. Their results suggest using the accommodative amplitude and monocular accommodative facility for diagnosing accommodative insufficiency and a high positive relative accommodation for accommodative excess. The remaining 9 articles did not analyze diagnostic accuracy, assessing a diagnosis with the criteria the authors considered. We also found differences between studies in the way of considering patients' symptomatology. 3 studies of 12 analyzed, performed a validation of a symptom survey used for convergence insufficiency. CONCLUSIONS Scientific literature reveals differences between authors according to diagnostic criteria for accommodative and nonstrabismic binocular dysfunctions. Diagnostic accuracy studies show that there is only certain evidence for accommodative conditions. For binocular anomalies there is only evidence about a validated questionnaire for convergence insufficiency with no data of diagnostic accuracy.
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Affiliation(s)
- Pilar Cacho-Martínez
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Alicante, Spain.
| | - Ángel García-Muñoz
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Alicante, Spain
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Diagnostic validity of clinical signs associated with a large exophoria at near. J Ophthalmol 2013; 2013:549435. [PMID: 23997945 PMCID: PMC3749604 DOI: 10.1155/2013/549435] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 05/12/2013] [Accepted: 06/02/2013] [Indexed: 11/17/2022] Open
Abstract
Purpose. To analyze the diagnostic validity of accommodative and binocular tests in a sample of patients with a large near exophoria with moderate to severe symptoms. Methods. Two groups of patients between 19 and 35 years were recruited from a university clinic: 33 subjects with large exophoria at near vision and moderate or high visual discomfort and 33 patients with normal heterophoria and low visual discomfort. Visual discomfort was defined using the Conlon survey. A refractive exam and an exhaustive evaluation of accommodation and vergence were assessed. Diagnostic validity by means of receiver operator characteristic (ROC) curves, sensitivity (S), specificity (Sp), and positive and negative likelihood ratios (LR+, LR-) were assessed. This analysis was also carried out considering multiple tests as serial testing strategy. Results. ROC analysis showed the best diagnostic accuracy for receded near point of convergence (NPC) recovery (area = 0.929) and binocular accommodative facility (BAF) (area = 0.886). Using the cut-offs obtained with ROC analysis, the best diagnostic validity was obtained for the combination of NPC recovery and BAF (S = 0.77, Sp = 1, LR+ = value tending to infinity, LR- = 0.23) and the combination of NPC break and recovery with BAF (S = 0.73, Sp = 1, LR+ = tending to infinity, LR- = 0.27). Conclusions. NPC and BAF tests were the tests with the best diagnostic accuracy for subjects with large near exophoria and moderate to severe symptoms.
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Cacho-Martínez P, García-Muñoz Á, Ruiz-Cantero MT. Do we really know the prevalence of accomodative and nonstrabismic binocular dysfunctions? JOURNAL OF OPTOMETRY 2010; 3:185-197. [PMCID: PMC3974377 DOI: 10.1016/s1888-4296(10)70028-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Accepted: 11/17/2010] [Indexed: 05/21/2023]
Abstract
Purpose To determine the scientific evidence about the prevalence of accommodative and nonstrabismic binocular anomalies. Methods We carried out a systematic review of studies published between 1986 and 2009, analysing the MEDLINE, CINAHL, FRANCIS and PsycINFO databases. We considered admitting those papers related to prevalence in paediatric and adult populations. We identified 660 articles and 10 papers met the inclusion criteria. Results There is a wide range of prevalence, particularly for accommodative insufficiency (2–61,7 %) and convergence insufficiency (2.25–33 %). More studies are available for children (7) compared with adults (3). Most of studies examine clinical population (5 studies) with 3 assessed at schools and 1 at University with samples that vary from 65 to 2048 patients. There is great variability regarding the number of diagnostic signs ranging from 1 to 5 clinical signs. We found a relation between the number of clinical signs used and prevalence values for convergence insufficiency although this relationship cannot be confirmed for other conditions. Conclusion There is a lack of proper epidemiological studies about the prevalence of accommodative and nonstrabismic binocular anomalies. Studies reviewed examine consecutive or selected patients in clinical settings and schools but in any case they are randomized and representative of their populations with no data for general population. The wide discrepancies in prevalence figures are due to both sample population and the lack of uniformity in diagnostic criteria so that it makes difficult to compile results. Biases and limitations of reports determine that prevalence rates offered are only estimations from selected populations.
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Affiliation(s)
- Pilar Cacho-Martínez
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Alicante, Spain
- Corresponding author: Departamento de Óptica, Farmacología y Anatomía. Apartado 99. Universidad de Alicante. 03080 Alicante, Spain. Phone: +34 965 903 400 Ext 2403; Fax: +34 965 909 472.
| | - Ángel García-Muñoz
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Alicante, Spain
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Cacho Martínez P, García Muñoz A, Ruiz-Cantero MT. Treatment of accommodative and nonstrabismic binocular dysfunctions: a systematic review. ACTA ACUST UNITED AC 2010; 80:702-16. [PMID: 19932444 DOI: 10.1016/j.optm.2009.06.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 05/20/2009] [Accepted: 06/02/2009] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study was to analyze the scientific evidence available on the nonsurgical treatment of accommodative and nonstrabismic binocular dysfunctions, identifying the types of treatment used and their efficacy. METHODS A systematic review of reports published from 1986 to 2007 was completed using several health science databases: FRANCIS, Medline, Cinahl, and PsycINFO. Those papers that analyzed the treatment of accommodative and nonstrabismic binocular anomalies were included. RESULTS Of the 565 articles identified, 16 met the inclusion criteria. Only 3 were clinical trials. All analyzed treatment of convergence insufficiency. Results of clinical trials support the conclusion that vision therapy improves symptoms and signs for convergence insufficiency. Further, the evidence indicates that pencil push-up treatment is not as effective as vision therapy and that prism glasses are no more effective than placebo glasses. For the other nonstrabismic binocular conditions and accommodative disorders, there is a lack of published randomized, clinical trials that support the evidence for the efficacy of each treatment. CONCLUSION Scientific evidence exists for the efficacy of vision therapy for convergence insufficiency. Insufficient scientific evidence exists on the best therapeutic options for treatment of the other nonstrabismic binocular anomalies and accommodative disorders.
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Affiliation(s)
- Pilar Cacho Martínez
- Departamento de Optica, Farmacología y Anatomía, Universidad de Alicante, Centro de Investigación Biomédica en Red, Alicante, Spain.
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Nathan J, Dwyer P. Letter to the Editor. Clin Exp Optom 1992. [DOI: 10.1111/j.1444-0938.1992.tb00616.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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