Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (5): 35-40.doi: 10.6040/j.issn.1673-3770.0.2021.198

Previous Articles    

Long-term effectiveness of virtual reality-based vision therapy for convergence insufficiency:a random clinical trial

LI Shijin1, TANG Angcang2, YANG Bi2, WANG Jianglan2, LIU Longqian1,2   

  1. 1. Department of Optometry, West China Clinical Medical College, Sichuan University, Chengdu 610041, Sichuan, China;
    2. Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
  • Published:2022-09-20

Abstract: Objective To investigate the long-term effectiveness of virtual reality-based vision therapy for convergence insufficiency,by evaluating the binocular visual function and subjective symptoms before and after vision therapy. Methods 36 participants with convergence insufficiency were enrolled. The participants were randomly allocated to virtual reality-based vision therapy and office-based vergence/accommodative therapy(OBVAT)groups. The duration of the training was 1 hour per week for 12 weeks. Binocular visual functions and subjective questionnaires.(Convergence insufficiency symptom survey, CISS)were completed before the training, after the 6th and 12th weeks of training, and 6 months after the vision therapy. A two-tailed t-test was used to assess differences between the two groups at baseline, and a two-factor repeated measures ANOVA was used to assess differences between the two groups before and after training. Results After 12 weeks of treatment for CI, significant improvements were found for near exophoria, near point of convergence, positive fusional vergence, and CISS score in both the VR and OBVAT(P<0.001)groups. No statistically significant difference was found between the results at the 6 months after training and the 12th week of training(P>0.05). No statistically significant difference was found in the improvements between the two groups(P>0.05). Conclusion Virtual reality-based vision therapy significantly improved binocular vision function and symptoms in young adults with CI, and the effect can be maintained for 6 months after the end of training. The efficacy of VR was not significantly different from that of OBVAT.

Key words: Virtual reality-based, Vision therapy, Convergence insufficiency, Long-term effectiveness

CLC Number: 

  • R777.4
[1] Rouse MW, Borsting E, Hyman L, et al. Frequency of convergence insufficiency among fifth and sixth graders. The Convergence Insufficiency and Reading Study(CIRS)group[J]. Optom Vis Sci, 1999, 76(9): 643-649. doi:10.1097/00006324-199909000-00022.
[2] Hussaindeen JR, Rakshit A, Singh NK, et al. Prevalence of non-strabismic anomalies of binocular vision in Tamil Nadu: report 2 of BAND study[J]. Clin Exp Optom, 2017, 100(6): 642-648. doi:10.1111/cxo.12496.
[3] Atowa UC, Wajuihian SO, Hansraj R. Vergence profile and prevalance of non-strabismic vergence anomalies among school children in abia state, Nigeria[J]. Ophthalmic Epidemiol, 2019, 26(2): 121-131. doi:10.1080/09286586.2018.1532523.
[4] Wajuihian SO, Hansraj R. Vergence anomalies in a sample of high school students in South Africa[J]. J Optom, 2016, 9(4): 246-257. doi:10.1016/j.optom.2015.10.006.
[5] Ma MM, Long W, She ZH, et al. Convergence insufficiency in Chinese high school students[J]. Clin Exp Optom, 2019, 102(2): 166-171. doi:10.1111/cxo.12838.
[6] Agarwal S, Goel D, Sharma A. Evaluation of the factors which contribute to the ocular complaints in computer users[J]. J Clin Diagn Res, 2013, 7(2): 331-335. doi:10.7860/JCDR/2013/5150.2760.
[7] Logaraj M, Madhupriya V, Hegde S. Computer vision syndrome and associated factors among medical and engineering students in Chennai[J]. Ann Med Health Sci Res, 2014, 4(2): 179-185. doi:10.4103/2141-9248.129028.
[8] Eastgate RM, Griffiths GD, Waddingham PE, et al. Modified virtual reality technology for treatment of amblyopia[J]. Eye(Lond), 2006, 20(3): 370-374. doi:10.1038/sj.eye.6701882.
[9] Žiak P, Holm A, Hali ka J, et al. Amblyopia treatment of adults with dichoptic training using the virtual reality oculus rift head mounted display: preliminary results[J]. BMC Ophthalmol, 2017, 17(1): 105. doi:10.1186/s12886-017-0501-8.
[10] Hali ka J, Sahatqija E, Krasňansky M, et al. Visual training in virtual reality in adult patients with anisometric amblyopia[J]. Cesk Slov Oftalmol, 2020, 76(1): 24-28. doi:10.31348/2020/3.
[11] Scheiman M, Mitchell GL, Cotter S, et al. A randomized clinical trial of treatments for convergence insufficiency in children[J]. Arch Ophthalmol, 2005, 123(1): 14-24. doi:10.1001/archopht.123.1.14.
[12] Scheiman M, Chase C, Borsting E, et al. Effect of treatment of symptomatic convergence insufficiency on reading in children: a pilot study[J]. Clin Exp Optom, 2018, 101(4): 585-593. doi:10.1111/cxo.12682.
[13] Convergence Insufficiency Treatment Trial Study Group. Long-term effectiveness of treatments for symptomatic convergence insufficiency in children[J]. Optom Vis Sci, 2009, 86(9): 1096-1103. doi:10.1097/OPX.0b013e3181b6210f.
[14] CITT Manual of Procedures. Othe Ohio State University College of Optometry. https://optometry.osu.edu/CITT-manual-procedures Chapter 8: Office-Based Vision Therapy(VT/Orthoptics).
[15] Yaramothu C, Vito d' Antonio- Bertagnolli J, Santos EM, et al. Proceedings #37: virtual eye rotation vision exercises(VERVE): a virtual reality vision therapy platform with eye tracking[J]. BrainStimul, 2019, 12(2): e107-e108. doi:10.1016/j.brs.2018.12.206.
[16] Boon MY, Asper LJ, Chik P, et al. Treatment and compliance with virtual reality and anaglyph-based training programs for convergence insufficiency[J]. Clin Exp Optom, 2020, 103(6): 870-876. doi:10.1111/cxo.13057.
[17] Scheiman M, Mitchell GL, Cotter S, et al. A randomized clinical trial of vision therapy/orthoptics versus pencil pushups for the treatment of convergence insufficiency in young adults[J]. Optom Vis Sci, 2005, 82(7): 583-595. doi:10.1097/01.opx.0000171331.36871.2f.
[18] Alvarez TL, Vicci VR, Alkan Y, et al. Vision therapy in adults with convergence insufficiency: clinical and functional magnetic resonance imaging measures[J]. Optom Vis Sci, 2010, 87(12): E985-E1002. doi:10.1097/OPX.0b013e3181fef1aa.
[19] Momeni-Moghaddam H, Kundart J, Azimi A, et al. The effectiveness of home-based pencil push-up therapy versus office-based therapy for the treatment of symptomatic convergence insufficiency in young adults[J]. Middle East Afr J Ophthalmol, 2015, 22(1): 97-102. doi:10.4103/0974-9233.148357.
[20] Widmer DE, Oechslin TS, Limbachia C, et al. Post-therapy functional magnetic resonance imaging in adults with symptomatic convergence insufficiency[J]. Optom Vis Sci, 2018, 95(6): 505-514. doi:10.1097/OPX.0000000000001221.
[21] Aletaha M, Daneshvar F, Mosallaei M, et al. Comparison of three vision therapy approaches for convergence insufficiency[J]. J Ophthalmic Vis Res, 2018, 13(3): 307-314. doi:10.4103/jovr.jovr_99_17.
[22] Singh A, Saxena V, Yadav S, et al. Comparison of home-based pencil push-up therapy and office-based orthoptic therapy in symptomatic patients of convergence insufficiency: a randomized controlled trial[J]. Int Ophthalmol, 2021, 41(4): 1327-1336. doi:10.1007/s10792-020-01689-7.
[23] Ma MM, Yeo ACH, Scheiman M, et al. Vergence and accommodative dysfunctions in emmetropic and myopic Chinese young adults[J]. J Ophthalmol, 2019, 2019: 5904903. doi:10.1155/2019/5904903.
[24] Scheiman M, Gallaway M, Frantz KA, et al. Nearpoint of convergence: test procedure, target selection, and normative data[J]. Optom Vis Sci, 2003, 80(3): 214-225. doi:10.1097/00006324-200303000-00011.
[25] Clark TY, Clark RA. Convergence insufficiency symptom survey scores for reading versus other near visual activities in school-age children[J]. Am J Ophthalmol, 2015, 160(5): 905-912.e2. doi:10.1016/j.ajo.2015.08.008.
[26] Cacho-Martínez P, Cantó-Cerdán M, Carbonell-Bonete S, et al. Characterization of visual symptomatology associated with refractive, accommodative, and binocular anomalies[J]. J Ophthalmol, 2015, 2015: 895803. doi:10.1155/2015/895803.
[27] Bade A, Boas M, Gallaway M, et al. Relationship between clinical signs and symptoms of convergence insufficiency[J]. Optom Vis Sci, 2013, 90(9): 988-995. doi:10.1097/OPX.0000000000000012.
[28] Golebiowski B, Long J, Harrison K, et al. Smartphone use and effects on tear film, blinking and binocular vision[J]. Curr Eye Res, 2020, 45(4): 428-434. doi:10.1080/02713683.2019.1663542.
[29] Jaiswal S, Asper L, Long J, et al. Ocular and visual discomfort associated with smartphones, tablets and computers: what we do and do not know[J]. Clin Exp Optom, 2019, 102(5): 463-477. doi:10.1111/cxo.12851.
[30] 陈晓琴, 王雁, 李丽华, 等. 视觉训练对症状性集合不足儿童疗效的持久性观察[J]. 中华眼视光学与视觉科学杂志, 2016, 18(10): 603-607. doi:10.3760/cma.j.issn.1674-845X.2016.10.006. CHEN Xiaoqin, WANG Yan, LI Lihua, et al. Long-term effectiveness of vision therapy for symptomatic convergence insufficiency in children[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2016, 18(10): 603-607. doi:10.3760/cma.j.issn.1674-845X.2016.10.006.
[1] YAN Bin, ZHOU Huaisheng, PI Liuqing, DUAN Hucheng, YAN Shigang. Effects of using corneal bandage lens on the cornea after strabismus surgery [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 87-90.
[2] HE Li, MA Luxin, ZHAO Bojun, CAO Suyan, WANG Yumei. Clinical characteristics of acute concomitant esotropia: long-term effects of curative treatment approaches [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(3): 89-90.
[3] LUAN Yanan, GUO Jingli, WANG Lihua. Outcome of artificial divergence surgery in patients with infantile nystagmus syndrome (6 cases report) [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(5): 69-71.
[4] WANG Xin, WEI Wei. Chinese materia medica Yishi mixture in treatment of amblyopia in children [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(1): 56-59.
[5] LIU Lai-fu1, ZHANG Qiang1, YU Li1, WEI De-you1,ZHAO Yan1,BAO Le-wei2. Clinical observation of combination of traditional Chinese medicine and western medicine for ocular myasthenia gravis [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2012, 26(6): 69-69.
[6] WANG Fei, CHEN Jin-mao, LAI Li-ping. Changes of extraocular muscle after single direct injection of nerve growth factor in rabbits [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2012, 26(2): 76-79.
[7] ZHANG We-tian, CHENG Fu-wei, ZHANG Yu-jun, ZHU Hua-ming, GUO Jin-bao, YIN Shan-kai. Endonasal endoscopic orbital decompression: Primary experience of the orbital sling technique [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2011, 25(6): 52-.
[8] DENG Zhifeng1, FAN Qingxia2, WU Qi1. Clinical effects of a network multimedia amblyopia training  system on refractive error amblyopia [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2011, 25(4): 81-.
[9] LIU Yong-mei,TIAN Xu,ZHANG Shuang,ZHANG Lin-na . Extracapsular cataract extraction combined with goniosynechialysis for acute angle closure glaucoma [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(3): 248-250 .
[10] LIU Chun-ping1,GAO Fei2,JIAO Wan-zhen3, JI Jia-fu4. General anesthesia with intra-operative wake-up test  in strabismus  surgery  in  70  patients [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2010, 24(6): 73-76.
[11] YUE Pengcheng, WANG Yuan, WAN Xiaomei, GONG Huaqing. Clinical analysis of botulinum toxin type A microinjection in the treatment of acute acquired concomitant esotropia [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 119-122.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!