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Convergence Insufficiency Treatment Trial - Attention & Reading Trial (CITT-ART)

Convergence insufficiency (CI) is a common childhood eye-teaming problem in which the eyes have a strong tendency to drift outward when reading or doing work close up. Double vision often occurs if an eye drifts out. To avoid seeing double, a child with CI must use extra effort to make the eyes turn back in. This extra effort can lead to annoying symptoms, such as eye strain, blurred or double vision, loss of concentration, and frequent loss of place when reading and working up close.

Children with CI have more symptoms and show worse attention when reading than children without CI. Research has shown that treatment using office-based accommodative-vergence vision therapy improves symptoms in children affected with CI. Some studies have suggested that this treatment also results in improvements in reading and attention. However, to know for sure whether vision therapy has a positive effect on reading and attention, we need to study this question using a randomized clinical trial design in a larger group of children.

The CITT-ART is designed to determine whether office-based vision therapy for CI improves reading and attention in children who have symptomatic CI. This study is funded by the National Eye Institute, which is a part of the National Institutes of Health. It is being conducted at 8 clinical eye care locations across the United States. Approximately 324 children will take part in the study.

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  CHILDREN AND CONVERGENCE INSUFFICIENCY
Convergence insufficiency is present in 1 out of every 20 children suggesting that in a typical classroom 1-2 children may have this condition. Studies has demonstrated that children with this problem are likely to experience performance related symptoms....more
  CONVERGENCE INSUFFICIENCY AND ATTENTION DISORDERS
The symptoms of convergence insufficiency can make it difficult for a child to concentrate on extended reading and may overlap with those of ADHD. The recent CITT study showed that 45% of the children with convergence insufficiency reported attention problems. ...more
  EFFECT OF CONVERGENCE INSUFFICIENCY ON EVERYDAY ACTIVITIES
Recent studies that have suggested a possible relationship between CI and Attention Deficit Hyperactivity Disorder (ADHD). Borsting et al argued that the symptoms frequently reported in CI such as loss of concentration when reading or reading slowly are similar to behaviors associated with ADHD (inattentive type), such as, failure to complete assignments and trouble concentrating in class....more
  HOW IS CONVERGENCE INSUFFICIENCY TREATED?
Most eye care professionals treat CI using a home-based therapy called “pencil push-ups.” With his eyes, the child follows a small letter on a pencil as the pencil is moved toward the bridge of his nose. ...more
  SIGNS AND SYMPTOMS OF CONVERGENCE INSUFFICIENCY
Difficulty converging while engaged in a reading task causes misalignment of the eyes results in double vision unless the individual exerts additional convergence effort to re-align the eyes. ...more
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