Authors
Alvarez, Tara L.; Vicci, Vincent R.; Alkan, Yelda; Kim, Eun H.; Gohel, Suril; Barrett, Anna M.∥; Chiaravalloti, Nancy; Biswal, Bharat B.

Vision Therapy in Adults with Convergence Insufficiency: Clinical and Functional Magnetic Resonance Imaging Measures

publication date
August 24, 2010
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Abstract/Introduction

Purpose

This research quantified clinical measurements and functional neural changes associated with vision therapy in subjects with convergence insufficiency (CI).

Methods. 

Convergence and divergence 4° step responses were compared between 13 control adult subjects with normal binocular vision and four CI adult subjects. All CI subjects participated in 18 h of vision therapy. Clinical parameters quantified throughout the therapy included: nearpoint of convergence, recovery point of convergence, positive fusional vergence at near, near dissociated phoria, and eye movements that were quantified using peak velocity. Neural correlates of the CI subjects were quantified with functional magnetic resonance imaging scans comparing random vs. predictable vergence movements using a block design before and after vision therapy. Images were quantified by measuring the spatial extent of activation and the average correlation within five regions of interests (ROI). The ROIs were the dorsolateral prefrontal cortex, a portion of the frontal lobe, part of the parietal lobe, the cerebellum, and the brain stem. All measurements were repeated 4 months to 1 year post-therapy in three of the CI subjects.


Conclusion/Results

RESULTS 

Wearing aspheric lenses with negative SA shifts the mean SA of the unaccommodated eyes from +0.05 μm (eyes only) to −0.029 μm (eyes + SVCL) and increases the negative SA for the eye + lens when accommodating from −0.029 to −0.07 μm for natural pupils. Aberration changes with accommodation were attenuated by the accommodative pupil miosis, which reduced binocular viewing pupil diameters from 3.9 to 3.3 mm. This alteration of the typical SA levels by the aspheric SVCL did not prevent accurate accommodation (mean ± standard deviation accommodative lag under binocular viewing were −0.08 ± 0.12D, −0.38 ± 0.12D, and −0.26 ± 0.08D for paraxial, minRMS, and peak IQ, respectively).

CONCLUSIONS 

These data clearly show that aspheric contact lenses designed to correct some or all of the unaccommodated eye’s positive SA do not interfere with accommodation.


Testimonials


  • Vision therapy is well worth the response, time and effort. Our Son had a hard time focusing and writing neatly. After vision therapy Seth could complete a task in half the time if previously took. His abilities to focus improved greatly and so did his handwriting.

    Also, he was better at listening. As a parent, we wanted learning to be fun for our Son, and vision therapy made this possible.


    Amanda T.

  • Vision Therapy is well worth the expense, time and effort. Our son had a hard time focusing handwriting neatly. After vision therapy Seth could complete a task in half the time it previously took his abilities to focus and improved greatly and so did his handwriting.

    Also, he was better at listening. As a parent you wanted learning to be fun for our son and vision therapy made this possible.


    Alexa H.

  • Vision Therapy has given or son the tools he needs to be able to scan and read the written word more effectively and efficiently.

    He love working with John and these working sessions give him the motivation to gladly work on his homework assignments.

    It amazed us to see the difference in the tracking of his eyes and along a line of it's from the beginning to the end of the treatment.

    Dr. McBryar , Kristen and John  are all marvelous and we would recommend them to anyone I only wish that we would have found them sooner!


    Charlotte M.

  • Prior to coming to the institute for vision development my son complained of daily headaches. Therapy has eliminated his headaches completely. I love knowing my son is able to learn pain-free for the rest of his life because of the work that has been done over just a few weeks in this office. He he absolutely loved coming that didn't even feel like going to a doctor or therapy. We are grateful for the relief he was able to find by coming here.

    Thank you!


    Olivia C.

  • Seems much less frustrated with life

    Reads non-stop and fast

    Spelling abilities have been hugely improved

    Seems much more confident

    Thank You!!!


    Kelly O.

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