The Effectiveness of Pencil Pushup Training and Office-Based Vision Therapy for Treatment of Convergence Insufficiency

To compare the effectiveness of pencil pushup training (PPT) versus office-based vision therapy in patients with convergence insufficiency. Sixty students of Zahedan Medical University with convergence insufficiency were randomly selected. After determining refractive error (by retinoscopy using cyclopentolate 1%, if needed), near point of convergence (by millimeter ruler), near heterophoria (by alternate prism cover test) and positive relative convergence (by prism bar); subjects were divided into two groups to receive PPT (3 times daily for 10 min), or office prism training (2 times each week for 30 min). Subjects were re-examined 4 and 8 weeks after initiation of treatment. Independent samples t-test showed that near point of convergence, phoria and positive relative convergence were not statistically different between the two groups before treatment. After 4 and 8 weeks of treatment only positive relative convergence was different between the two groups. Repeated measurement ANOVA showed considerable difference between the two groups in general but the Bonferroni test showed that the observed difference was related only to positive relative convergence. PPT and office-based vision therapy are comparable for treatment of convergence insufficiency.