{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T20:06:33Z","timestamp":1780085193832,"version":"3.54.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T00:00:00Z","timestamp":1713139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000053","name":"National Eye Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmic Physiologic Optic"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To report the change in the magnitude of near exodeviation in children with symptomatic convergence insufficiency successfully treated with office\u2010based vergence\/accommodative therapy in the Convergence Insufficiency Treatment Trial\u2013Attention and Reading Trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 131 children 9\u201314\u2009years of age with symptomatic convergence insufficiency classified as successfully treated with office\u2010based vergence\/accommodative therapy at the 16\u2010week outcome visit were included. Masked examiners measured the near ocular deviation by the prism and alternate cover test at baseline, primary outcome and 1\u2010year post\u2010treatment. The mean change in near deviation was calculated from baseline to primary outcome, from primary outcome to 1\u2010year post\u2010treatment and from baseline to 1\u2010year post\u2010treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 131 participants successfully treated with vergence\/accommodative therapy, 120 completed the 1\u2010year post\u2010treatment visit. A significant change in near exodeviation was observed at baseline to primary outcome (2.6\u0394 less exo,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, moderate effect size\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.61) and at baseline to 1\u2010year post\u2010treatment (2.0\u0394 less exo;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, small effect size\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.45). The change from primary outcome to 1\u2010year post\u2010treatment (0.6\u0394 more exo;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06, small effect size\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.11) was not significant. Forty per cent (48\/120) of participants had a decrease in near exodeviation &gt;3.5\u2206 (expected test\/retest variability) between baseline and the primary outcome examination. Of the 120 participants, one (1.0%) was esophoric at the primary outcome and was subsequently exophoric at 1\u2010year post\u2010treatment. Four participants (3.3%) who were orthophoric or exophoric at the primary outcome were esophoric (all \u22643\u2206) at the 1\u2010year post\u2010treatment visit.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>On average, the near exodeviation was smaller in size immediately after the discontinuation of vergence\/accommodative therapy (2.6\u2206, moderate effect size) and 1\u2009year post vergence\/accommodative therapy (2.0\u2206, small effect size) in children with convergence insufficiency who were successfully treated; 40% had a clinically meaningful decrease in exophoria. The development of near esophoria was rare.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opo.13316","type":"journal-article","created":{"date-parts":[[2024,4,15]],"date-time":"2024-04-15T08:33:27Z","timestamp":1713170007000},"page":"936-944","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of vision therapy on near exodeviation in children with convergence insufficiency treated during the convergence insufficiency treatment trials"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3400-1671","authenticated-orcid":false,"given":"Erica","family":"Schulman","sequence":"first","affiliation":[{"name":"College of Optometry State University of New York  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9274-5696","authenticated-orcid":false,"given":"Mitchell","family":"Scheiman","sequence":"additional","affiliation":[{"name":"Pennsylvania College of Optometry Salus University  Elkins Park Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0486-6998","authenticated-orcid":false,"given":"Marjean T.","family":"Kulp","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Optometry  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6835-5559","authenticated-orcid":false,"given":"Tawna L.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8402-0521","authenticated-orcid":false,"given":"Susan","family":"Cotter","sequence":"additional","affiliation":[{"name":"Southern California College of Optometry Marshall B. Ketchum University  Fullerton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loraine T.","family":"Sinnott","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Optometry  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0535-2685","authenticated-orcid":false,"given":"Andrew","family":"Toole","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Optometry  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The CITT\u2010ART Investigator Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006768.pub3"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.123.1.14"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.opx.0000171331.36871.2f"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0000000000001443"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.126.10.1336"},{"key":"e_1_2_11_7_1","first-page":"480","article-title":"Nearpoint visual stress: clinical implications","volume":"56","author":"Birnbaum MH","year":"1985","journal-title":"J Am Optom Assoc"},{"key":"e_1_2_11_8_1","first-page":"495","volume-title":"Vergence eye movements: basic and clinical aspects","author":"Schor CM","year":"1983"},{"key":"e_1_2_11_9_1","first-page":"187","article-title":"Effectiveness of vision therapy in school children with symptomatic convergence insufficiency","volume":"12","author":"Jang JU","year":"2017","journal-title":"J Ophthalmic Vis Res"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-198604000-00002"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.optom.2016.10.001"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.4103\/0974-9233.148357"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/jovr.jovr_99_17"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.visres.2015.04.001"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-199204000-00007"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.04-1372"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3341\/kjo.2011.25.3.185"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-1313.1992.tb00403.x"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0b013e3181ae00a5"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-198009000-00015"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1114\/1.162"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-1313.1993.tb00426.x"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-198301000-00001"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-198109000-00009"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-1313.1989.tb00904.x"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.62.10.19"},{"key":"e_1_2_11_27_1","first-page":"234","article-title":"Oculomotor adaptation to induced heterophoria and anisometropia","volume":"22","author":"Henson DB","year":"1982","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.visres.2014.04.003"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-196503000-00001"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1953.00920020322009"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-198009000-00013"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-198806000-00006"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-200312000-00014"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0b013e3181989252"},{"key":"e_1_2_11_35_1","first-page":"214","article-title":"Convergence insufficiency treatment trial\u2014attention and reading trial (CITT\u2010ART): design and methods","volume":"1","author":"CITT\u2010ART Investigator Group","year":"2015","journal-title":"Vis Dev Rehabil"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/09286580701772037"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-199810000-00016"},{"key":"e_1_2_11_38_1","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J","year":"1988"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu14163321"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010021\u201002732\u20107"},{"key":"e_1_2_11_41_1","volume-title":"Researches in binocular vision","author":"Ogle KN","year":"1950"},{"key":"e_1_2_11_42_1","volume-title":"Clinical management of binocular vision: heterophoric, accommodative and eye movement disorders","author":"Scheiman M","year":"2019"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/0042-6989(79)90151-2"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-199204000-00008"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-197901000-00005"},{"key":"e_1_2_11_46_1","volume-title":"Binocular anomalies: theory, testing and therapy","author":"Griffin JR","year":"2010"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0b013e3181d1d954"}],"container-title":["Ophthalmic and Physiological Optics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/opo.13316","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T11:24:21Z","timestamp":1767785061000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/opo.13316"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,15]]},"references-count":46,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1111\/opo.13316"],"URL":"https:\/\/doi.org\/10.1111\/opo.13316","archive":["Portico"],"relation":{},"ISSN":["0275-5408","1475-1313"],"issn-type":[{"value":"0275-5408","type":"print"},{"value":"1475-1313","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,15]]},"assertion":[{"value":"2023-10-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}