{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T07:40:11Z","timestamp":1760341211055,"version":"build-2065373602"},"reference-count":19,"publisher":"Korean Ophthalmological Society","issue":"5","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ekjo.org"],"crossmark-restriction":true},"short-container-title":["Korean J Ophthalmol"],"published-print":{"date-parts":[[2025,10,5]]},"abstract":"<jats:p>Purpose: To evaluate the long-term efficacy of home-based convergence exercises using pencil push-ups in adult patients with convergence insufficiency (CI)-type exotropia with receded near point of convergence (NPC).Methods: This retrospective observational study included 30 adult patients diagnosed with CI-type exotropia, who were divided into two groups based on their adherence to pencil push-up exercises: pencil push-ups group (n = 20) and noncompliant control group (n = 10). Pencil push-ups were performed four times daily (15 repetitions per session) for 6 months. The outcomes were changes in the angle of exodeviation (distance and near), NPC, and stereopsis. Measurements were taken at baseline and after 6 months. Between-group comparisons were performed using parametric statistical tests.Results: The pencil push-ups group showed significant improvement in both distance (from 24.65\u202f\u00b1\u202f5.46 to 14.40\u202f\u00b1\u202f5.71 prism diopters, &lt;i&gt;p&lt;\/i&gt; &lt; 0.001) and near exodeviation (from 35.25\u202f\u00b1\u202f5.36 to 23.85\u202f\u00b1\u202f6.68 prism diopters, &lt;i&gt;p&lt;\/i&gt; &lt; 0.001). NPC improved significantly from 22.6\u202f\u00b1\u202f5.2 to 8.6\u202f\u00b1\u202f3.1\u202fcm (&lt;i&gt;p&lt;\/i&gt; &lt; 0.001). In contrast, the noncompliant group showed no significant changes in either parameter. No measurable improvement in stereopsis was observed in either group.Conclusions: Consistent home-based pencil push-up exercises significantly improved convergence and reduced exodeviation in adult patients with CI-type exotropia with receded NPC. Pencil push-ups may serve as an effective first-line or adjunctive therapy, particularly in motivated patients with moderate deviations.<\/jats:p>","DOI":"10.3341\/kjo.2025.0085","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T04:57:34Z","timestamp":1755147454000},"page":"446-453","update-policy":"https:\/\/doi.org\/10.3341\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Pencil Push-up Exercises in Patients with Convergence Insufficiency-Type Exotropia with Receded Near Point of Convergence: A Retrospective Observational Study"],"prefix":"10.3341","volume":"39","author":[{"given":"Ju Seouk","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung Uk","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang Joon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang Zoo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1893","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.04-1372"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-022-02393-z"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2015.06.004"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(66)92570-0"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9394(65)93991-7"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1046\/j.1475-1313.2002.00080.x"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.123.1.14"},{"key":"ref8","first-page":"187","volume-title":"Effectiveness of vision therapy in school children with symptomatic convergence insufficiency","author":"Jang","year":"2017"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1097\/opx.0b013e31822f4d7c"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1097\/01.opx.0000171331.36871.2f"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1097\/wno.0000000000000480"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3341\/kjo.2011.25.3.185"},{"key":"ref13","first-page":"137","volume-title":"Convergence insufficiency-a major review","author":"Cooper","year":"2012"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3126\/hren.v9i3.5583"},{"key":"ref15","first-page":"83","volume-title":"Role of orthoptic treatment in the management of intermittent exotropia","author":"Singh","year":"1992"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.12974\/2311-8687.2023.11.11"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.optom.2025.100540"},{"key":"ref18","first-page":"35","volume-title":"Orthoptic treatment in the management of intermittent exotropia","author":"Asadi","year":"2009"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd006768"}],"container-title":["Korean Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.ekjo.org\/upload\/pdf\/kjo-2025-0085.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.ekjo.org\/journal\/view.php?doi=10.3341\/kjo.2025.0085","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.ekjo.org\/upload\/pdf\/kjo-2025-0085.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T07:05:12Z","timestamp":1760339112000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.ekjo.org\/journal\/view.php?doi=10.3341\/kjo.2025.0085"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,5]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"URL":"https:\/\/doi.org\/10.3341\/kjo.2025.0085","relation":{},"ISSN":["1011-8942","2092-9382"],"issn-type":[{"type":"print","value":"1011-8942"},{"type":"electronic","value":"2092-9382"}],"subject":[],"published":{"date-parts":[[2025,10,5]]},"assertion":[{"value":"2025-06-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-14","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-05","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}