Effective treatment for CI can reduce school-related behavioral problems in children

For children with convergence insufficiency (CI)—who have difficulty focusing on objects close up—effective treatments can help to reduce problems at school, reports a study in the January issue of Optometry and Vision Science, official journal of the American Academy of Optometry. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

"A successful or improved outcome after CI treatment was associated with a reduction in the frequency of adverse academic behaviors and parental concern associated with reading and school work," concludes the new research, led by Eric Borsting, OD, of Southern California College of Optometry, Fullerton.

After Positive Effects of CI Treatment, Parents See Fewer School-Related Problems
The researchers analyzed 218 children and adolescents from a previous study of treatment for CI. Convergence insufficiency is a condition in which the eyes have trouble working together to focus on close-up objects. In addition to symptoms like eyestrain, headache, and double vision, CI has been linked to problems in doing school work, reading, and studying.

In the study, children were assigned to different treatments for CI—office treatment by an eye care professional, two different types of home-based treatment, or an inactive "placebo" treatment. In 42 children, treatment was rated "successful" (near-normal binocular vision), while another 60 children were rated "improved." The remaining 116 children did not respond to treatment.

The researchers compared scores on a simple scale of academic behavior problems. Rated by parents, the scale included problems like difficulty completing assignments, avoiding reading or other close work, and careless mistakes in doing school work. Before treatment, the children's average score on the academic behavior problem scale was about 13 out of 24 (with higher scores indicating more problems).

For children who had improvement in CI after treatment, academic behavior problems were significantly reduced. The average improvement was four points in children whose treatment was rated "successful" and three points in those rated "improved." By comparison, children who did not improve with treatment had just a one-point improvement on the problem scale.

In particular, parents reported fewer worries about the child's school performance and fewer problems with attention to detail after effective CI treatment. Children in the "successful" and "improved" groups had similar improvement in academic behavior problems.

Convergence insufficiency is a relatively common problem, affecting about five percent of school-aged children. In addition to eyestrain and visual symptoms, children with CI are more likely to have problems such as difficulty completing school work, avoiding reading and studying, and inattentiveness while reading and studying. The new study sought to determine whether treatment for CI can alleviate such problems.

The results suggest that children who respond to treatment for CI have significant improvement in academic-related behavior problems, as rated by parents. When treatment is effective, attention to detail improves and parents are less worried about how their child is doing in school.

Although the study has some limitations, it is among the first to show how effective treatment for CI can affect school-related behavioral problems.