|
suggest transfer of the base-out experimental training to this task.
In conclusion, we have demonstrated a significant reduction in asthenopia after fusional vergence training in patients with convergence insufficiency. The automated fusional vergence training resulted in an increase in fusional convergence ranges during the experimental procedure on vectograms, and on the fixation disparity curves, although transfer was less than that found in normals. Traditional orthoptic therapy resulted in the greatest improvement of fusional convergence ranges and the greatest reduction in asthenopia. This further reduction suggests the need for a multi-method approach to fusional vergence training in order to maximize transfer to the patient’s normal working environment.
APPENDIX A
|
1.
|
How long
can
you do “nearwork” (i.e., reading,
|
writing, sewing, etc.) with no discomfort (e.g., headaches, eye ache, burning, stinging, watering, blurriness, double vision; loss of concentration or tiredness?
|
2.
|
How often do you get headaches when you do
|
nearwork?
|
(1)
|
every time (100% of the time)
|
|
(2)
|
very often (about 75% of the time)
|
|
(3)
|
often (about 50% of the time)
|
|
(4)
|
occasionally (about 25% of the time)
|
|
(5)
|
never (0% of the time)
|
|
3.
|
If you experience headaches during nearwork, how
|
bothersome are these headaches (i.e., the
degree
to which they interfere with your normal functioning (1) extremely bothersome
|
(3)
|
moderately bothersome
|
|
4.
|
Do your eyes pull, ache, or water when you do
|
nearwork?
|
(1)
|
every time that I read (100% of the time)
|
|
(2)
|
very often (about 75% of the time)
|
|
(3)
|
often (about 50% of the time)
|
|
(4)
|
occasionally (about 25% of the time)
|
|
(5)
|
never (0% of the time)
|
|
5.
|
Does the reading material ever become blurry, run
|
together, or jump when you do nearwork?
|
(1)
|
every time that I read (about 100% of the time)
|
|
(2)
|
very often (about 75% of the time)
|
|
(3)
|
often (about 50% of the time)
|
|
(4)
|
occasionally (about 25% of the time)
|
|
(5)
|
never (0% of the time)
|
|
6.
|
Does the reading material ever become double when
|
you do nearwork?
|
(1)
|
every time I read (100% of the time)
|
|
(2)
|
very often (about
75%
of the time)
|
|
(3)
|
often (about 50% of the time)
|
|
(4)
|
occasionally (about 25% of the time)
|
|
(5)
|
never (0% of the time)
|
|
7.
|
Do your eyes feel “tired” and/or do you lose your
|
concentration when you do nearwork?
|
(1) every time that I read (100% of the time)
(2) very often (about 75% of the time) (3) often (about 50% of the time) (4) occasionally (about 25% of the time) (5) never (0% of the time)
|
8.
|
Please briefly describe any other problems you have
|
when you do nearwork.
REFERENCES
|
1.
|
Norn MS. Convergence insufficiency. Incidence in
|
ophthalmic practice. Results of orthoptic treatment. Acta Ophthalmol (Kbl) 1966;44:132—8.
|
2.
|
Duke-Elder S, Wybar K. Ocular motility and stra
|
bismus. In: Duke-Elder 5, ed. System of Ophthalmology, vol VI, St Louis: CV Mosby, 1973:566—
72.
|
3.
|
Kratka Z, Kratka WH. Convergence insufficiency;
|
its frequency and importance. Am Orthopt J
1956;6:72—3.
|
4.
|
Cooper
J, Duckman A, Convergence insufficiency:
|
incidence, diagnosis, and treatment. J Am Optom Assoc 1 978;49:473—80.
|
5.
|
White JW, Brown HW. Occurrence of vertical an
|
omalies associated with convergent and divergent anomalies. Arch Ophthal 1 939;21 :999—1 009.
|
6.
|
Passmore JW, MacLean F. Convergence insuffi
|
ciency and its management. An evaluation of 100
patients receiving a course of orthoptics. Am J
Ophthalmol 1 957;43:448—56.
|
7.
|
Mayou S. The treatment of convergence defi
|
ciency. Br Ophthopt J 1945;3:72—82.
|
8.
|
Hirsch MJ. A study of forty-eight cases of conver
|
gence insufficiency at the near point. Am J Optom Arch Am Acad Optom 1 943;20:52—8.
|
9.
|
Cooper J, Feldman J. Operant conditioning of fu
|
sional convergence ranges using random dot ster
eograms.
Am J Optom Physiol Opt 1 980;57:205—
13.
|
10.
|
Ogle KN, Martens TG, Dyer JA. Oculomotor Im
|
balance in Binocular Vision and Fixation Disparity. Philadelphia: Lea & Febiger, 1967.
|
11.
|
Ciuffreda KJ. Near
point
of convergence as a func
|
tion of target accommodative demand. Opt J Rev Optom 1974;1 11:9—10.
|
12.
|
Borish IM. Clinical Refraction. 3rd ed. Chicago:
|
Professional Press, 1970.
|
13.
|
Cooper J, Feldman J. Random-dot-stereogram
|
performance by strabismic, amblyopic, and ocular- pathology patients in an operant-discrimination task. Am J Optom Physiol Opt 1 978;55:599—609.
|
14.
|
Cooper J, Feldman J, Horn D, Dibble C. Reliability
|
of fixation disparity curves. Am J Optom Physiol Opt 1981 ;58:960—4.
|
15.
|
Alpern M. The after effect of lateral duction testing
|
on subsequent phoria measurements. Am J Optom Arch Am Acad Optom 1946;23:442—7.
|
16.
|
Liu JS,
Lee
M, Jang J, Ciuffreda KJ, Wong JH,
|
Grisham D, Stark L. Objective assessment of accommodation orthoptics. I. Dynamic insufficiency. Am J Optom Physiol Opt 1979; 56:285—94.
|
17.
|
Griffin Jr. Binocular Anomalies: Procedures for Vi
|
sion Therapy. Chicago: Professional Press, 1976.
|
18.
|
Siegel S. Nonparametric Statistics for the Behav
|
ioral Sciences. New York: McGraw Hill, 1956.
|
19.
|
Nawratzki L, Avrouskine M. Psychogenic factors
|
in disturbances of ocular muscle balance. Exo
|
