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training5,’6 with computerization results in an increase in both accommodation and vergence abilities which are not due to placebo effects. Asthenopia is reduced or eliminated when accommodative and vergence skills are improved.71’ Computerized orthoptics have been shown to be effective in remedying convergence insufficiency where traditional orthoptics have failed.5’9
Computer-generated analyphic stimuli coupled with behavior modification techniques have been used to improve orthoptic therapy. These systems have enabled the clinician to motivate his/her patients more effectively and to treat patients in a more controlled manner. The three patients discussed demonstrated that an automated system can improve vergence abilities in a young noncoznmunicative patient, in a very difficult child, and in a hyperactive demanding child. These three patients are representative of over 100 patients whom we have treated. Computerized orthoptics have been used to treat various accommodative and binocular anomalies.
Computerized orthoptics allow for standardization of orthoptic testing and therapy. It improves intra- and interexaminer/therapist reliability. Computerized orthoptics permit development of specific vergence abilities, i.e., sustained ramp vergence, slow ramp vergence, fast ramp vergence, increasing step vergence, and unpredictable step vergence. Computerized orthoptics should lead to more effective diagnosis and therapy of the young noncommunicative patient.

REFERENCES
1.
Cooper J. Feldman J. Operant conditioning and
assessment of stereopsis in young children. Am J Optom Physiol Opt 1978;55:532—42.
2.
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 1978;55:599—609.
3.
Feldman J, Cooper J. Rapid assessment of star
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1980;51 :767—71.
4.
Fox R, Aslin RN, Shea SL, Dumais ST. Stereopsis
in human infants. Science 1980:207:323—4.
5.
Cooper J, Feldman J. Operant conditioning of tu
sional covergence ranges using random dot stareograrns. Am J Optom Physiol Opt 1980;57:205—
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6.
Daurn KM. Rutstern RP, Eskrldge JB. Efficacy of
computerized vergence therapy. Am J Optorn Physiol Opt 1987;64:83—9.
7.
Cooper J, Selenow A, Ciuffreda KJ, Feldman J,
Faverty J, Hokada S, Silver J. Reduction of asthenopia in patients with convergence insufficiency after fusional vergence training. Am J Optom Physiol Opt 1983;6O:982-9.
8.
Cooper J, Feldman J, Selenow A, Fair R, Bucceno
F, MacDonald D, Levy M. Reduction of asthenopta after accommodative facility training. Am J Optom Physiol Opt 1987;64:430-.6.
9.
Kertesz AE. Kertesz J. Wide-field fusional stimula
tion in strabismus. Am J Optom Physiol Opt
1986;63:217-22.
10.
Somers WW, Happel AW. Phillips JD. Use of a
personal microcomputer for orthoptic therapy. J Am Optom Assoc 1 984;55:262-7.
11.
Griffin JR. Efficacy of vision therapy of nonstra
bismuc vergence anomalies. Am J Optom Physiol Opt 1987;64:411-4.
12.
Cooper J, Citron M. Microcomputer produced an
agtyphs for evaluation and therapy of binocular anomalies. J Am Optom Assoc 1983;54:785—8.

AUTHOR’S ADDRESS:
Jeffrey Cooper
State College of Optometry
State University of New York
100 East 24th Street
New York, New York 10010-3677
Orthoptics for Convergence Insufficiency—Cooper
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