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Interventions for convergence insufficiency: a network meta-analysis

Scheiman M, Kulp MT, Cotter SA, Lawrenson JG, Wang L, Li T

The Cochrane database of systematic reviews, 2020

1,289 participants · 40 citations

Abstract

Background: Convergence insufficiency is a common binocular vision disorder in which the eyes have a strong tendency to drift outward (exophoria) with difficulty turning the eyes inward when reading or doing close work.

Objectives: To assess the comparative effectiveness and relative ranking of non-surgical interventions for convergence insufficiency through a systematic review and network meta-analysis (NMA).

Search methods: We searched CENTRAL, MEDLINE, Embase, PubMed and three trials registers up to 20 September 2019.

Selection criteria: We included randomized controlled trials (RCTs) examining any form of non-surgical intervention versus placebo, no treatment, sham treatment, or other non-surgical interventions. Participants were children and adults with symptomatic convergence insufficiency.

Data collection and analysis: We followed standard Cochrane methodology. We performed NMAs separately for children and adults.

Main results: We included 12 trials (six in children and six in adults) with a total of 1289 participants. Trials evaluated seven interventions: 1) office-based vergence/accommodative therapy with home reinforcement; 2) home-based pencil/target push-ups; 3) home-based computer vergence/accommodative therapy; 4) office-based vergence/accommodative therapy alone; 5) placebo vergence/accommodative therapy or other placebo intervention; 6) prism reading glasses; and 7) placebo reading glasses. Six RCTs in the pediatric population randomized 968 participants. Of…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,289 participants or records.

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