Persistent Post-Concussion Symptoms With Convergence Insufficiency (PPCS-CI)
Persistent Post-concussive Symptoms, Convergence Insufficiency, Mild Traumatic Brain Injury
About this trial
This is an interventional treatment trial for Persistent Post-concussive Symptoms
Eligibility Criteria
Inclusion Criteria:
- Between 13 to 25 years
- Concussion diagnosed by a clinical 1 to 3 months ago
- Best-corrected visual acuity of 20/25 in both eyes at distance and near
- willing to wear glasses or contact to correct refractive error if needed
- Global stereopsis of 500 sec of arc or better and 70 sec of arc of better using Randot Stereo Test
- Diagnosis of convergence insufficiency from an optometrist defined as near point of convergence of greater than or equal to 6 cm, positive fusional vergence at 40 cm not meeting Sheard's criteria of at least twice the near phoria or a range of less than or equal to 15 prism diopters, and a convergence insufficiency symptom survey score of 21 or greater for adults or 16 or greater for children.
Exclusion Criteria:
- History of performing office or home-based vision therapy, orthoptics, home-based near target push-ups, or pencil push ups
- Amblyopia (lazy eye) or constant strabismus or strabismus surgery
- Any conditions or diseases that affect accommodation, vergence or ocular motility, such as Multiple Sclerosis, Graves' thyroid disease, Myastheria Gravis, Diabetes, Chemotherapy, or Parkinson's Disease
- Non-removable metal in the body
- Pregnant, planning on becoming pregnant during the study duration, or breastfeeding
- Metal worker
Sites / Locations
- NJITRecruiting
- Somerset Pediatric GroupRecruiting
- The Children's Hospital of PhiladelphiaRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Office based Vergence and Accommodative Therapy immediately after enrollement
Office based Vergence and Accommodative Therapy Delay 6 weeks post enrollment
This arm will start immediately after baseline assessment. The participant will have two sessions of one hour each for 6 weeks (12 office-based vergence and accommodative therapy sessions). The first outcome measurement will be attained by a masked optometrist. Then, the participant will have 2 more weeks of therapy (4 office-based vergence and accommodative therapy sessions). The second and final outcome measurement will be attained. Assessments include a masked optometric vision exam, objective eye movement recordings and an functional MRI scan.
This arm will start with a 6 week delay (no vision therapy) after baseline assessment to evaluate natural recovery. After 6 weeks, the first outcome assessment will be attained by a masked optometrist. The participant will have two sessions of one hour each for 8 weeks (16 office-based vergence and accommodative therapy sessions). The second and final outcome measurement will be attained. Assessments include a masked optometric vision exam, objective eye movement recordings and an functional MRI scan.