An observational study in Convergence Insufficiency, Divergence Insufficiency and Hypertropia, sponsored by Jaeb Center for Health Research. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-07-06.
Sponsored by Jaeb Center for Health Research · Observational
The purpose of this study is to describe clinical characteristics, treatments, and one-year outcomes of adults with convergence insufficiency, divergence insufficiency, or small angle hypertropia.
The purpose of this study is to describe clinical characteristics, treatments, and one-year outcomes of adults with convergence insufficiency, divergence insufficiency, or small angle hypertropia. Treatment comparisons within the studied conditions will also be done to help develop future studies.
142 studies on the registry are indexed under Strabismus; 31 are open to participants now.
This study's enrollment of 217 is above the median of 96 across 54 observational studies indexed under Strabismus.
Browse Strabismus studies →Jaeb Center for Health Research is the lead sponsor of 129 studies on the registry; 16 are open to participants now.
Of its 17 completed or terminated interventional studies of FDA-regulated products, 15 (88%) have results posted.
Compared within Strabismus, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Ocular Motility Disorders. The counts are of registry records indexed under each term, refreshed daily. How we classify →
Community Sample
Eligibility Criteria for Convergence Insufficiency (CI) Group:
The following inclusion criteria must be met for the subject to be enrolled into the study:
Eligibility Criteria for Divergence Insufficiency (DI) Group:
The following inclusion criteria must be met for the subject to be enrolled into the study:
Eligibility Criteria for Small-angle Hypertropia (HT) Group:
The following inclusion criteria must be met for the subject to be enrolled into the study:
Exclusion Criteria for Convergence Insufficiency (CI) Group:
The following criteria exclude a subject from enrollment into the study:
Exclusion Criteria for Divergence Insufficiency (DI) Group:
The following criteria exclude a subject from enrollment into the study:
Exclusion Criteria for Small-angle Hypertropia (HT) Group:
The following criteria exclude a subject from enrollment into the study:
Eligible adults with convergence insufficiency can be treated with prism, orthoptic exercises, eye muscle surgery, or botox injection, per the investigator's usual clinical practice.
Device: Prism · Other: Orthoptic Exercises · Procedure: Eye Muscle Surgery · Procedure: Botox Injection
Eligible adults with divergence insufficiency can be treated with prism, orthoptic exercises, eye muscle surgery, or botox injection, per the investigator's usual clinical practice.
Device: Prism · Other: Orthoptic Exercises · Procedure: Eye Muscle Surgery · Procedure: Botox Injection
Eligible adults with small-angle hypertropia can be treated with prism, orthoptic exercises, eye muscle surgery, or botox injection, per the investigator's usual clinical practice.
Device: Prism · Other: Orthoptic Exercises · Procedure: Eye Muscle Surgery · Procedure: Botox Injection
Ground-in or Fresnel prism
Orthoptic exercises- fusion, convergence, divergence, and others, including computer-based therapy
* Bilateral medial rectus muscle resection surgery * Single medial rectus muscle resection surgery * Recess lateral rectus muscle resection medial rectus muscle surgery * Bilateral lateral rectus muscle recession surgery * Single lateral rectus muscle recession surgery * Bilateral lateral rectus muscle resection surgery * Single lateral rectus muscle resection surgery * Recess medial rectus muscle resection lateral rectus muscle surgery * Bilateral medial rectus muscle recession surgery * Single medial rectus muscle recession surgery * Vertical rectus muscle recession surgery * Vertical rectus muscle mini-tenotomy (snip) surgery
Botulinum toxin injection
Also known as: Botulinum toxin injection
Number of Participants With Symptom Success at 10 Weeks
In the convergence insufficiency group, the primary outcome will be symptom success at the 10-week and 12-month visit, defined as improvement of CI Symptom Survey (CISS) score of at least 9 points and an outcome score of \<21 points. In the divergence insufficiency group, the primary outcome will be symptom success at the 10-week and 12-month visit, defined as diplopia "rarely" or "never" in primary position at distance on the diplopia questionnaire. In the small-angle hypertropia group, the primary outcome will be symptom success at the 10-week and 12-month visit, defined as diplopia "rarely" or "never" both in primary position at distance and in reading position on the diplopia questionnaire.
Time frame: 10 weeks after enrollment
Number of Participants With Symptom Success at 12 Months
In the convergence insufficiency group, the primary outcome will be symptom success at the 10-week and 12-month visit, defined as improvement of CI Symptom Survey (CISS) score of at least 9 points and an outcome score of \<21 points. In the divergence insufficiency group, the primary outcome will be symptom success at the 10-week and 12-month visit, defined as diplopia "rarely" or "never" in primary position at distance on the diplopia questionnaire. In the small-angle hypertropia group, the primary outcome will be symptom success at the 10-week and 12-month visit, defined as diplopia "rarely" or "never" both in primary position at distance and in reading position on the diplopia questionnaire.
Time frame: 12 months after enrollment
Mean of Near Point of Convergence in Convergence Insufficiency Group
Near point of convergence (convergence insufficiency group only).
Time frame: 12 months after enrollment
Mean Positive Fusional Vergence in Convergence Insufficiency Group
Positive fusional vergence (convergence insufficiency group only).
Time frame: 12 months after enrollment
Adult Strabismus 20 Questionnaire Score (DI)
Adult Strabismus Quality of Life Questionnaire (AS-20) For AS-20, scores are reported for the following subscales. A total score will not be reported. 1. Self-perception score 2. Interaction score 3. Reading function score 4. General function score Values for each subscale range from 0 to 100. 0 indicates poor quality of life (the patient reported "always" for all questions) and 100 represents good quality or life (patient reported "never" for all questions)
Time frame: 12 months after enrollment
Mean Convergence Insufficiency Symptom Survey Score
Mean Convergence Insufficiency Symptom Survey Score (convergence insufficiency group only) For CISS, the range is from 0 (having no symptoms of CI) to 60 (always showing all symptoms of CI).
Time frame: 12 months after enrollment
Adult Strabismus 20 Questionnaire Score (CI)
Adult Strabismus Quality of Life Questionnaire (AS-20) For AS-20, scores are reported for the following subscales. A total score will not be reported. Self-perception score Interaction score Reading function score General function score Values for each subscale range from 0 to 100. 0 indicates poor quality of life (the patient reported "always" for all questions) and 100 represents good quality or life (patient reported "never" for all questions)
Time frame: 12 months after enrollment
| Milestone | Convergence Insufficiency | Divergence Insufficiency | Small-angle Hypertropia |
|---|---|---|---|
| Started | 81 | 114 | 22 |
| Completed | 63 | 111 | 21 |
| Not completed | 18 | 3 | 1 |
| Withdrew: Deemed no longer eligible | 18 | 3 | 1 |
In the convergence insufficiency group, the primary outcome will be symptom success at the 10-week and 12-month visit, defined as improvement of CI Symptom Survey (CISS) score of at least 9 points and an outcome score of \<21 points. In the divergence insufficiency group, the primary outcome will be symptom success at the 10-week and 12-month visit, defined as diplopia "rarely" or "never" in primary position at distance on the diplopia questionnaire. In the small-angle hypertropia group, the primary outcome will be symptom success at the 10-week and 12-month visit, defined as diplopia "rarely" or "never" both in primary position at distance and in reading position on the diplopia questionnaire.
| Participants | Convergence Insufficiency | Divergence Insufficiency | Small-angle Hypertropia |
|---|---|---|---|
| Number of Participants With Symptom Success at 10 Weeks | 25 | 91 | 12 |
In the convergence insufficiency group, the primary outcome will be symptom success at the 10-week and 12-month visit, defined as improvement of CI Symptom Survey (CISS) score of at least 9 points and an outcome score of \<21 points. In the divergence insufficiency group, the primary outcome will be symptom success at the 10-week and 12-month visit, defined as diplopia "rarely" or "never" in primary position at distance on the diplopia questionnaire. In the small-angle hypertropia group, the primary outcome will be symptom success at the 10-week and 12-month visit, defined as diplopia "rarely" or "never" both in primary position at distance and in reading position on the diplopia questionnaire.
| Participants | Convergence Insufficiency | Divergence Insufficiency | Small-angle Hypertropia |
|---|---|---|---|
| Number of Participants With Symptom Success at 12 Months | 25 | 73 | 6 |
Near point of convergence (convergence insufficiency group only).
| centimeters | Convergence Insufficiency |
|---|---|
| Mean of Near Point of Convergence in Convergence Insufficiency Group | 14.1 ± 6.2 |
Positive fusional vergence (convergence insufficiency group only).
| prism diopters | Convergence Insufficiency |
|---|---|
| Mean Positive Fusional Vergence in Convergence Insufficiency Group | 11.6 ± 7.1 |
Adult Strabismus Quality of Life Questionnaire (AS-20) For AS-20, scores are reported for the following subscales. A total score will not be reported. 1. Self-perception score 2. Interaction score 3. Reading function score 4. General function score Values for each subscale range from 0 to 100. 0 indicates poor quality of life (the patient reported "always" for all questions) and 100 represents good quality or life (patient reported "never" for all questions)
| score on a scale | Divergence Insufficiency |
|---|---|
| General Function Score | 62 ± 22 |
| Reading Function Score | 71 ± 23 |
| Self Perception Score | 87 ± 19 |
| Interaction Score | 94 ± 11 |
Mean Convergence Insufficiency Symptom Survey Score (convergence insufficiency group only) For CISS, the range is from 0 (having no symptoms of CI) to 60 (always showing all symptoms of CI).
| points | Convergence Insufficiency |
|---|---|
| Mean Convergence Insufficiency Symptom Survey Score | 37.5 ± 9.1 |
Adult Strabismus Quality of Life Questionnaire (AS-20) For AS-20, scores are reported for the following subscales. A total score will not be reported. Self-perception score Interaction score Reading function score General function score Values for each subscale range from 0 to 100. 0 indicates poor quality of life (the patient reported "always" for all questions) and 100 represents good quality or life (patient reported "never" for all questions)
| points | Convergence Insufficiency |
|---|---|
| General Function | 55.7 ± 24.6 |
| Reading Function | 43.9 ± 22.2 |
| Interaction | 92.2 ± 14.7 |
| Self Perception | 83.8 ± 22.6 |
Collected over Adverse event data was not collected since treatment was prescribed per usual standard of care.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Convergence Insufficiency | — | — | — |
| Divergence Insufficiency | — | — | — |
| Small-angle Hypertropia | — | — | — |
| Age, Continuous(years) | Convergence Insufficiency | Divergence Insufficiency | Small-angle Hypertropia | Total |
|---|---|---|---|---|
| Mean | 42.4 ± 18.6 | 67.4 ± 13.7 | 68.6 ± 13.0 | 59.5 ± 19.4 |
| Age, Continuous(years) | Convergence Insufficiency | Divergence Insufficiency | Small-angle Hypertropia | Total |
|---|---|---|---|---|
| Median | 38.2 (25.6 to 57.2) | 71.2 (60.8 to 75.7) | 71.5 (65.7 to 76.6) | 65.3 (44.2 to 74.1) |
| Sex: Female, Male(Participants) | Convergence Insufficiency | Divergence Insufficiency | Small-angle Hypertropia | Total |
|---|---|---|---|---|
| Female | 48 | 74 | 10 | 132 |
| Male | 15 | 37 | 11 | 63 |
| Race/Ethnicity, Customized(Participants) | Convergence Insufficiency | Divergence Insufficiency | Small-angle Hypertropia | Total |
|---|---|---|---|---|
| White | 32 | 107 | 19 | 158 |
| Non-white | 31 | 4 | 2 | 37 |
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: Yes — In accordance with the NIH data sharing policy, a de-identified database is placed in the public domain on the Pediatric Eye Disease Investigator Group (PEDIG) public website after the completion of each protocol and publication of the primary manuscript.
Supporting information: Study protocol, Statistical analysis plan, Informed consent form
Time frame: After completion of the protocol and publication of the primary manuscript, the data will be made available for the duration of the grant and any future grants.
Access criteria: public
Ran from Aug 2015 to primary completion in Dec 2017, 28 months.
Results were first posted in Apr 2021, 3 years 3 months after primary completion.
Of 26 observational studies under Strabismus, half reached primary completion within 24 months of starting (the median), counting those still running; a quarter within 7 and three quarters within 50. This study's 28 months is above that.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in Jun 2023. You cannot join it, but the record below documents what was studied.
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