CClinicalTrials.gg
CompletedNCT04487249VT-IXTUpdated Sep 3, 2026

Trial of Vision Therapy for Intermittent Exotropia

An interventional study of Vision Therapy in Intermittent Exotropia, sponsored by Southern California College of Optometry at Marshall B. Ketchum University. Completed at 6 sites in United States. Open to participants aged 8 Years to 16 Years. Per ClinicalTrials.gov, last updated 2026-09-03.

Sponsored by Southern California College of Optometry at Marshall B. Ketchum University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
47
Allocation
Randomized
Ages
8 Years to 16 Years
Sex
All
01

Study summary

The main objective of this randomized trial comparing vision therapy to observation is to determine the short-term effectiveness of vision therapy on distance intermittent exotropia control. The results will help determine whether to proceed to a full-scale, long-term randomized trial.

Read the detailed description

Vision therapy (VT) is a commonly prescribed treatment for children with intermittent exotropia (IXT). The effectiveness of VT as a treatment modality for children with IXT is unknown because previous studies have largely limited observational or retrospective case series without comparison groups. The objective of this multi-centered pilot randomized trial of VT for IXT compared to observation is to 1) determine the short-term effectiveness of VT on distance intermittent exotropia and 2) determine the feasibility of recruitment and retention of children aged 8 to 16 years old with IXT to participate in a randomized trial of 20 weeks of in-office VT. The results of this trial will provide the needed information to plan and conduct a large-scale randomized trial to determine short-term and long-term effectiveness of VT for IXT in children, with the full-scale randomized trial helping to fill in the gaps in scientific knowledge concerning VT as a treatment for IXT.

02

Conditions studied

  • Intermittent Exotropia

Keywords

  • Intermittent Exotropia
  • Vision Therapy
03

Who can participate

Ages eligible
8 Years to 16 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Major Inclusion Criteria-

  • Age 8 - 16 years
  • Intermittent exotropia meeting all of the following:

    • Distance exodeviation of 15∆ to 35∆ by prism alternating cover test (PACT)
    • IXT, exophoria, or orthophoria at near
    • Near exodeviation that does not exceed the distance exodeviation by more than 10∆
    • Mean distance control score of 2 points or more with at least one measure being 3 points or higher
    • Mean near control score less than 5 points
  • Random dot stereopsis of 200" or better on Preschool Randot Stereotest
  • Willingness to accept randomization and no plan to relocate in the next 6 months

Major Exclusion Criteria-

  • Treatment for IXT or amblyopia (other than refractive correction) within 3 months prior to enrollment
  • Office-based vision therapy for IXT within 6 months prior to enrollment
  • Prior office-based vision therapy for IXT of ≥10 sessions
  • Prior strabismus, intraocular, or refractive surgery (including BOTOX injection)
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
47 participants (actual)

Study arms

  • Experimental
    Vision Therapy

    Participants will receive 20 consecutive weeks of office-based vision therapy with home therapy.

    Other: Vision Therapy

  • No intervention
    Observation

    Participants will receive no treatment for IXT is received during the study unless one of the deterioration criteria is met.

Interventions

  • OtherVision Therapy

    20 consecutive weeks of office-based vision therapy with home therapy that aim to improve the participant's vergence skills, accommodative skills, and sensory fusion.

    Also known as: Orthoptics

05

What researchers measure

Primary outcomes

  1. Mean Distance Control Score

    The primary analysis will be an intent-to-treat comparison of mean distance control score, determine by the intermittent exotropia office control scale, at outcome using an analysis of covariance model, which will adjust for baseline distance control. The intermittent exotropia office control scale grades the control on a scale of 0 (best control; phoria) to 5 (worst control; constant exotropia).

    Time frame: 21 weeks

Secondary outcomes

  1. No Spontaneous Tropia

    The proportion of participants with no spontaneous tropia at outcome will be compared between treatment groups.No spontaneous tropia is defined as control score of 2 or less on all three assessments of control at distance and near and no exotropia lasting more than 5 seconds throughout the examination.

    Time frame: 21 weeks

  2. Change in Distance Control

    The proportion of participants with \>= 1 point change in control and \>= 2 points change in control will be compared between treatment groups.

    Time frame: 21 weeks

Other outcomes

  1. Change in Vergence and Accommodative Measures

    The near point of convergence, positive and negative fusional vergence ranges at distance and near, vergence facility, accommodative amplitude, and accommodative facility at outcome will be compared between treatment groups adjusting for the corresponding baseline value. The analysis will be completed separately for each vergence and accommodative measures.

    Time frame: 21 weeks

  2. Suppression Status

    Suppression status will be compared at outcome between treatment groups, adjusting for baseline suppression status. Suppression status when the participant's eyes are in tropic position will be assessed using the suppression scale ranging from 0 (negligible suppression) to 4 (dense suppression).

    Time frame: 21 weeks

  3. Objective Eye Movement Recordings

    Frequency of intermittent exotropia by objective eye movement recordings will be compared between treatment groups.

    Time frame: 21 weeks

06

Study locations

6 sites
  • University of Alabama in Birmingham
    Birmingham, Alabama 35294, United States
  • Southern California College of Optometry at Marshall B. Ketchum University
    Fullerton, California 92831, United States
  • Stanford University
    Stanford, California 94305, United States
  • Ohio State University
    Columbus, Ohio 43210, United States
  • Salus University
    Philadelphia, Pennsylvania 19141, United States
  • Southern College of Optometry
    Memphis, Tennessee 38104, United States
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT04487249
Lead sponsor
Southern California College of Optometry at Marshall B. Ketchum University
Collaborators
Stanford University, Ohio State University, Salus University, University of Alabama at Birmingham, Southern College of Optometry, Case Western Reserve University, American Academy of Optometry, University of Houston
Responsible party
Sponsor
First posted
Jul 27, 2020
Start date
Oct 1, 2021
Primary completion
Apr 30, 2026
Completion
Apr 30, 2026
Last update
Sep 3, 2026

Study contacts

Angela Chen, OD, MS
study chair · Southern California College of Optometry at Marshall B. Ketchum University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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