Effectiveness of Vision Therapy in Managing Convergence Insufficiency Among School Children in Enugu State

Convergence insufficiency is a prevalent binocular vision disorder associated with near work difficulties and academic underperformance, yet evidence on the effectiveness of vision therapy in the Nigerian context is limited. This randomized controlled trial evaluates the effectiveness of an eight-week office-based vision therapy program compared to home-based pencil push-ups in managing convergence insufficiency among school children in Enugu State, South East Nigeria. Participants aged 9 to 15 years with confirmed convergence insufficiency will be recruited from three secondary schools in Enugu and randomized into two groups of 60 each. Outcome measures will include the near point of convergence, positive fusional vergence at near, the Convergence Insufficiency Symptom Survey (CISS) score, and near visual acuity. Assessments will be conducted at baseline, four weeks, and eight weeks. Data analysis will employ repeated measures ANOVA and independent t-tests. The study expects to demonstrate significantly greater improvement in convergence parameters and symptom relief in the office-based vision therapy group. Findings will provide Nigerian-specific evidence to inform clinical protocols for binocular vision management in pediatric optometry and will be submitted to the Nigerian Optometric Association for integration into clinical practice guidelines. This research addresses a critical evidence gap in vision therapy outcomes research in West Africa and contributes to the evidence base for evidence-based binocular vision care in Nigeria's South East zone. Keywords: convergence insufficiency, vision therapy, school children, Enugu State, binocular vision