June 1988

training5,’6 with computerization results in an

increase in both accommodation and vergence

abilities which are not due to placebo effects.

Asthenopia is reduced or eliminated when ac-

commodative and vergence skills are im-

proved.71’ Computerized orthoptics have been

shown to be effective in remedying convergence

insufficiency where traditional orthoptics have

failed.5’9

Computer-generated analyphic stimuli cou-

pled with behavior modification techniques have

been used to improve orthoptic therapy. These

systems have enabled the clinician to motivate

his/her patients more effectively and to treat

patients in a more controlled manner. The three

patients discussed demonstrated that an auto-

mated system can improve vergence abilities in

a young noncoznmunicative patient, in a very

difficult child, and in a hyperactive demanding

child. These three patients are representative of

over 100 patients whom we have treated. Com-

puterized orthoptics have been used to treat

various accommodative and binocular anoma-

lies.

Computerized orthoptics allow for standardi-

zation of orthoptic testing and therapy. It

improves intra- and interexaminer/therapist

reliability. Computerized orthoptics permit de-

velopment of specific vergence abilities, i.e., sus-

tained ramp vergence, slow ramp vergence, fast

ramp vergence, increasing step vergence, and

unpredictable step vergence. Computerized or-

thoptics should lead to more effective diagnosis

and therapy of the young noncommunicative

patient.

REFERENCES

1.

Cooper J. Feldman J. Operant conditioning and

assessment of stereopsis in young children. Am J

Optom Physiol Opt 1978;55:532—42.

2.

Cooper J. Feldman J. Random.dot-stereogram

performance by strabismic, amblyopic, and ocular

pathology patients in an operant-discrimination

task. Am J Optom Physiol Opt 1978;55:599—609.

3.

Feldman J, Cooper J. Rapid assessment of star-

eopsis in preverbal children using operant tech-

niques: a preliminary study. J Am Optom Assoc

1980;51 :767—71.

4.

Fox R, Aslin RN, Shea SL, Dumais ST. Stereopsis

in human infants. Science 1980:207:323—4.

5.

Cooper J, Feldman J. Operant conditioning of tu-

sional covergence ranges using random dot star-

eograrns. Am J Optom Physiol Opt 1980;57:205—

13.

6.

Daurn KM. Rutstern RP, Eskrldge JB. Efficacy of

computerized vergence therapy. Am J Optorn

Physiol Opt 1987;64:83—9.

7.

Cooper J, Selenow A, Ciuffreda KJ, Feldman J,

Faverty J, Hokada S, Silver J. Reduction of as-

thenopia in patients with convergence insufficiency

after fusional vergence training. Am J Optom Phys-

iol Opt 1983;6O:982-9.

8.

Cooper J, Feldman J, Selenow A, Fair R, Bucceno

F, MacDonald D, Levy M. Reduction of asthenopta

after accommodative facility training. Am J Optom

Physiol Opt 1987;64:430-.6.

9.

Kertesz AE. Kertesz J. Wide-field fusional stimula-

tion in strabismus. Am J Optom Physiol Opt

1986;63:217-22.

10.

Somers WW, Happel AW. Phillips JD. Use of a

personal microcomputer for orthoptic therapy. J

Am Optom Assoc 1 984;55:262-7.

11.

Griffin JR. Efficacy of vision therapy of nonstra-

bismuc vergence anomalies. Am J Optom Physiol

Opt 1987;64:411-4.

12.

Cooper J, Citron M. Microcomputer produced an-

agtyphs for evaluation and therapy of binocular

anomalies. J Am Optom Assoc 1983;54:785—8.

AUTHOR’S ADDRESS:

Jeffrey Cooper

State College of Optometry

State University of New York

100 East 24th Street

New York, New York 10010-3677

Orthoptics for Convergence Insufficiency—Cooper

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