I read the article by Scheiman et al1 entitled “A Randomized Clinical Trial of Treatments for Convergence Insufficiency in Children” in the January 2005 issue of the ARCHIVES with great interest. I would like to congratulate Scheiman and colleagues for venturing into this area where, truly, not many randomized clinical trials have been done.
I would, however, like to raise some important issues regarding the entire study, particularly with reference to the treatment regimens. As Kushner2 has rightly pointed out, the intensive therapy that Scheiman and colleagues have provided for the treatment group is much more intensive than the therapy for home exercises. For example, a child in group 1 exercises for only a total of 15 hours (15 min/d for 12 weeks, although this could have been just 6-8.5 min/d) whereas a child in group 2 exercises for nearly 75 hours (an excess of 60 hours of the intensive office-based exercises). I also think this shows in the results.
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