Preferred clinical practice in convergence insufficiency in India: A survey

摘要

PurposeConvergence insufficiency (CI) is a common binocular vision disorder. However, there is a lackof consensus regarding the treatment most appropriate for CI. The aim of the study was to investigate thetreatment for CI by surveying the ophthalmologists regarding the most common treatment modalities usedin India.Materials and Methods:Four hundred questionnaires were distributed amongst ophthalmologists attendingdifferent sessions of the Delhi Ophthalmological Society annual conference held in April 2007. Two hundredand three ophthalmologists responded (response rate 50.75%). The responders included 109 privatepractitioners, 57 consultants attached to teaching institutes and 37 residents.Results:The majority of ophthalmologists (66.7%) claimed encountering >5% outpatient departmentpatients with CI. Pencil push-ups therapy (PPT) was the most common first line of treatment offeredby ophthalmologists (79%) followed by synoptophore exercises (18%). Only 3% referred the patients tooptometrists. Thirty per cent ophthalmologists claimed good results with PPT, which was significantly higherin private practitioners (35%). Only 26% ophthalmologists explained physiological diplopia to patients ona regular basis and reported significantly higher percentage of patients (46.3%) with good results. Only12.3% ophthalmologists needed to refer >30% patients for synoptophore exercises. For failure of PPT 86.7%considered lack of compliance as the major reason as perceived by ophthalmologists.Conclusions:This survey suggested that most ophthalmic practitioners prescribed PPT as the initial treatmentfor CI and had satisfactory results with PPT. The majority of the practitioners did not explain to the patientabout physiological diplopia. Explaining physiological diplopia may improve outcome, as perceived fromthe survey.