Efficacy of Pencil Pushup Exercises versus Base Out Exercising Prisms in Patients with Convergence Insufficiency

Abstract

Background: Convergence insufficiency is a common binocular vision disorder in children and adolescents, often leading to symptoms like eye strain, blurred vision, and difficulty reading. Various non-surgical interventions exist, including pencil push-up exercises and base-out prism therapy.  Objective: To compare the efficacy of base-out exercising prisms and pencil push-up exercises in improving convergence insufficiency. Methodology: This controlled trial included 28 participants aged 10 to 15 years with clinically diagnosed convergence insufficiency. A total of 28 individuals aged 10-15 were selected through random sampling based on near point of convergence and convergence insufficiency symptom survey scores. Patients with history of strabismus, amblyopia, or refractive error more than six diopters, patients with a history of prism prescription, history of strabismus surgery, or refractive error surgery, eye trauma, or any systemic and neurological diseases affecting binocular vision were excluded. Participants were randomly divided into two groups: Group A received base-out exercising prisms for 15-20 minutes daily, five days a week, for 12 weeks, while Group B performed pencil pushup exercises for the same duration. After 12 weeks, the same tests will be repeated to assess improvements in both scores. Data was securely recorded and analysed to ensure accurate and consistent evaluation of the interventions. Statistical analysis was conducted using Kruskal-Wallis and Friedman tests. Results: Baseline, midline, and Post, the mean ranks decrease from baseline to post, with a chi-square of 53.05 and a p-value of 0.000. This suggests a significant difference across the time points for the near point of convergence. Baseline, midline, and postline mean ranks also decrease, with a chi-square of 51.92 and a p-value of 0.000. This indicates a significant difference in symptom scores across these time points. Conclusion: Both near point of convergence and convergence insufficiency symptom survey scores show significant changes over time (from baseline to post), as indicated by the low p-values (0.000). The decrease in mean ranks for both scores from baseline to post suggests an improvement in convergence ability and a reduction in symptoms throughout the study. Results suggest that base-out exercising prism is more effective than pencil push-up exercises in improving convergence ability.