Despite ongoing research, investigators are still unsure if vision therapy (VT) helps decrease myopia progression in children. While VT has proven useful for vergence dysfunctions, less is known about its effect on accommodative dysfunction, which many suspect is related to the development and progression of myopia.

Researchers in China recently studied the effects of office-based accommodative/vergence therapy in a cohort of myopic children and discovered that, while it improved accommodative facility, it was no better at improving the lag of accommodation compared with office-based placebo therapy.1

The prospective, single-masked, randomized clinical trial included 33 children, ages eight to 12, with low to moderate myopia and at least 1D of lag of accommodation. The children were randomized to either office-based accommodative/vergence therapy with home reinforcement or office-based placebo therapy, and assessed at baseline and at a 13-week follow-up visit. Researchers measured the change in the monocular lag of accommodation, as well as changes in accommodative amplitude and monocular accommodative facility.

Both groups had significant improvements in the lag of accommodation, with no statistically significant difference between the two. Those who had office-based accommodative/vergence therapy showed a statistically significant improvement in monocular accommodative facility, while the placebo group did not.1

The team’s earlier research suggested that office-based VT could improve monocular lag of accommodation, accommodative facility and accommodative amplitude.2 This follow-up study was designed to determine whether a true effect exists by including a control group—a major limitation of the early research. Despite the earlier findings, the researchers were unsurprised by the results; they started with a hypothesis that there would be no statistical difference between the two groups because of regression to the mean and the placebo effect.1  

“Considering that a significant improvement was noted in accommodative facility and that accommodative facility has been suggested to be an independent predictor of myopia progression, clinical trials designed to investigate the effect of office-based accommodative/vergence therapy on myopia progression in Chinese myopic children are recommended,” they concluded.1

1. Ma MM, Shi J, Li N, et al. Effect of vision therapy on accommodative lag in myopic children: A randomized clinical trial. Optom Vis Sci. 2019;96(1):17-26.

2. Ma MM, Scheiman M, Su C, et al. Effect of vision therapy on accommodation in myopic Chinese children. J Ophthalmol. 2016;2016:1202469.