Clinical Research Study Viewer

CITT-ART: Convergence Insufficiency Attention and Reading Trial

What is convergence insufficiency?

Convergence insufficiency (CI) affects about 5 out of every 100 people. CI is an eye-teaming problem in which the eyes have a strong tendency to drift outward when reading or doing work up close. If the eyes drift out, the person may see double. To avoid seeing double, a person with CI must use extra effort to make the eyes turn back in. This extra effort can lead to annoying symptoms that can interfere with the ability to read and work comfortably up close.

Symptoms often associated with CI:

  • Eye strain and headaches
  • Inability to concentrate
  • Short attention span
  • Frequent loss of place
  • Blur
  • Trouble remembering what was read
  • The need to re-read the same line of words

What is the purpose of the CITT?

The CITT-ART was designed to find out whether therapy for CI improves reading and attention. Children with CI have many more symptoms when reading and show worse attention than children without CI. We know that CI therapy improves these symptoms and we have some early evidence that treatment also results in improvements in reading and attention.

However, to know for sure, we need to study this question in a larger group of children, and some children need to receive a harmless control therapy that is not designed to treat convergence insufficiency.

What will happen during the study?

If you agree to have your child take part in the study, a computer program will determine whether your child will receive active or control therapy. This is similar to flipping a coin. Two of every three children will receive the active therapy. Children who receive the control therapy and don’t get better will be given the active treatment.

The study involves standard tests and treatments which have the same risks as receiving treatment outside the study. No long-term problems are expected. The only known risk is that your child may continue to have eyestrain/headaches.

To allow your child to take part in the study, you must be willing to bring your child to The Ohio State University’s College of Optometry for the following tests and sessions:

  1. Initial testing to see if your child is eligible.
  2. Initial tests of reading and attention.
  3. Weekly therapy sessions for 16 weeks in a row.
  4. Follow-up visits to check your child’s vision, attention and reading about one week and one year after completing the therapy.

You will also need to ensure that your child performs the prescribed home therapy.

Who can I contact for more information?

If you have questions or would like your child to take part in this study, please contact Dr. Marjean Kulp at or 614-688-3336. For more information online, you can visit

Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000