ArticleOphthalmology and therapy2026
Combined Accommodation and Fusional Training Paradigm Versus Prism Correction for Small-Angle Acute Acquired Comitant Esotropia: A Cohort Study.
Article in Ophthalmology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06622044 (Accommodation and Vergence Exercises Versus Prism Treatment for Small-angle Acute Acquired Concomitant Esotropia), which is not on this map. Not yet cited in PubMed.
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The trial behind it
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Accommodation and Vergence Exercises Versus Prism Treatment for Small-angle Acute Acquired Concomitant Esotropia
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Authors and funding
10 authors.
Funding
Abstract
introductionThis study explored 6-month ocular alignment and visual function outcomes associated with a combined accommodative and fusional training paradigm and compared them with outcomes observed after prism correction in patients with small-angle acute acquired comitant esotropia.
methodsThis prospective, single-center, nonrandomized cohort study enrolled 42 patients with small-angle acute acquired comitant esotropia. Following counseling regarding both treatment options, patients selected visual training (N = 22) or prism correction (N = 20). The training group completed a 6-month, two-step paradigm: accommodative facility training using ± 2.00 diopter flippers and computer-based fusional divergence training with red-blue glasses. The prism group received prism correction to relieve diplopia. Examinations were performed at baseline, 1 week, 1 month, 3 months, and 6 months.
resultsAt 6 months, the training group achieved complete motor success (orthophoria without diplopia) in 16/22 (72.7%) at distance and 17/22 (77.3%) at near, compared with 0/20 at either fixation distance in the prism group. Functional success, defined as an ocular deviation of ≤ 5 PD at both distance and near without diplopia, was achieved in 20/22 (90.9%) of the training group versus 0/20 (0.0%) of the prism group. All patients in the prism group reported relief of diplopia during prism wear but persistent diplopia when assessed without prism correction. The training group also showed more favorable changes in several stereopsis and accommodative measures.
conclusionsIn this small nonrandomized cohort, preference-based selection of combined visual training was associated with more favorable 6-month outcomes than prism correction when outcomes were assessed without prism correction. These exploratory findings are hypothesis-generating and require confirmation in adequately powered randomized studies.
trial registrationClinicalTrials.gov identifier, NCT06622044.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.