Table 2.

CITT-ART Eligibility & Exclusion Criteria

Eligibility Criteria	Exclusion Criteria
Age 9 to 14 years Grades 3 through 8 Cl Symptom Survey score ≥ 16 Exophoria at near at least 4Δ greater than at far Receded near point of convergence (NPC) of ≥ 6 cm break Insufficient positive fusional vergence (PFV) at near (i.e., failing Sheard’s criterion or PFV ≤15Δ base-out break) Best-corrected distance and near visual acuity of 20/25 or better in each eye Random dot stereopsis appreciation of 500 seconds of arc or better Willing to wear refractive correction for any of the following uncorrected refractive errors (based on cycloplegic refraction within prior 6 months). (Correction must be worn for at least 2 weeks): - Myopia ≥ −0.75 D spherical equivalent in either eye - Hyperopia ≥ +1.50 D spherical equivalent in either eye - Anisometropia ≥1.00 D spherical equivalent or ≥ 1.50 D in any meridian - Astigmatism ≥1.00 D in either eye Not wearing BI prism or plus add at near for 2 weeks prior to study and for duration of study English is primary language spoken at home or child proficient in English as determined by the school Parental permission to contact the child’s teacher for study purposes Parent and child understand protocol and are willing to accept randomization Parent does not expect child to start any new ADHD medicine or change the dose of any currently taken ADHD medicine while child is being treated in the study	Constant strabismus at distance or near Esophoria of ≥ 2Δ at distance Vertical heterophoria ≥ 2Δ at distance or near ≥ 2 line interocular difference in best-corrected visual acuity Monocular near point of accommodation >20 cm (accommodative amplitude < 5D) as measured by push-up method Manifest or latent nystagmus Single-word decoding difficulties (associated with phonological-based reading disabilities or dyslexia) based on Wide Range Achievement Test (WRAT-4) Word Reading Subtest score < 80 Kaufman Brief Intelligence Test (KBIT-2) non-verbal subscale score < 70 (excludes intellectual disability) History of strabismus surgery or refractive surgery Cl previously treated with any form of office-based vergence/accommodative therapy or home-based vergence therapy (e.g., computerized vergence therapy) Cl associated with head trauma or known disease of the brain Diseases known to affect accommodation, vergence, or ocular motility such as multiple sclerosis. Graves orbitopathy, myasthenia gravis, diabetes mellitus, Parkinson disease Inability to comprehend and/or perform any study-related test or procedure Speech-language disorder (e.g., stuttering) that would interfere with interpretation of digital recordings of reading tests Significant hearing loss Household member enrolled in present CITT-ART or treated within the past 6 months with any form of office-based vergence/accommodative therapy or home-based vergence therapy (e.g., computerized vergence therapy)? Household member is an eye care professional, ophthalmic technician, ophthalmology or optometry resident, or optometry student

Eligibility Criteria

Exclusion Criteria

Age 9 to 14 years
Grades 3 through 8
Cl Symptom Survey score ≥ 16
Exophoria at near at least 4Δ greater than at far
Receded near point of convergence (NPC) of ≥ 6 cm break
Insufficient positive fusional vergence (PFV) at near (i.e., failing Sheard’s criterion or PFV ≤15Δ base-out break)
Best-corrected distance and near visual acuity of 20/25 or better in each eye
Random dot stereopsis appreciation of 500 seconds of arc or better
Willing to wear refractive correction for any of the following uncorrected refractive errors (based on cycloplegic refraction within prior 6 months). (Correction must be worn for at least 2 weeks):
- -
  Myopia ≥ −0.75 D spherical equivalent in either eye
- -
  Hyperopia ≥ +1.50 D spherical equivalent in either eye
- -
  Anisometropia ≥1.00 D spherical equivalent or ≥ 1.50 D in any meridian
- -
  Astigmatism ≥1.00 D in either eye
Not wearing BI prism or plus add at near for 2 weeks prior to study and for duration of study
English is primary language spoken at home or child proficient in English as determined by the school
Parental permission to contact the child’s teacher for study purposes
Parent and child understand protocol and are willing to accept randomization
Parent does not expect child to start any new ADHD medicine or change the dose of any currently taken ADHD medicine while child is being treated in the study

Constant strabismus at distance or near
Esophoria of ≥ 2Δ at distance
Vertical heterophoria ≥ 2Δ at distance or near
≥ 2 line interocular difference in best-corrected visual acuity
Monocular near point of accommodation >20 cm (accommodative amplitude < 5D) as measured by push-up method
Manifest or latent nystagmus
Single-word decoding difficulties (associated with phonological-based reading disabilities or dyslexia) based on Wide Range Achievement Test (WRAT-4) Word Reading Subtest score < 80
Kaufman Brief Intelligence Test (KBIT-2) non-verbal subscale score < 70 (excludes intellectual disability)
History of strabismus surgery or refractive surgery
Cl previously treated with any form of office-based vergence/accommodative therapy or home-based vergence therapy (e.g., computerized vergence therapy)
Cl associated with head trauma or known disease of the brain
Diseases known to affect accommodation, vergence, or ocular motility such as multiple sclerosis. Graves orbitopathy, myasthenia gravis, diabetes mellitus, Parkinson disease
Inability to comprehend and/or perform any study-related test or procedure
Speech-language disorder (e.g., stuttering) that would interfere with interpretation of digital recordings of reading tests
Significant hearing loss
Household member enrolled in present CITT-ART or treated within the past 6 months with any form of office-based vergence/accommodative therapy or home-based vergence therapy (e.g., computerized vergence therapy)?
Household member is an eye care professional, ophthalmic technician, ophthalmology or optometry resident, or optometry student