Comparative Effectiveness of Pencil Push-Up Exercises and Jump Vergence Exercises in Treating Convergence Insufficiency among Digital Screen Users

Abstract

CI which is also called convergence insufficiency, is a disease occurring in both eyes in which there is no proper eye alignment while doing near tasks, often exacerbated by prolonged near work. That’s the reason, most digital screen users have convergence insufficiency. Traditional treatment methods for CI include some orthoptic exercises like pencil push-up exercises and jump vergence exercises to improve coordination and strength of eye muscles. Pencil push-up is that exercise which involves focusing on a small target as it is slowly brought towards the nose, thereby stimulating convergence. While other exercises like JVE train the eyes to quickly alternate attention between close and far targets, helping to improve flexibility. To assess the efficacy of two commonly used orthoptic techniques PPU exercises and jump vergence exercises –in improving CI among those individuals who use prolong digital screens in daily routine. To investigate the effectiveness of jump vergence exercises versus pencil push-ups in the treatment of convergence insufficiency among digital screen users, this study was conducted at Haji Murad Trust Eye Hospital for 4 months through a randomized control trial design. Random sampling was utilized in the recruitment of willing participants. Total 52 patients diagnosed with convergence Insufficiency were enrolled and randomly allocated into two groups, each with 26 patients. Group A received pencil push-up exercise while Group B was treated with jump vergence exercise. The study followed single blind design where outcome assessor was unaware of their treatment allocation group. Baseline NPC and CISS scores were recorded before any intervention, and follow-up measurements were taken at 6 weeks. Post-test data were gathered following the intervention period of 6 weeks through the use of RAF ruler in measuring near point of convergence and the CISS questionnaire in determining symptom severity. The Shapiro-Wilk test was applied to assess the normality of data. Statistical analysis was performed by SPSS 27. After applying Shapiro-Wilk test all variables showed p values greater than 0.005 the data were considered normally disturbed. Within group analysis showed statistically significant reduction in NPC and improvement in CISS scores in Group B from baseline to follow-up visit (p<0.001), demonstrating enhancement over time. In Group A, both NPC and CISS scores showed improvement, however, no significant changes were observed after 6 weeks. At 6 weeks, mean scores decreased by 3.8 (SD 1.9) in Group B versus 9.0 (SD 2.2) in Group A. The mean group difference was 5.2 (95% CI: 4.0 to 6.4), p < .001. Group B also showed greater improvement in reduction of near point of convergence and symptoms in comparison of Group A. The study concluded that although improvement had been achieved with the two techniques, the jump vergence exercises showed higher improvements compared to pencil push-up exercises on the NPC and alleviation of symptoms. Despite the temporary nature of the investigation, the results clearly show the high efficiency of jump vergence exercises and make a preferred treatment method a strongly feasible option.