NCT07452679

Effectiveness of Osteopathy as an Adjunct to Optometric Vision Therapy in Vergence Disorders

Effectiveness of Osteopathy as an Adjunct to Optometric Vision Therapy in Subjects With Vergence Disorders: A Randomized, Double-Blind, Controlled Clinical Trial

• Status: Not Yet Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 100 (estimated)
• Sponsor: Jordi Zaragoza · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

Vergence disorders are common binocular vision conditions that can cause symptoms such as eyestrain, blurred vision, headaches, and difficulty maintaining clear vision during near tasks. These symptoms are particularly frequent in situations involving sustained near visual demand, such as prolonged use of digital devices, which is increasingly common in daily life. Optometric vision therapy is considered the reference treatment for vergence disorders. However, not all individuals respond in the same way, and some continue to experience symptoms despite appropriate treatment. For this reason, adjunct therapeutic approaches are being explored to improve clinical outcomes. The purpose of this study is to evaluate whether osteopathic manual therapy, when used as an adjunct to optometric vision therapy, provides additional benefits compared with vision therapy alone or vision therapy combined with a sham osteopathic intervention. This randomized, controlled, double-blind clinical trial will compare three parallel groups and will assess changes in vergence function, oculomotor performance measured by video-oculography, and symptom improvement related to vergence disorders.

Detailed description

Vergence disorders are binocular vision dysfunctions characterized by an impaired ability to coordinate eye movements during visual tasks, particularly at near distances. These disorders are associated with a range of symptoms, including visual discomfort, reduced visual efficiency, and decreased functional performance during sustained near-vision activities. Optometric vision therapy is an evidence-based intervention aimed at improving vergence function and visual efficiency. Despite its effectiveness, clinical response varies among individuals, and a subset of participants may continue to experience persistent symptoms. This variability has prompted interest in adjunctive interventions that may influence neuromuscular, musculoskeletal, or functional components related to oculomotor control. This study is designed as a randomized, controlled, double-blind clinical trial with three parallel arms. Participants diagnosed with vergence disorders will be randomly assigned to one of the following groups: (1) optometric vision therapy combined with osteopathic treatment, (2) optometric vision therapy combined with a sham osteopathic intervention, or (3) optometric vision therapy alone. The primary objective of the study is to evaluate whether the addition of osteopathy to optometric vision therapy results in greater improvements in ocular mobility and efficiency, assessed using video-oculography systems (REMOBI and EyeSeeCam). Secondary objectives include the evaluation of symptom changes associated with vergence disorders using a validated questionnaire (CISS-V15), as well as the exploration of potential relationships between functional ocular impairment, identified somatic dysfunctions, and the anatomical distribution of reported symptoms. Ocular motor performance will be objectively quantified through standardized vergence tasks recorded by video-oculography, including measures of reaction latency, amplitude variability, amplitude error, and neglect rate. Assessments will be conducted at baseline (pre-intervention), post-intervention (within two weeks after completion of the visual therapy program), and at follow-up time points of three and six months after the intervention. The osteopathic intervention consists of a standardized manual treatment protocol targeting somatic dysfunctions potentially related to binocular vision and vergence function. The sham osteopathic intervention is designed to mimic the context, duration, and therapist-participant interaction of the active manual treatment without applying therapeutic osteopathic techniques, in order to preserve participant blinding. The results of this study are expected to contribute to a better understanding of the potential role of osteopathy as an adjunctive intervention in the management of vergence disorders and to provide clinically relevant data on the relationship between somatic dysfunctions and functional visual alterations in individuals with high visual demand.

Conditions

• Vergence Disorders
• Binocular Vision Dysfunction
• Convergence Insufficiency

Interventions

Type	Name	Description
BEHAVIORAL	Optometric Vision Therapy	Structured optometric vision therapy program consisting of in-office and home-based visual exercises aimed at improving binocular vision and vergence function. The intervention is standardized across participants and delivered by qualified optometrists following a predefined protocol.
BEHAVIORAL	Osteopathic Manual Therapy	Standardized manual osteopathic intervention delivered as an adjunct to optometric vision therapy. The intervention consists of predefined manual techniques targeting somatic dysfunctions potentially related to binocular vision and vergence, applied according to a fixed protocol and session schedule. The intervention protocol is predefined and documented in detail to ensure consistency across participants.
BEHAVIORAL	Sham Osteopathic Intervention	Sham manual intervention designed to mimic the context, duration, and therapist-participant interaction of the osteopathic intervention without applying therapeutic osteopathic techniques. The procedure is standardized and intended to maintain participant blinding.

Timeline

• Start date: 2026-04-01
• Primary completion: 2026-12-01
• Completion: 2027-02-01
• First posted: 2026-03-05
• Last updated: 2026-03-25

Locations

1 site across 1 country: Andorra