Convergence Insufficiency Games: What the Research Shows

Updated 2026-10-23

Written by the Optics Trainer team from published research, with every source linked below. Not yet reviewed by a clinician.

Convergence insufficiency games are computer, app or VR activities that ask both eyes to turn inward together, usually while making the task harder as you improve. They aim to make practice more engaging, and a few small studies found better adherence with a game or app than with standard exercises. In the biggest trials of children, home computer therapy did no better than placebo, and weekly office therapy with home practice had the highest success rate. This guide explains what computer vision therapy for convergence insufficiency is, what CITT, CITT-ART and newer studies found, how home and office care differ, and what to ask your eye doctor.

What are convergence insufficiency games?

Convergence insufficiency (CI) means the eyes have trouble turning in together for close work like reading. It can cause eye strain, headaches, blur or double vision up close. Treatment usually means vergence exercises, which train the eyes to aim together at near targets.

Vision therapy games for convergence insufficiency are digital versions of those exercises. Most show each eye a slightly different image, often with red-blue glasses or a VR headset, and the player has to keep the two images fused into one. Many programs adjust the difficulty after each session.

Computer programs are not new, and they are not only for home. In the CITT trials, office therapy used both computerized and non-computerized equipment. In an adult trial called CINAPS, home practice was entirely computer-based, and office sessions included computer orthoptics too.

What the big trials found about home computer therapy

The Convergence Insufficiency Treatment Trial (CITT), published in 2008 in Archives of Ophthalmology, tested a home computer program head to head. It enrolled 221 children aged 9 to 17 for 12 weeks. One group used the Home Therapy System (HTS/CVS) software 15 minutes a day plus 5 minutes of pencil push-ups, 5 days a week. The program changed the exercises after each session based on how the child did. Eye care professionals can read our clinician article on game-based therapy for convergence insufficiency.

After 12 weeks, 73% of children in weekly office therapy with home practice were successful or improved. That compared with 43% for home pencil push-ups, 33% for the home computer group and 35% for placebo office therapy. On symptoms, the home computer group did no better than placebo. A 2005 pilot by the same group had already found office therapy led to more improvement than pencil push-ups or placebo.

A second trial tested home therapy alone. Published in 2016 in Optometry and Vision Science, it randomly assigned 204 children to home computer therapy, home push-ups or a home placebo program. Most children in every group did not reach success at 12 weeks, and some on placebo did. The study recruited only 34% of the children it planned.

A 2020 Cochrane review pooled these trials. It found high-certainty evidence that, for children, office therapy with home practice beat home computer therapy. It found no clear difference between the two home options, or between either one and placebo.

Randomized trials in children that included a home computer vergence program. Percentages are the share meeting each study's outcome measure at 12 weeks ("successful or improved" in CITT, "successful" in the 2016 trial), as reported by the authors.
Trial	Children	Home computer therapy	Comparison groups
CITT, Arch Ophthalmol 2008	221, aged 9 to 17	33% successful or improved	Office therapy 73%, home pencil push-ups 43%, placebo office therapy 35%
PEDIG home-based trial, Optom Vis Sci 2016	204, aged 9 to under 18	23% successful	Home push-ups 22%, home placebo 16% (recruited only 34% of plan)

Home vs office: why setting and sticking with it matter

Office therapy in these trials meant a one-hour visit each week with a trained therapist, plus 15 minutes of practice at home, 5 days a week. Home groups were taught the exercises, then checked in less often. In CITT, home families got monthly visits and weekly phone calls.

Several things differ between the two settings, so it is hard to say which one made the difference:

Time: in CITT, the office groups were prescribed about 135 minutes a week, the home computer group 115 and the push-up group 90, counting the home groups' weekly phone calls with the therapist.
Coaching: in the office, a therapist guided every procedure. At home, CITT families kept logs and the computer saved data to bring to visits.
Adherence: at 12 weeks in CITT, therapists rated 67.3% of the home computer group as doing their home practice at least 75% of the time, compared with 91.4% of the office group. In the 2016 home trial, practice dropped off in the second six weeks.
The Cochrane review reported adherence of 96.6% or higher for office therapy in two trials, and less consistent adherence at home.

VR for convergence insufficiency and newer game studies

Researchers have kept testing whether games and VR can make practice more appealing. The studies so far are small, mostly in young adults, and short.

In a 2020 study in Clinical and Experimental Optometry, 18 young adults used either a VR Snakes game or anaglyph exercises, 20 minutes three times a week for six weeks. The authors said the VR game was feasible and linked with better compliance. In a 2022 pilot trial in BMC Ophthalmology, VR therapy given in the office one hour a week and standard office therapy both improved eye teaming in 33 young adults with CI. A 2026 feasibility study in Bioengineering randomly assigned 25 people to a phone app that tracked the eyes with the camera or to pencil push-ups at home for 8 weeks. Recorded adherence was 90.1% with the app and 75.4% with push-ups, but the change in symptoms was not clearly different between groups.

Two reviews put this in context. A 2025 review in the Journal of Optometry found only three VR studies and said the evidence was not enough to draw firm conclusions. A 2026 review in the Journal of Eye Movement Research found that, in CI, digital and VR therapy reduced the eye drift up close but did not clearly improve near point of convergence or fusional vergence. It rated the evidence low to moderate. No large trial has tested a home VR program against office therapy.

Kids, adults, reading, attention and ordinary video games

Most of the trials were in children. For adults, a 2005 CITT trial in 46 adults aged 19 to 30 found that only office therapy clearly improved eye-teaming measures, though symptoms got better in every group, including placebo. The 2020 CINAPS trial in 50 adults found the same pattern. The Cochrane review called adult evidence less clear.

Families often hope eye-teaming practice will help with school. The CITT-ART trial, in 310 children aged 9 to 14, found that 16 weeks of office therapy improved eye teaming but did not raise reading scores more than placebo. A 2021 paper from the same trial found therapy was no better than placebo for attention. Both groups improved a lot, which the authors linked to the intensive program itself rather than to the eye exercises.

What about everyday video games? We could not find any trial testing ordinary entertainment games as a treatment for CI, or showing that they cause it. The usual advice on screen breaks and comfortable viewing distance still applies.

Questions to ask your eye doctor

Eye care groups do not fully agree on home care. The American Optometric Association says the most successful treatment involves home plus office therapy, and that CI does not improve if the therapy is not done. AAPOS, a pediatric ophthalmology group, says home treatment is often enough and that no option has been shown to be best. The American Academy of Ophthalmology says your doctor may prescribe in-office exercises, home exercises or both, and notes that computer-based exercises exist. Our guide to convergence insufficiency exercises covers the non-digital options.

Bring these questions to your visit:

Is this convergence insufficiency, and do my symptoms need treatment? AAPOS and the AAO say people without symptoms do not need it.
Should I start with office therapy, home practice, or both?
If I use a game or app at home, which settings should I use, and how will you track my progress?
How often should I come back, and what result would make us change the plan?
What should I do if I get new double vision, worse headaches or eye pain?

Where Optics Trainer fits

Optics Trainer is a set of game-based vision and brain training apps for iPhone, iPad, Android, web browsers and Meta Quest. It includes eye-teaming games with adjustable convergence and divergence levels, games where each eye gets its own target while both stay open, and depth and visual reaction games.

It is a way to practice visual skills at home. It is not a diagnosis or treatment, and it was not tested in the studies described above. It is not FDA cleared, and it is not an alternative to office therapy or to home exercises your clinician prescribes. If your eye care professional agrees that extra home practice fits alongside your plan, ask how it should fit with your prescribed exercises, and keep your follow-up visits. Optics Trainer is not a substitute for professional diagnosis or prescribed care. Consult your eye care professional for guidance about your specific condition.

As of October 2026, mobile and web training is $14.99 a month or $149.99 a year. The phone and tablet apps start with a 7-day free trial, and a free web account includes 3 plays a day. VR training on Meta Quest is $19.99 a month or $199 a year after a 7-day free trial.

Frequently asked questions

Do video games help convergence insufficiency?

We found no trial testing ordinary entertainment games as a CI treatment. Purpose-built vergence programs have been tested. In children, a home computer program did no better than placebo on symptoms in the CITT trial, while office therapy with home practice had the highest success rate.

Does vision therapy work for convergence insufficiency?

In children, office-based therapy with home practice beat home options and placebo in CITT and in a 2020 Cochrane review. In the later CITT-ART trial, it improved eye-teaming measures, but symptoms improved about as much with placebo. Home-only pencil push-ups and home computer therapy did not clearly beat placebo. In adults, office therapy improved eye-teaming measures, but symptoms improved in every group, including placebo.

Is computer vision therapy for convergence insufficiency as good as office therapy?

The Cochrane review found high-certainty evidence that office therapy with home practice beat home computer therapy in children. Office therapy itself often uses computer programs, and the trials also differed in supervision, time and follow-up, so they cannot show which of these made the difference.

Is VR good for convergence insufficiency?

In a small 2020 study of young adults, the authors linked a VR game with better compliance. A 2026 review found VR and digital therapy reduced eye drift up close but did not clearly improve other key measures. No large trial has tested a home VR program against office therapy.

Are there vision therapy games for kids?

Yes, several computer and app programs are made for children, and the CITT trials used one at home. In CITT, 73% of children were successful or improved with weekly office therapy plus home practice, compared with 33% with the home computer program. Ask your child's eye doctor how to use any game and when to recheck.

Can vision therapy games help my child read better?

In the CITT-ART trial, office therapy improved eye teaming in children with CI, but reading scores rose no more than with placebo. A later paper found no attention benefit over placebo either.