Please select the eligibility criteria that correspond to the clinical trial below.
Title: Convergence Insufficiency Treatment Trial (CITT)
Brief Summary: The purposes of the CITT are:

* To determine whether Home-based Pencil Push-up therapy, Home-based Pencil Push-ups with Computer Vision Therapy/Orthoptics or Office-based VT/Orthoptics more effective than placebo treatment, and whether there are differences between the three treatments in improving subject symptoms and signs.
* To evaluate whether improvements in outcome measures are still present after one year of observation.


Options:
A: Inclusion Criteria:

1. Age 9 to less than 14 years
2. Grades 3 through 8
3. CI Symptom Survey (CISS) score greater or equal to 16
4. Exophoria at near at least 4 prism diopters greater than at far
5. Receded near point of convergence (NPC) of 6 cm or greater break
6. Insufficient positive fusional vergence (PFV) at near (i.e., failing Sheard's or PFV less than or equal to 15 BO break)
7. Best-corrected distance visual acuity of 20/25 or better in each eye
8. Random dot stereopsis appreciation of 500 seconds of arc or better
9. Wearing appropriate refractive correction (spectacles or contact lenses) for at least 2 weeks prior to final determination of eligibility for any of the following uncorrected refractive errors (based on cycloplegic refraction within prior 12 months)

   * Myopia greater than -0.75D spherical equivalent (SE) in either eye
   * Hyperopia greater than +2.00D SE in either eye
   * SE anisometropia greater than 0.75D
   * Astigmatism greater than 1.00D in either eye

   Correction for patients meeting above refractive error criteria must meet the following guidelines:
   * SE anisometropia must be within 0. 75D of the full anisometropic correction
   * Astigmatism must be within 0.75D of full correction; axis must be within 6◦ if astigmatism greater than or equal to 1.00D
   * For hyperopia, the sphere can be reduced by up to 1.50 D provided reduction is symmetrical
   * For myopia, the SE must be within 0.75D of the full myopic correction
10. No use of BI prism or plus add at near for 2 weeks prior to study and for duration of study
11. English is primary language spoken at home or child proficient in English as determined by the school
12. 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
13. Parental permission to contact the child's teacher(s) for study purposes
14. Parent and child understand protocol and are willing to accept randomization

Exclusion Criteria:

1. Constant strabismus at distance or near
2. Esophoria of greater than or equal to 2∆ at distance
3. Vertical heterophoria greater than or equal to 2∆ at distance or near
4. greater than or equal to 2 line interocular difference in best-corrected distance visual acuity
5. Monocular near point of accommodation greater than 20 cm (accommodative amplitude less than 5D) in right eye
6. Manifest or latent nystagmus
7. Word Reading subtest score less than 80 on the Wide Range Achievement Test (WRAT-4)
8. Kaufman Brief Intelligence Test (KBIT-2) Matrices subtest score less than 70
9. History of prior strabismus, intraocular, or refractive surgery
10. CI previously treated with any form of office-based vergence/accommodative therapy or home-based vergence therapy (e.g., computerized vergence therapy)
11. CI associated with head trauma or known disease of the brain
12. Diseases known to affect accommodation, vergence, or ocular motility
13. Inability to comprehend and/or perform any study-related test or therapy procedure
14. Speech-language disorder (e.g., stuttering) that would interfere with interpretation of digital recordings of reading tests
15. Significant hearing loss
16. Household member enrolled in present CITT-ART, treated currently, 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)
17. Parent or other household member is an eye care professional, ophthalmic technician, ophthalmology or optometry resident, or optometry student
B: Inclusion Criteria:

* Children between the ages of 9 and 17 years with symptomatic convergence insufficiency
* Exophoria at near at least 4Δ greater than at far
* Insufficient positive fusional convergence at near
* A receded near point of convergence of ≥6 cm break
* CI Symptom Survey score ≥16

Exclusion Criteria:

* Previous treatment with office-based vision therapy/orthoptics or pencil push-ups
* Systemic diseases known to affect accommodation, vergence and ocular motility
* Developmental disability, mental retardation, attention deficit hyperactivity disorder (ADHD), or learning disability diagnosis that in the investigator's discretion would interfere with treatment
C: Inclusion Criteria:

* Age 9-30 years
* Best corrected visual acuity of 20/25 in both eyes at distance and near
* Willingness to wear eyeglasses or contact lenses to correct refractive error, if necessary
* Exophoria at near at least 4 prism diopters greater than at far
* Insufficient positive fusional convergence (i.e., failing Sheard's criterion or minimum normative positive fusional vergence (PFV) of 15 base-out break).
* Receded near point of convergence of \> 6 cm break.
* Normal random dot stereopsis using a 500 seconds of arc target.
* CI Symptom Survey score \> 16 for subjects in 9-18 year age range and \> 21 for subjects in the 19-30 year age range.
* Informed consent and willingness to participate in the study and be randomized

Exclusion Criteria:

* CI previously treated with pencil push-ups (no more than 2 months of treatment within the past year)
* CI previously treated with office-based vision therapy/orthoptics (no more than 2 months of treatment within the past year)
* Amblyopia
* Constant strabismus
* History of strabismus surgery
* Anisometropia \>1.50D difference between eyes
* Prior refractive surgery
* Vertical heterophoria greater than 1 
* Systemic diseases known to affect accommodation, vergence, and ocular motility such as: multiple sclerosis, Graves's thyroid disease, myasthenia gravis, diabetes, and Parkinson disease
* Any ocular or systemic medication known to affect accommodation or vergence
* Monocular accommodative amplitude less than 4 D in either eye as measured by the Donder's push-up method
* Manifest or latent nystagmus
* Attention deficit hyperactivity disorder (ADHD) or learning disability diagnosis by parental report
* Household member or sibling already enrolled in the CITT
* Any eye care professional, technician, medical student, or optometry student
D: Inclusion Criteria:

* Age: 9 to \<19 years.
* Best corrected visual acuity of ≥20/25 in each eye at distance and near
* Willingness to wear eyeglasses or contact lenses to correct refractive error, if necessary
* Willingness to wear glasses for reading and other near work
* Exophoria at near at least 4 greater than at far
* Insufficient positive fusional convergence (fails Sheard's criterion)
* Receded near point of convergence of  6 cm break
* Random dot stereopsis appreciation using a 500 seconds of arc target.
* CI Symptom Survey score  16

Exclusion Criteria:

* Amblyopia (\> 2 line difference in best corrected visual acuity between the two eyes).
* Constant strabismus
* History of strabismus surgery.
* Anisometropia  2D in any meridian between the eyes.
* Prior refractive surgery.
* Vertical heterophoria greater than 1 .
* Systemic diseases known to affect accommodation, vergence and ocular motility such as: multiple sclerosis, Graves thyroid disease, myasthenia gravis, diabetes, Parkinson disease.
* Any ocular or systemic medication known to affect accommodation or vergence (Anti-anxiety agents (Librium or Valium), Anti-arrhythmic agents (Cifenline or Cibenzoline), Anticholinergics (Motion sickness patch (scopolamine), Bladder spasmolytic drugs (Propiverine), Chloroquine, Phenothiazines (Compazine, Mellaril, or Thorazine), Tricyclic antidepressants (Elavil, Nortriptyline, or Tofranil)
* Accommodative amplitude \<5 D in either eye as measured by the Donder's push-up method.
* Manifest or latent nystagmus.
* Developmental disability, mental retardation, attention deficit hyperactivity disorder (ADHD), or learning disability diagnosis in children that in the investigator's discretion would interfere with treatment.
* Household member or sibling already enrolled in the BI-CITT.
* Any eye care professional, ophthalmic technician, ophthalmology or optometry resident or optometry student.

Answer: B