Cacho Martinez et al. 19 performed a systematic review of the literature from 1986 to 2007 using four major medical databases and strict inclusion criteria. Reviewing 16 studies performed over 20 years, of which only three were clinical trials, the authors concluded that optical treatment of CI with prism in pre-presbyopes was no more effective than placebo, and that PPT was not as effective as other forms of vision therapy, such as office-based. 19 Pencil push-ups were still modestly effective, however, which may be one reason they are still used, as reported in the current study.

The subjects were followed up 4 and 8 weeks later, and in the follow-up visits, near heterophoria, NPC and PFV were investigated. The near heterophoria was determined using the alternate prism cover test method with the best correction. Subjects fixated on an accommodative target, a small isolated letter “E” of approximately (6/9) size from the reduced Snellen chart, on a metal reading rod at eye level at 40 cm. As the alternate cover test was performed, the prism power was adjusted until there was no recovery movement in either eye. For confirmation of the neutral point, the prism power was increased until a reversal movement was seen. The prism power was reduced until no movement was seen. For determination of NPC, the previous target was moved gradually from 40 cm in the subject's midline toward the bridge of the nose of the subject at a rate of approximately 3-5 cm/sec. 3 The subjects were instructed to keep the target single during the test and report when it appeared double (break point). The distance between break point to the plane of the lateral canthus was measured with a millimeter ruler. For subjects who did not report diplopia, the examiner measured the distance at which eye lost fixation on the target. For each subject, the NPC was measured only after giving adequate instructions. 15 A prism bar was used for measurement of fusional reserves at near. Target used was the same as before. The subject was asked to look at the target and the prism with base-in was introduced over the habitual correction and prism power slowly increased step-by-step until the subject reported sustained break and recovery. The above procedure was repeated with base-out prism and the break and recovery points were determined and recorded in prism diopters. We observed the subject's eyes during measurement for detection of possible suppression. 2 , 16 All testing was performed under full room illumination with best correction in place. The following are some pointers on how to sharpen eyeliner without using a sharpening tool. The correct sharpener is determined by the brand or size of the eyeliner pencil. If you use a sharpener too large or small, it can break and make sharpening more difficult. Sharpening eyeliners with the appropriate size eyeliner sharpener is the most effective method. If you have a brand-new pencil sharpener that you haven’t used for pencils, it could be a good solution for this task. Cleaning the inside of the sharpener after each use can also help prevent breakage. StyleCheer offers tips on how to apply eyeliner without damaging or smearing your eyeshadow. It is important to remember that the Convergence Insufficiency Symptom Survey used for the Convergence Insufficiency Treatment Trial established that a score of 16 or greater is considered significant for symptoms associated with Convergence Insufficiency. Comparing the established score of 16 to the score of 9.5 following 12 weeks of in-office vision therapy and to the score of 25.9 following 12 weeks of pencil pushups, it is easy to understand why pencil pushups are considered an ineffective form of therapeutic treatment. To sharpen Maybelline Gel Eyeliner Pencils, start by removing the cap and turning the pencil to expose the tip. Then, insert the tip into a sharpener that is designed for eyeliner pencils. Turn the pencil in the sharpener until you have a thin, pointed tip. When finished, remove the pencil and test the tip on your hand to ensure it is sharp enough for use. Be careful to not over-sharpen the pencil, as this will cause the tip to break off and become unusable. Finally, replace the cap on the pencil and use as normal.

How To Twist Up Eyeliner

Heat the tip of the pencil with a hairdryer to soften it and make it easier to apply. In her opinion, keep it there for a short period of time. It only takes two or three seconds for the pencil to glide across the water line.

The Effectiveness of Home-based Pencil Push-up Therapy Versus Office-based Therapy for the Treatment of Symptomatic Convergence Insufficiency in Young Adults: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302485/ The inclusion criteria were, a survey score 21 or greater using the convergence insufficiency symptom survey (CISS) questionnaire 14[see Appendix A], near exo-deviation which was at least 4 prism diopters more than distance, remote NPC (6 cm or more), insufficient near PFV (not meeting Sheard's criterion, 4 or break point less than 15 prism diopters), the best corrected monocular VA of 20/25 or better at far and near. Although the Eyeliner appears to be plastic, its cosmetic sharpener, such as our Dual Sharpener, can be used to sharpen it. Turn the pencil gently three or four times with the sharpener to achieve the best results, not to apply too much pressure. After sharpening, it is recommended that you remove all shavings from the edge of the blade. How Do You Use Maybelline Gel Pencil Liner?

Are Pencil Pushups Effective?

CI is more prevalent than other types of non-strabismic binocular vision anomalies. The prevalence of CI has been reported about 3-5% of population. Studies have reported a higher prevalence of 5.3% in subjects 6-18 years old, 6% in children 8-12 years old, 4.2% in children of 9-12 years old, and 7.7% in university students. 2 , 3 , 4 The prevalence may be higher still in the presbyopic adult population due to decompensated accommodative convergence, but it may be better treated with base-in prism at near. Barnhardt C, Cotter SA, Mitchell GL, Scheiman M, Kulp MT. Symptoms in children with convergence insufficiency: before and after treatment. Optom Vis Sci. 2012;89(10):1512-20. doi:10.1097/OPX.0b013e318269c8f9 Pencil push-ups treatment (PPT) is a commonly prescribed eye exercise approach for convergence insufficiency (CI). They are also called or categorized as near point of convergence exercises. Typically, this exercise is done with a pencil but any object with the shape of a pencil could work. Pencils used in PPT can have an alphabet or other characters on it to stimulate the accommodative system. If the patient does not know their letters yet, the optometrist may opt for a more familiar symbol like animal or shape and have the patient look at that while they perform the pencil pushup task. There are several studies evaluating the effectiveness of in-office vision therapy vs pencil pushups. One such study revealed that after 12 weeks of therapy the convergence insufficiency score was significantly reduced in the in-office vision therapy group from 32.1 to 9.5. However, after 12 weeks of pencil pushups the convergence insufficiency score decreased from 29.3 to 25.9. It is of particular interest to note that pencil pushup therapy was found to be no more effective than the placebo therapy. Hassan LI, Ibrahim SM, Abdu M, Mohamedsharif A. Prevalence of convergence insufficiency among secondary school students in Khartoum, Sudan. Oman J Ophthalmol. 2018;11(2):129-133. doi:10.4103/ojo.OJO_170_2017

Keep your dominant hand in place by holding the scissors between your fingers and running the blade of the scissors down the eyeliner pencil, but don’t wrap your hand around the blades. A repeated measures ANOVA was used for comparison of the mean of measured variables (NPC, PFV and phoria) before 4 and 8 weeks after intervention in each group. This test showed differences in the mean NPC, PFV, and phoria between before 4 and 8 weeks after intervention in each group, separately. The Bonferroni test was used for the pairwise comparisons. Scheiman M, Mitchell GL, Cotter SA, et al. Convergence Insufficiency Treatment Trial - Attention and Reading Trial (CITT-ART): Design and Methods. Vis Dev Rehabil. 2015;1(3):214-228. What should you do and how to do it? Apply the gel liner along the lash line from the inner to outer corners of the eye. The Eyeliner Remover from Maybelline Expert Eyes® 100% Oil-Free Eye Makeup Remover will easily remove eye liner from the eyes. Do You Sharpen The Maybelline Tattoo Gel Pen?

If you have been prescribed PPT by a Developmental Optometrist as part of an overall comprehensive Vision Therapy program, then, yes you should use your pencil pushups. From the information above you can tell that, pencil pushups alone are no better than placebo in studies. This makes them not as effective as a stand alone treatment when compared to an overall comprehensive vision therapy program. How often you should use PPT is usually directed by your doctor, but, to make a change in your vision, it is important to use this (and other protocols) at least 5x/week. The results of this study indicated that there was a statistically significant decrease in symptoms in both groups, but there was no significant difference between the efficacy of PPT versus office-based therapy for the treatment of CI. However, changes in NPC and near heterophoria in the office-based therapy group were somewhat greater than the home-based therapy group. By comparison, home-based therapy showed significantly lower improvement in positive fusional vergence. Table 2 presents the data for NPC in both home-based therapy and in office-based therapy groups, there was significant difference in the mean of NPC between before and 4 weeks after intervention, and before with 8 weeks after ( P< 0.05, all comparisons), but not between 4 and 8 weeks ( P> 0.05). After therapy, the NPC became closer to the eyes, there was no statistical difference based on length of therapy. There was a significant difference in the mean PFV among the three time periods tested (before with 4 weeks after intervention, before with 8 weeks after, and 4 with 8 weeks after) in both groups ( P< 0.05, all comparisons). The difference near phoria before and 4 weeks after intervention, and before and 8 weeks after intervention was statistically significant ( P< 0.05). But not between 4 and 8 weeks after intervention ( P> 0.05).

Eye makeup is an important part of an overall look, and eyeliner is a great way to accentuate the eyes and add definition. Pushing up an eyeliner pencil is a simple and essential step in the makeup application process, as it helps the pencil glide across the eyelids more smoothly and evenly, producing a cleaner, more professional look. In this guide, we’ll walk you through the steps of how to properly push up an eyeliner pencil, so you can create a stunning and flawless eye makeup look. Prior to starting therapy, the NPC ( P = 0.610), near heterophoria ( P = 0.821), and PFV ( P = 0.580) were not statistically different between groups. After 4 and 8 weeks, only PFV was statistically significantly different between groups ( P = 0.001). After 4 and 8 weeks, NPC was not statistically different between groups ( P = 0.805). There was no statistical difference between groups in near heterophoria after 4 and 8 weeks ( P = 0.701). Momeni-moghaddam H, Kundart J, Azimi A, Hassanyani F. The effectiveness of home-based pencil push-up therapy versus office-based therapy for the treatment of symptomatic convergence insufficiency in young adults. Middle East Afr J Ophthalmol. 2015;22(1):97-102. doi:10.4103/0974-9233.148357In CI, patient's complaints are frequently associated with reading or near work. The common symptoms are eyestrain and headache after short periods of reading, blurred vision, diplopia, sleepiness, difficulty in concentrating, loss of comprehension over time, a pulling sensation in eyes, and movement of letters while studying or reading. 5 Yet some patients with CI do not report any problems. 4 This absence of complaints may be due to suppression, avoidance of near visual tasks, high discomfort threshold, or occlusion of one eye during reading. 4 Why, then, do pencil push-ups remain so popular among the eye care providers as a treatment option? The likely reasons include the simplicity, accessibility, and affordability of this treatment. With CI, the most common of the Duane-White accommodative-vergence syndromes, it is likely that the capacity of patients with this condition exceeds the number of vision therapy practitioners in many parts of the world. Gallaway et al. 18 investigated the efficacy of the treatment of CI by using PPT and indicated that therapy was valuable in 58% of cases in normalization of NPC, and in 91.7% of cases reduced the patient's symptoms. These observations were confirmed in our study. Another study by Scheiman et al 16 on children 9-18 years old reported lower efficacy of PPT at home compared with office therapy, which is in contradiction with the results of present study. The mean changes in PFV and NPC before and at the end of the treatment phase in Scheiman et al. 16 study concurs with our study. The amount of near phoria was not investigated as a parameter is Scheiman et al 16 study before and after treatment, whereas we investigated this parameter and observed that there was no significant difference in the two groups. Of note, with true CI, the observed difference in amount of phoria before and after the treatment can attributed to the vergence after-effect, as the amount of deviation will not change with therapy if prolonged occlusion is used. This may not be the case in pseudo-CI, which is really accommodative insufficiency with a false apparent high exophoria. Brautaset et al. 17 showed the efficacy of PFV therapy for the reduction of asthenopia in patients with CI, which concurs with the result of present study. Arnoldi et al. 7 investigated the efficacy of PPT and reported that the NPC after the treatment in 98.9% of patients was less than 10 cm, in 95.7% less than 8.5 cm and in 80.4% less than 6.5 cm. Their results were similar to our study in that the mean NPC decreased from 13.0 cm to 8.5 cm in the PPT group.