Prevalence of convergence insufficiencytype symptomatology. By emphasizing reading, the convergence insufficiency symptom survey score significantly overestimates near visual symptoms in children with normal binocular. Jul 15, 2017 convergence insufficiency is a condition in which your eyes are unable to work together when looking at nearby objects. Convergence insufficiency treatment trial citt full text. There are a lot of signs and symptoms for convergence disorder or convergence insufficiency. Treatments for convergence insufficiency the article states that pencil pushups is the most commonly prescribed treatment for convergence insufficiency, but that is because many optometrists do.
Convergence insufficiency ci is characterized by a decreased ability to converge the eyes and maintain binocular fusion while focusing on a near target. There are complications which are subtle but can be bothersome for the sufferers. To determine the distribution of scores on the ciss when administered to large numbers of students with histories of poor reading. Pdf validity and reliability of the revised convergence. The ciss also serves to educate the patient to common symptoms associated with ci. The convergence insufficiency symptom survey ciss was designed to quantify the severity of symptoms associated with convergence insufficiency ci. Convergence insufficiency symptom survey scores for reading versus other near visual activities in schoolage children. These measures were tested and validated for this study by. This study includes two stages pre and post convergence insufficiency survey ciss questionnaire 11. Beginning each survey with the question about selfrated reading speed could eliminate the need for additional questions if a child selfrates his or. Convergence insufficiency is a common condition that is characterized by a patient s inability to maintain proper binocular eye alignment on objects as they approach from distance to near. Figure 1 the convergence insufficiency symptom survey. We also report the clinical and demographic characteristics of patients.
There is typically an exophoria or intermittent exotropia at near, a receded near point of convergence, reduced positive fusional convergence amplitudes. The score ranges from 0 to 60, with 60 representing the most symptomatic case. Improvements in 1 near point of convergence npc, 2 positive fusional vergence pfv, and 3 selfreported symptoms convergence insufficiency symptom survey ciss score were compared. Methods the ciss questionnaire was administered, followed by a full orthoptic evaluation, to 167 university undergraduate and postgraduate students during the recruitment phase. There are few tests to diagnose convergence disorder or convergence. For adults total score 21 or higher is suggestive of convergence insufficiency. This randomized clinical trial included patients meeting the eligibility criteria and with symptomatic ci, who were allocated into three groups. Convergence insufficiency symptom survey scores for. Data from individuals n 87 with, n 94 without pd who were approached but who reported having a known oculovisual condition were analysed. The score becomes a measure of the morbidity of ci. The secondary outcome measures are the near point of convergence and positive fusional vergence at near.
Officebased vergenceaccommodative therapy was significantly more effective than homebased or. Officebased vergenceaccommodative therapy was significantly more effective than homebased or placebo therapies. This report describes the design and methodology of the convergence insufficiency treatment trial citt, the first largescale, placebocontrolled, randomized clinical trial evaluating treatments for convergence insufficiency ci in children. Convergence insufficiency symptom survey scores for required. Assessments included near and distance bestcorrected visual acuity and near and distance cover tests, as well as randot stereopsis and maddox distance and maddoxthorington near. Convergence and accommodative insufficiency represent the main cause of complaints during close visual work and can reduce visual performance and comfort. The authors of this cohort study of schoolaged children with normal binocular vision compared the convergence insufficiency symptom survey. The purpose of this study was to estimate the frequency of these conditions in children in 5th and 6th school years in inland portugal. Apr 02, 2018 there are a lot of signs and symptoms for convergence disorder or convergence insufficiency. We compared the effectiveness of three active vision therapy approaches for convergence insufficiency ci. An individual who has this disorder might show and grumble of the subsequent signs when performing close work like, computer work, deskwork, reading, doing crafts, playing video games in hand held devices etc. Most studies have been conducted with school age children or adults and show that the prevalence of convergence insufficiency is similar across all populations.
Results from research studies show that about 1 out of every 20 people 5% have convergence insufficiency. Convergence insufficiency treatment trial citt full. Convergence insufficiency symptom survey scores vary greatly depending on the type of near activity being surveyed and thus do not accurately isolate and reflect near visual ability. Convergence insufficiency symptom survey sankara nethralaya. Outcome data on the convergence insufficiency symptom survey ciss score primary outcome, near point of convergence npc, and positive fusional vergence were collected after 12 weeks of active. Methods in a randomized clinical trial, 221 children aged 9 to 17 years with symptomatic convergence insufficiency were assigned to 1 of 4 treatments. In the homebased vision orthoptic therapy hbvot group, patients performed the pencil pushup procedure 15 minday for 5.
For each question, tick the box that indicates the frequency of the symptoms. Symptom survey score for the children with ci was 30. To assess the validity and reliability of the revised convergence insufficiency symptom survey ciss in adults aged 1930 years. Oct 08, 2012 to help quantify symptoms, citt developed the convergence insufficiency symptom survey ciss. Read the following subject instructions and then each item exactly as written. Convergence insufficiency symptom survey scores for reading. They were administered the convergence insufficiency symptom survey ciss15 over the phone. Methods the ciss questionnaire was administered, followed by a full orthoptic evaluation, to 167 university undergraduate and postgraduate students during the recruitment phase of another. In the original convergence insufficiency symptom survey study, question 15 only contributed an average of 0. Convergence insufficiency symptom survey scores in children. Convergence insufficiency symptoms survey ciss wow vision.
Convergence insufficiency symptom survey guide scoring 1. Assessing whiplashrelated convergence insufficiency. Initial studies indicated good construct validity and reliability 1, 2 and later studies confirmed the validity and reliability of the revised version of the survey. Secondary outcomes were near point of convergence and positive fusional vergence at near. Validity and reliability of the revised convergence insufficiency symptom survey in children. Convergence insufficiency symptoms and causes mayo clinic. Borsting ej, rouse mw, mitchell gl, et al and the citt group. To describe the design and methodology of the convergence insufficiency treatment trial. Convergence insufficiency and accommodative insufficiency. The objectives of the present study were to evaluate whether investigator bias influenced the convergence insufficiency symptom survey ciss scores of. Validity and reliability of the revised convergence.
The objectives of the present study were to evaluate whether investigator bias influenced the convergence insufficiency symptom survey ciss scores of children with normal binocular vision nbv in our original validation study, reevaluate the usefulness of the cutoff score of 16, and reexamine the validity of the ciss. Add up the number of ticks for each column and multiply this by the amount at the bottom. For children score 16 or higher is suggestive of convergence insufficiency. Outcome data on the convergence insufficiency symptom survey ciss score primary outcome, near point of convergence npc, and positive fusional vergence were collected after 12 weeks of active treatment and again at 6 and 12 months posttreatment. Screening for convergence insufficiency using the ciss is not. A questionnaire designed to quantify symptoms associated with reading and near work.
Difficulty in catching balls or other objects passed through the air is one of the symptom of convergence disorder or convergence insufficiency. Results after 12 weeks of treatment, the obvat groups mean convergence insufficiency symptom survey score 15. Convergence insufficiency specialists warminster pa. Main outcome measures convergence insufficiency symptom survey score after 12 weeks of treatment. Rouse mw, borsting ej, mitchell gl, scheiman m, cotter sa, cooper j, et al. Convergence insufficiency is usually diagnosed in schoolage children and adolescents. The primary outcome measure is a symptom score obtained via the convergence insufficiency symptom survey. Validity and reliability of the revised convergence insufficiency symptom survey in adults. Jun 20, 2006 the convergence insufficiency treatment trial citt is a prospective, masked, placebocontrolled, multicenter clinical trial in which 208 subjects between the ages of 9 to score for children with normal binocular vision, 15 so excluding this question should not substantially affect the symptom scores for either group. Aim this paper presents convergence insufficiency symptom survey ciss and orthoptic findings in a sample of typical young adults who considered themselves to have normal eyesight apart from weak spectacles. Convergence insufficiency is a common near vision problem that due to recent scientific research is gaining public recognition. All participants completed the convergence insufficiency symptom survey ciss, which is a validated questionnaire, and underwent a detailed visual exam. Convergence insufficiency and divergence insufficiency this chapter discusses the characteristics, diagnosis, and management of nonstrabismic binocular disorders associated with a low accommodative convergence to accommodation aca ratio. Treatment of convergence insufficiency in childhood.
Convergence insufficiency symptom survey scores in. Comparison of three vision therapy approaches for convergence. Mar, 2018 convergence insufficiency is a common binocular vision condition with a prevalence of approximately two to eight per cent in which a person is unable to adequately converge for near work. Jan 24, 2012 convergence insufficiency symptom survey ciss. This survey documents symptoms a patient might experience and how often the symptom presents. Factor structure of the convergence insufficiency symptom. Convergence insufficiency is a common binocular vision condition with a prevalence of approximately two to eight per cent in which a person is unable to adequately converge for near work. Attention and reading trial cittart, the first randomized clinical trial evaluating the effect of vision therapy on reading and attention in schoolage children with symptomatic convergence insufficiency ci. If subject responds with yes please qualify with frequency choices. Although there are some significant differences among these conditions, they are grouped together based on the classification system. The convergence insufficiency symptom survey score was originally created to monitor improvement in asthenopic symptoms before and after treatment for convergence insufficiency ci.
The multivariate statistical analysis of the convergence insufficiency symptom survey revealed a threefactor structure, so new forms of questionnaire analysis can be designed in order to obtain gains in the management of a symptomatic patient, using 3 subscores, one for each factor, instead of a total score. The ciss was developed to be the primary outcome measure for studies evaluating various treatments for convergence insufficiency ci. Symptomatic convergence insufficiency was defined as 1 a score of 16 or higher on the convergence insufficiency symptom survey, 2 exophoria at near at least 4 prism diopters. Sum each of these scores to give a final score see example below. This condition causes one eye to turn outward instead of inward with the other eye creating double or blurred vision. Randomized clinical trial of treatments for symptomatic. Convergence insufficiency treatment study cits full text. Participants who use smart phone more than one hour before going to sleep were asked to take this survey and questions used were common given by patients for near visual tasks and ocular discomfort after post test. Validity of the convergence insufficiency symptom survey. To help quantify symptoms, citt developed the convergence insufficiency symptom survey ciss. Convergence insufficiency symptom survey scores for required reading versus leisure reading in schoolage children.
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