Main outcome measures convergence insufficiency symptom survey score after 12 weeks of treatment. Jul 15, 2017 convergence insufficiency is a condition in which your eyes are unable to work together when looking at nearby objects. Convergence insufficiency symptom survey scores in children. Methods the ciss questionnaire was administered, followed by a full orthoptic evaluation, to 167 university undergraduate and postgraduate students during the recruitment phase. 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. These measures were tested and validated for this study by. 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. Convergence insufficiency treatment trial citt full text. There is typically an exophoria or intermittent exotropia at near, a receded near point of convergence, reduced positive fusional convergence amplitudes. Convergence insufficiency symptom survey scores for reading versus other near visual activities in schoolage children. Convergence insufficiency treatment study cits full text. To describe the design and methodology of the convergence insufficiency treatment trial.
Convergence insufficiency symptom survey sankara nethralaya. To determine the distribution of scores on the ciss when administered to large numbers of students with histories of poor reading. 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. Jan 24, 2012 convergence insufficiency symptom survey ciss. Randomized clinical trial of treatments for symptomatic.
Oct 08, 2012 to help quantify symptoms, citt developed the convergence insufficiency symptom survey ciss. Validity and reliability of the revised convergence. Convergence insufficiency ci is characterized by a decreased ability to converge the eyes and maintain binocular fusion while focusing on a near target. Sum each of these scores to give a final score see example below.
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. 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. Although there are some significant differences among these conditions, they are grouped together based on the classification system. Beginning each survey with the question about selfrated reading speed could eliminate the need for additional questions if a child selfrates his or.
Pdf validity and reliability of the revised convergence. The ciss was developed to be the primary outcome measure for studies evaluating various treatments for convergence insufficiency ci. By emphasizing reading, the convergence insufficiency symptom survey score significantly overestimates near visual symptoms in children with normal binocular. The score becomes a measure of the morbidity of ci. Convergence insufficiency specialists warminster pa. The purpose of this study was to estimate the frequency of these conditions in children in 5th and 6th school years in inland portugal. Convergence insufficiency symptom survey scores for. Secondary outcomes were near point of convergence and positive fusional vergence at near. Officebased vergenceaccommodative therapy was significantly more effective than homebased or placebo therapies. All participants completed the convergence insufficiency symptom survey ciss, which is a validated questionnaire, and underwent a detailed visual exam.
Convergence insufficiency symptom survey scores for required. 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. The objectives of the present study were to evaluate whether investigator bias influenced the convergence insufficiency symptom survey ciss scores of. Knowing their prevalence among schoolchildren is fundamental to define strategies for action. Rouse mw, borsting ej, mitchell gl, scheiman m, cotter sa, cooper j, et al.
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. 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. 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. Prevalence of convergence insufficiencytype symptomatology. 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. Validity and reliability of the revised convergence insufficiency symptom survey in children. The ciss also serves to educate the patient to common symptoms associated with ci. Screening for convergence insufficiency using the ciss is. Figure 1 the convergence insufficiency symptom survey. The authors of this cohort study of schoolaged children with normal binocular vision compared the convergence insufficiency symptom survey. 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. This condition causes one eye to turn outward instead of inward with the other eye creating double or blurred vision.
We compared the effectiveness of three active vision therapy approaches for convergence insufficiency ci. Factor structure of the convergence insufficiency symptom. 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. Results from research studies show that about 1 out of every 20 people 5% have convergence insufficiency. This study includes two stages pre and post convergence insufficiency survey ciss questionnaire 11. 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. 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. There are complications which are subtle but can be bothersome for the sufferers.
The score ranges from 0 to 60, with 60 representing the most symptomatic case. Borsting ej, rouse mw, mitchell gl, et al and the citt group. Convergence and accommodative insufficiency represent the main cause of complaints during close visual work and can reduce visual performance and comfort. Convergence insufficiency treatment trial citt full. Data from individuals n 87 with, n 94 without pd who were approached but who reported having a known oculovisual condition were analysed. There are a lot of signs and symptoms for convergence disorder or convergence insufficiency. There are few tests to diagnose convergence disorder or convergence. The convergence insufficiency symptom survey ciss was designed to quantify the severity of symptoms associated with convergence insufficiency ci. Add up the number of ticks for each column and multiply this by the amount at the bottom. They were administered the convergence insufficiency symptom survey ciss15 over the phone. The maximum possible score is 60 all 4s and a patient was considered to be showing symptoms of convergence insufficiency if his score was above 16.
Convergence insufficiency symptom survey guide scoring 1. To assess the validity and reliability of the revised convergence insufficiency symptom survey ciss in adults aged 1930 years. Methods in a randomized clinical trial, 221 children aged 9 to 17 years with symptomatic convergence insufficiency were assigned to 1 of 4 treatments. For adults total score 21 or higher is suggestive of convergence insufficiency. Convergence insufficiency symptom survey scores for required reading versus leisure reading in schoolage children. 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. Read the following subject instructions and then each item exactly as written. Assessing whiplashrelated convergence insufficiency. 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.
Symptom survey score for the children with ci was 30. Convergence insufficiency ci is the leading cause of eyestrain, blurred vision, double vision diplopia, andor headaches. Results after 12 weeks of treatment, the obvat groups mean convergence insufficiency symptom survey score 15. Most studies have been conducted with school age children or adults and show that the prevalence of convergence insufficiency is similar across all populations. 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. Validity and reliability of the revised convergence insufficiency symptom survey in adults. Screening for convergence insufficiency using the ciss is not. Convergence insufficiency symptom survey scores for reading.
Difficulty in catching balls or other objects passed through the air is one of the symptom of convergence disorder or convergence insufficiency. The primary outcome measure is a symptom score obtained via the convergence insufficiency symptom survey. The secondary outcome measures are the near point of convergence and positive fusional vergence at near. Convergence insufficiency symptoms and causes mayo clinic.
Convergence insufficiency symptom survey scores in. The convergence insufficiency symptom survey score was originally created to monitor improvement in asthenopic symptoms before and after treatment 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. To help quantify symptoms, citt developed the convergence insufficiency symptom survey ciss.
Officebased vergenceaccommodative therapy was significantly more effective than homebased or. 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. Treatment of convergence insufficiency in childhood. A questionnaire designed to quantify symptoms associated with reading and near work. Objective assessment of disparity vergence after treatment. We also report the clinical and demographic characteristics of patients. The convergence insufficiency treatment trial citt is a prospective, masked, placebocontrolled, multicenter clinical trial in which 208 subjects between the ages of 9 to 16. Convergence insufficiency is usually diagnosed in schoolage children and adolescents. This randomized clinical trial included patients meeting the eligibility criteria and with symptomatic ci, who were allocated into three groups. Apr 02, 2018 there are a lot of signs and symptoms for convergence disorder or convergence insufficiency. Convergence insufficiency ci is a common binocular visual problem characterized by exophoria that is greater at near distances than at far distances as well as an increased near point of convergence npc and reduced positive fusional vergence convergence amplitude pfv at near distance. 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.
Convergence insufficiency symptoms survey ciss wow vision. In the original convergence insufficiency symptom survey study, question 15 only contributed an average of 0. 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. Comparison of three vision therapy approaches for convergence. If subject responds with yes please qualify with frequency choices. This survey documents symptoms a patient might experience and how often the symptom presents. 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.