Purpose Convergence and accommodative insufficiency represent the main cause of complaints during close visual work and can reduce visual performance and comfort. Knowing their prevalence among schoolchildren is fundamental to define strategies for action. The purpose of this study was to estimate the frequency of these conditions in children in 5th and 6th school years in inland Portugal and to assess the impact that each visual condition has on their quality of life, based on the level of visual symptoms. Methods a cross-sectional study was carried out with children enrolled in the 5th and 6th school years. 372 children (192 girls) were assessed, with average ages of 10.9 ± 0.9 years. Refractive error and binocular vision assessment, integrating accommodative parameters, were used to analyse the visual condition. Symptoms were quantified using the Portuguese version of the CISS (Convergence Insufficiency Symptom Survey). Results The prevalence of definite Convergence Insufficiency (CI) in the children assessed was 2%. A prevalence of 6,8% could be considered if clinically significant CI (high suspect and definite categories) cases are accounted. In relation to Accommodative Insufficiency (AI), a frequency rate of 10% was recorded, with 3% of the evaluated children presenting AI and CI simultaneously. The symptoms score was higher in AI than in CI. Conclusions A frequency of approximately 10% was found for each one of the visual syndromes, and it was verified that visual discomfort is common among teenagers who carry these conditions. In cases of asthenopia, such as headaches and loss of concentration, associated with near vision activities, there is a requirement to evaluate the quality of binocular vision.

This study evaluates in terms of reliability, internal consistency, and validity a modification of the Adult Developmental Eye Movement (ADEM) test, ADEM with distractors (ADEMd), designed to analyse oculomotor system, visual processing and visual attentional behaviour. 302 healthy subjects participated in the study (20–86 years old). Intrasession repeatability was evaluated by analysing the correlation between the time needed to read different parts of the test. Inter-session analyses were carried in 40 subjects by calculating intraclass correlation coefficients and using the Bland–Altman method. Validity was assessed in the outcomes obtained according to age as well as investigating the correlation between ADEMd and attentional useful field of vision (UFOV) test. Correlation coefficients between times need to read each sheet were ≥ 0.95 (p < 0.001). The inter-session intraclass correlation coefficient ranged from 0.81 in the horizontal distractor sheet to 0.97 in the vertical sheet. Bland–Altman analysis showed clinically acceptable limits of agreement. Statistically significant correlations were found between age and ADEMd outcomes (r ≥ 0.55, p < 0.001). Processing velocity, divided attention and selective attention measured with the UFOV were correlated with the horizontal distractor times (r ≥ 0.32, p < 0.001). ADEMd test may be a useful clinical tool to evaluate the combined interaction of ocular movements and visual attentional behaviour.

Projecto n o CE-FCS-2012-027 -Faculdade Ciências da Saúde -UBI. ABSTRACTPurpose: Translate and adapt the Convergence Insuficiency Symptom Survey (CISS) questionnaire to the Portuguese language and culture and assess the psychometric properties of the translated questionnaire (CISSvp). Methods: The CISS questionnaire was adapted according to the methodology recommended by some authors. The process involved two translations and backtranslations performed by independent evaluators, evaluation of these versions, preparation of a synthesis version and its pre-test. The final version (CISSvp) was applied in 70 patients (21.79 ± 2.42 years) students in higher education, and at two different times, by two observers, to assess its reliability. Results:The results showed good internal consistency of the CISSvp (Cronbach's alpha -α=0.893). The test re-test revealed an average of the differences between the first and second evaluation of 0.75 points (SD ± 3.53), which indicates a minimum bias between the two administrations. The interrater reliability assessed by intraclass correlation coefficient ranged from 0.880 to 0.952, revealing that the CISSvp represents an appropriate tool for measuring the visual discomfort associated with near vision tasks with a high level of reproducibility. Conclusions: The CISS Portuguese version, showed good psychometric properties and has been sown to be applicable to the Portuguese population, to quantify the visual discomfort associated with near vision, in higher education students.

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Introduction Anisometropia is characterized by a refractive inter ocular difference greater than 1.00 dioptre (D). It is the main cause of amblyopia and loss of binocular vision. Its prevalence depends on several factors, being different values in different geographical areas of the world and in different age groups. Objectives To estimate the frequency of anisometropia in children of the 2nd cycle of Basic Education. Methodology A total of 519 children attending the 5th and 6th school years, from Covilhã schools, from urban and rural areas, aged between 9 and 14 years (10.8 ± 0.8 years) were enrolled in the study. The refractive error was measured with a paediatric auto refractometer (Plusoptix), without cycloplegic and in binocular conditions. Anisometropia was defined as the inter ocular difference in spherical equivalent or cylindrical, greater than 1.00 D and a separate analysis for values greater than 2.00 D. Results The sample was symmetrically divided into genders (50.9% Male), between school grade (53% 5th year) and higher in urban areas (70.1%). The prevalence of anisometropia with cut-off points of 1.00 D and 2.00 D was 12.3% and 5.0%, respectively. There was a higher prevalence among males, in rural areas and in 6th grade. The Chi-square test (□2) shows that the difference is statistically significant only between years of schooling, with a higher prevalence in the 6th grade (p = 0.001). Conclusion There was a slightly higher prevalence of spherical and cylindrical anisometropia (5% and 12.3%) than is reported in the literature (rates between 4.4% and 9.4%). The 6th school year presented rates significantly higher than the 5th year, which points out that anisometropia increases with age, as was also advocated by other authors. Visual screening programs in adolescence for the detection of anisometropia are fundamental, since their timely correction allows to safeguard the binocular vision.