Convergence insufficiency: Review of clinical diagnostic signs

Gantz, Liat; Stiebel‐Kalish, Hadas

doi:10.1016/j.optom.2021.11.002

Cited by 7 publications

(4 citation statements)

References 110 publications

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“…Lastly, Wajuihian [17] suggested that accommodation dysfunction is the most common among black South African populations aged 10 to 40. The high prevalence of myopia (93.0%) is likely the cause of the high incidence of CI, as it is one of the most common binocular vision disorders, affecting around 7.5% of the population [18] . Symptoms of CI are usually related to nearrelated activities, such as eye fatigue, headache, intermittent blurring or double vision, font movement on the page, difficulty concentrating, slow reading, and loss of position when reading.…”

Section: Studymentioning

confidence: 99%

Frequency and associated factors of accommodation and non-strabismic binocular vision dysfunction among medical university students

Cai,

Zhong,

Wen

et al. 2024

Int J Ophthalmol

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AIM: To investigate the frequency and associated factors of accommodation and non-strabismic binocular vision dysfunction among medical university students. METHODS: Totally 158 student volunteers underwent routine vision examination in the optometry clinic of Guangxi Medical University. Their data were used to identify the different types of accommodation and non-strabismic binocular vision dysfunction and to determine their frequency. Correlation analysis and logistic regression were used to examine the factors associated with these abnormalities. RESULTS: The results showed that 36.71% of the subjects had accommodation and non-strabismic binocular vision issues, with 8.86% being attributed to accommodation dysfunction and 27.85% to binocular abnormalities. Convergence insufficiency (CI) was the most common abnormality, accounting for 13.29%. Those with these abnormalities experienced higher levels of eyestrain (χ2=69.518, P<0.001). The linear correlations were observed between the difference of binocular spherical equivalent (SE) and the index of horizontal esotropia at a distance (r=0.231, P=0.004) and the asthenopia survey scale (ASS) score (r=0.346, P<0.001). Furthermore, the right eye's SE was inversely correlated with the convergence of positive and negative fusion images at close range (r= -0.321, P<0.001), the convergence of negative fusion images at close range (r=-0.294, P<0.001), the vergence facility (VF; r=-0.234, P=0.003), and the set of negative fusion images at far range (r=-0.237, P=0.003). Logistic regression analysis indicated that gender, age, and the difference in right and binocular SE did not influence the emergence of these abnormalities. CONCLUSION: Binocular vision abnormalities are more prevalent than accommodation dysfunction, with CI being the most frequent type. Greater binocular refractive disparity leads to more severe eyestrain symptoms.

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Section: Studymentioning

confidence: 99%

Frequency and associated factors of accommodation and non-strabismic binocular vision dysfunction among medical university students

Cai,

Zhong,

Wen

et al. 2024

Int J Ophthalmol

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“…The most common parameter currently measured to quantify convergence and diagnose CI is near point of convergence (NPC), which is the minimum distance from the bridge of the nose that both eyes can focus on a target without losing binocular fusion. Specific diagnostic criteria for CI are inconsistent within the existing literature, however normative NPC values tend to range from 6 to 10 cm [ 22 ]. NPC has also been shown to increase linearly with age, reaching a maximum average value of approximately 13 cm in individuals 70 and older [ 23 ].…”

Section: Ocular Motor- and Vision-based Approachesmentioning

confidence: 99%

Precision Concussion Management: Approaches to Quantifying Head Injury Severity and Recovery

de Souza,

Jarmol,

Bell

et al. 2023

Brain Sciences

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Mitigating the substantial public health impact of concussion is a particularly difficult challenge. This is partly because concussion is a highly prevalent condition, and diagnosis is predominantly symptom-based. Much of contemporary concussion management relies on symptom interpretation and accurate reporting by patients. These types of reports may be influenced by a variety of factors for each individual, such as preexisting mental health conditions, headache disorders, and sleep conditions, among other factors. This can all be contributory to non-specific and potentially misleading clinical manifestations in the aftermath of a concussion. This review aimed to conduct an examination of the existing literature on emerging approaches for objectively evaluating potential concussion, as well as to highlight current gaps in understanding where further research is necessary. Objective assessments of visual and ocular motor concussion symptoms, specialized imaging techniques, and tissue-based concentrations of specific biomarkers have all shown promise for specifically characterizing diffuse brain injuries, and will be important to the future of concussion diagnosis and management. The consolidation of these approaches into a comprehensive examination progression will be the next horizon for increased precision in concussion diagnosis and treatment.

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“…Symptoms of CI include difficulty seeing at close range, headaches, eye pain during reading or studying, blurred vision, diplopia, movement of words while reading, a feeling of pressure in the eyes, and difficulty concentrating. Signs of it include an increasing near point of convergence, more exophoria at near than distance, a decreased AC/A ratio, and a decreased positive fusional vergence [ 7 ] and the convergence insufficiency symptom survey (CISS) questionnaire is the initial standardized and valid tool used to evaluate the frequency and nature of symptoms in patients with CI [ 8 , 9 ]. Vision therapy is typically considered as the primary treatment option for CI, with base in prism prescription being an alternative choice [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Vision therapy is typically considered as the primary treatment option for CI, with base in prism prescription being an alternative choice [ 6 ]. However, given the age-related changes in the interaction and functioning of the accommodation and convergence systems, it is crucial to study how these systems interact in elderly individuals [ 7 ]. It is also important to compare the responses of these age groups to vision therapy and base in prism prescription [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Home vision therapy and prism prescription in presbyopic persons with convergence insufficiency: study protocol for a randomized controlled trial

Abdi,

Kangari,

Rahmani

et al. 2024

BMC Ophthalmol

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Background Convergence insufficiency is a common issue in the field of binocular vision. Various treatment options have been suggested for managing this condition, but their efficacy in individuals with presbyopia remains unclear. The objective of this study is to compare the effectiveness of home-based vision therapy and prism prescription, in presbyopic patients with convergence insufficiency. Methods/design It is a randomized, prospective, double-blind clinical trial, with total of 150 participants randomly assigned to the three groups. The Control Group will receive a new near glasses as a conventional prescription, along with aimless and random eye movement exercises that do not have any convergence or accommodation effects. The Home Vision Therapy Group will receive new near glasses with accommodative and convergence eye exercises. The Prism Group will receive a near prismatic glasses prescribed using the Sheard’s criterion. All treatments will be administered for a period of 2 months, and measurements of the modified convergence insufficiency symptoms survey (CISS), near point convergence, near phoria, and positive fusional vergence will be taken at baseline, one month later, and at the end of the treatment. Discussion We aim to identify which component - either the prism prescription or the home vision therapy - is more effective in improving binocular abilities and reducing patients’ symptom scores. Trial registration ClinicalTrials.gov NCT05311917 with last update on 04/22/2023.

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Convergence insufficiency: Review of clinical diagnostic signs

Cited by 7 publications

References 110 publications

Frequency and associated factors of accommodation and non-strabismic binocular vision dysfunction among medical university students

Frequency and associated factors of accommodation and non-strabismic binocular vision dysfunction among medical university students

Precision Concussion Management: Approaches to Quantifying Head Injury Severity and Recovery

Home vision therapy and prism prescription in presbyopic persons with convergence insufficiency: study protocol for a randomized controlled trial

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