Frequency of Convergence Insufficiency in Optometry Clinic Settings

Rouse, Michael W.; Hyman, Leslie; Hussein, Mohamed Toufic El; Solan, Harold A.

doi:10.1097/00006324-199802000-00012

Cited by 92 publications

(85 citation statements)

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“…Orthoptic evaluation of vergence (made by using the cover test,bar of prisms,Maddox rod and synoptophore technique) revealed, for all subjects, one or more signs of vergence abnormalities (see Table 1 A,children examined and Table 1 B,normal children); e. g. distant near point of convergence (≥ 10 cm), exophoria (i. e. latent deviation of one eye when the other eye is covered) at far viewing that was larger than 3 ∆, and exophoria at near viewing larger than 6 ∆; the range of fusional vergence at far and at close viewing was also limited. According to Rouse et al [23,24] and Rainey [22] subjects S1, S3-S7, S10 and S12 were classified as having convergence abnormalities while subjects S2, S8, S9 and S11 had divergence abnormalities.…”

Section: Orthoptic Testsmentioning

confidence: 99%

Abnormality of vergence latency in children with vertigo

Bucci

Kapoula

Yang

et al. 2004

Journal of Neurology

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It is well known that vergence movements are important for distance appreciation, depth vision and stereopsis. Moreover, vergence movements are very probably used by the CNS during head and body motion to adjust the gain of the vestibulo-ocular reflex (VOR) according to the viewing distance. A recent clinical study of Anoh-Tanon et al. suggested that vertigo in children with normal vestibular function could be associated with abnormal vergence clinically assessed. The purpose of this study was to test this hypothesis with objective vergence eye movement recordings. We examined the latency of vergence, saccades and combined movements in twelve children with the complaint of vertigo but without vestibular abnormality. Convergence and saccades combined with convergence or with divergence had abnormally long latencies (relative to normal children of matched age). In contrast, divergence and isolated saccades showed only mild latency increase relative to normals. Lengthening of latency could be due to impaired cortical control. Orthoptic vergence training reduced all latencies; however, even the reduced latency of vergence and of combined movements was still abnormal. The improvement after orthoptic vergence training could be due to increased visual attention, although such mechanism cannot eliminate completely the initiation deficit of vergence movements. Objective eye movement recordings are thus useful for a diagnosis and treatment of children with vertigo.

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Section: Orthoptic Testsmentioning

confidence: 99%

Abnormality of vergence latency in children with vertigo

Bucci

Kapoula

Yang

et al. 2004

Journal of Neurology

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“…In this sense, the CITT group developed a classification scheme for CI based on the following signs: exophoria at near vision greater than distance, ≥4 prismatic diopters (Δ), receded NPC, and reduced PFV range [28]. This classification system, as the authors declare in their study, is based on the signs most often associated with CI and many investigators have used it for prevalence, diagnosis and treatment purposes [1, 6–8, 11–14, 18, 22, 28, 29, 40, 41, 44].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Validity of Clinical Signs Associated with a Large Exophoria at Near

Cacho-Martínez

García-Muñoz

Ruiz-Cantero

2013

Journal of Ophthalmology

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Purpose. To analyze the diagnostic validity of accommodative and binocular tests in a sample of patients with a large near exophoria with moderate to severe symptoms. Methods. Two groups of patients between 19 and 35 years were recruited from a university clinic: 33 subjects with large exophoria at near vision and moderate or high visual discomfort and 33 patients with normal heterophoria and low visual discomfort. Visual discomfort was defined using the Conlon survey. A refractive exam and an exhaustive evaluation of accommodation and vergence were assessed. Diagnostic validity by means of receiver operator characteristic (ROC) curves, sensitivity (S), specificity (Sp), and positive and negative likelihood ratios (LR+, LR−) were assessed. This analysis was also carried out considering multiple tests as serial testing strategy. Results. ROC analysis showed the best diagnostic accuracy for receded near point of convergence (NPC) recovery (area = 0.929) and binocular accommodative facility (BAF) (area = 0.886). Using the cut-offs obtained with ROC analysis, the best diagnostic validity was obtained for the combination of NPC recovery and BAF (S = 0.77, Sp = 1, LR+ = value tending to infinity, LR− = 0.23) and the combination of NPC break and recovery with BAF (S = 0.73, Sp = 1, LR+ = tending to infinity, LR− = 0.27). Conclusions. NPC and BAF tests were the tests with the best diagnostic accuracy for subjects with large near exophoria and moderate to severe symptoms.

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“…4–6 In studies that used standardized definitions of CI, investigators have reported a prevalence of 4.2% to 6% in school and pediatric clinic settings. 5,10,11 There are, however, no known prevalence reports of convergence insufficiency among adult populations with which to compare the findings of the current study.…”

Section: Discussionmentioning

confidence: 82%

The Incidence and Clinical Characteristics of Adult-Onset Convergence Insufficiency

et al. 2015

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Objective The purpose of this study was to describe the clinical characteristics and natural history of convergence insufficiency (CI) in a population-based cohort of adults. Design Retrospectively reviewed population-based cohort. Participants Adult (≥19 years of age) residents of Olmsted County, Minnesota. Methods The medical records of all adults diagnosed with CI over a 20-year period were retrospectively reviewed. Main outcome measures Clinical characteristics and outcomes for adult-onset convergence insufficiency. Results A total of 118 adults (annual incidence of 8.44 per 100 000 patients older than 19 years) were diagnosed with CI during the 20-year period, comprising 15.7% of all forms of adult-onset strabismus observed in this population. The median age at diagnosis was 68.5 years (range 21.7 to 97.1 years) and 68 (57.6%) were female. The mean initial exodeviation at near was 14.1 PD (range 1 to 30 PD) and 1.7 PD (range 0 to 10 PD) at distance. The Kaplan-Meier rate of exotropia increasing by 7 prism diopters or more at near over time was 4.2% at 5 years, 13.5% at 10 years, and 24.4% at 20 years. Approximately 88% were managed with prisms while less than 5% underwent surgical correction. Conclusions Adult-onset convergence insufficiency comprised approximately 1 in 6 adults who were newly diagnosed with strabismus in this 20-year cohort. There was a significant increase in incidence with increasing age. Nearly one-fourth had an increase of their near exodeviation of at least 7 PD by 20 years after their diagnosis and most patients were managed conservatively.

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Frequency of Convergence Insufficiency in Optometry Clinic Settings

Cited by 92 publications

References 0 publications

Abnormality of vergence latency in children with vertigo

Abnormality of vergence latency in children with vertigo

Diagnostic Validity of Clinical Signs Associated with a Large Exophoria at Near

The Incidence and Clinical Characteristics of Adult-Onset Convergence Insufficiency

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