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| convergence_insufficency [2025/02/15 17:39] – Scott Larson | convergence_insufficency [2025/06/14 04:44] (current) – [Convergence Insufficiency Symptom Survey] Scott Larson | ||
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| * Before reaching the break point, the patient may note a point where the image blurs, the patient can no longer use fusional convergence and resorts to accommodative convergence which may improve convergence but causes a blurred image due to over-convergence | * Before reaching the break point, the patient may note a point where the image blurs, the patient can no longer use fusional convergence and resorts to accommodative convergence which may improve convergence but causes a blurred image due to over-convergence | ||
| * Reduce the base out prism until the patient recovers single vision, this is the **recovery point**. | * Reduce the base out prism until the patient recovers single vision, this is the **recovery point**. | ||
| - | * if exotropia present ensure not worse XT in downgaze | + | * if exotropia present ensure not worse XT in downgaze. |
| - | * encouragement | + | * Encouragement |
| + | * Testing convergence after testing divergence amplitudes will reduce convergence. | ||
| - | == Convergence Amplitudes reported by Several Authors == | + | === Normal |
| + | ^ Prism Diopters | ||
| + | | **Near** | ||
| + | | Break Point | 20-25 | 38-51 | 35 | 45 | | ||
| + | | Recovery Point | 18-22 | ||
| + | | **Distance** | ||
| + | | Break Point | 15 | | 26 | 25 | | ||
| + | | Recovery Point | 12 | | ||
| - | ^ Prism Diopters | + | ====Convergence Amplitudes in Convergence Insufficiency==== |
| - | | | + | Most studies would include patients with **≤ 15 PD break point** |
| - | | Break Point | 20-25 | 38-51 | 35-40 | 35 | 45 | | + | |
| - | | Recovery Point | 18-22 | + | |
| - | | **Distance** | + | |
| - | | Break Point | 15 | | + | |
| - | | Recovery Point | 12 | | + | |
| ====Other Signs of CI==== | ====Other Signs of CI==== | ||
| * Low [[accommodative_convergence_to_accommodation_ratio|AC/ | * Low [[accommodative_convergence_to_accommodation_ratio|AC/ | ||
| - | * Reduced Positive fusional vergence <15PD | + | * Esophoria larger at near than at distance |
| * High CI symptom survey score of ≥16 | * High CI symptom survey score of ≥16 | ||
| ====Convergence Insufficiency Symptom Survey==== | ====Convergence Insufficiency Symptom Survey==== | ||
| - | Developed by the Convergence Insufficiency Treatment Trial Investigator Group | ||
| - | - Borsting EJ, Rouse MW, Mitchell GL, et al. Validity and reliability of the revised convergence insufficiency symptom survey in children aged 9 to 18 years. Optom Vis Sci. 2003; | ||
| + | - Do your eyes feel tired when reading or doing close work? | ||
| + | - Do your eyes feel uncomfortable when reading or doing close work? | ||
| + | - Do you have headaches when reading or doing close work? | ||
| + | - Do you feel sleepy when reading or doing close work? | ||
| + | - Do you lose concentration when reading or doing close work? | ||
| + | - Do you have trouble remembering what you have read? | ||
| + | - Do you have double vision when reading or doing close work? | ||
| + | - Do you see the words move, jump, swim or appear to float on the page when reading or doing close work? | ||
| + | - Do you feel like you read slowly? | ||
| + | - Do your eyes ever hurt when reading or doing close work? | ||
| + | - Do your eyes ever feel sore when reading or doing close work? | ||
| + | - Do you feel a “pulling” feeling around your eyes when reading or doing close work? | ||
| + | - Do you notice the words blurring or coming in and out of focus when reading or doing close work? | ||
| + | - Do you lose your place while reading or doing close work? | ||
| + | - Do you have to re-read the same line of words when reading? | ||
| + | |||
| + | ===Scoring=== | ||
| + | - Collect response to each question from one of the 5 possible responses: | ||
| + | - " | ||
| + | - " | ||
| + | - " | ||
| + | - " | ||
| + | - " | ||
| + | - Tally points from each question- the total will be from 0-60 points | ||
| + | |||
| + | ===Analysis of Score=== | ||
| + | If score is **≥ 16** CI is likely | ||
| + | * Convergence Insufficiency mean= 30.8 ± 8.4 | ||
| + | * Normal mean = 8.4 ± 6.4 | ||
| + | * Cut of value of **16** gives sensitivity of 95.7% and specificity of 87.5% | ||
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| + | <WRAP round info 50%> | ||
| + | [[https:// | ||
| + | </ | ||
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| + | ====Resources===== | ||
| + | * [[http:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | |||
| + | {{tag> | ||