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Convergence Insufficiency Symptom Score Calculator
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<html>
<head>
<title>Convergence Insufficiency Symptom Survey Calculator</title>
<link rel="stylesheet" href="style.css">
<meta name="viewport" content="width=device-width, initial-scale=1.0">
<link href="https://fonts.googleapis.com/css?family=Noto+Sans|Roboto+Mono&display=swap" rel="stylesheet">
</head>
<body>
<!--Questions 1 to 15-->
<div class="Survey">
<h3>Questions</h3>
<div class="question1">
<label for="q1">1. Do your eyes feel tired when reading or doing close work?</label>
<select id="q1" name="q1">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question2">
<label for="q2">2. Do your eyes feel uncomfortable when reading or doing close work?</label>
<select id="q2" name="q2">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question3">
<label for="q3">3. Do you have headaches when reading or doing close work?</label>
<select id="q3" name="q3">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question4">
<label for="q4">4. Do you feel sleepy when reading or doing close work?</label>
<select id="q4" name="q4">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question5">
<label for="q5">5. Do you lose concentration when reading or doing close work?</label>
<select id="q5" name="q5">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question6">
<label for="q6">6. Do you have trouble remembering what you have read?</label>
<select id="q6" name="q6">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question7">
<label for="q7">7. Do you have double vision when reading or doing close work?</label>
<select id="q7" name="q7">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question8">
<label for="q8">8. Do you see the words move, jump, swim or appear to float on the page when reading or doing close work?</label>
<select id="q8" name="q8">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question9">
<label for="q9">9. Do you feel like you read slowly?</label>
<select id="q9" name="q9">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question10">
<label for="q10">10. Do your eyes ever hurt when reading or doing close work?</label>
<select id="q10" name="q10">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question11">
<label for="q11">11. Do your eyes ever feel sore when reading or doing close work?</label>
<select id="q11" name="q11">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question12">
<label for="q12">12. Do you feel a 'pulling' feeling around your eyes when reading or doing close work?</label>
<select id="q12" name="q12">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question13">
<label for="q13">13. Do you notice the words blurring or coming in and out of focus when reading or doing close work?</label>
<select id="q13" name="q13">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question14">
<label for="q14">14. Do you lose your place while reading or doing close work?</label>
<select id="q14" name="q14">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
<div class="question15">
<label for="q15">15. Do you have to re-read the same line of words when reading?</label>
<select id="q15" name="q15">
<option value="" disabled selected>Choose a response</option>
<option value="0">Never</option>
<option value="1">Infrequently</option>
<option value="2">Sometimes</option>
<option value="3">Farily Often</option>
<option value="4">Always</option>
</select>
</div>
</div>
<!-- Calculate button -->
<br><br>
<button onclick="calculateSum()">Calculate Score</button>
<br><br>
<!-- Display result -->
<p id="result"></p>
<script>
function calculateSum() {
let sum = 0;
// Loop through all 15 questions
for (let i = 1; i <= 15; i++) {
const selectElement = document.getElementById(`q${i}`);
const value = parseInt(selectElement.value, 10); // Convert value to integer
if (!isNaN(value)) { // Ensure the default option is not included
sum += value;
}
}
// Display the total sum with an extra line
let resultText = `Total Score: ${sum}<br><br>`;
// Add a message if the score is greater than 15
if (sum > 15) {
resultText += "A score greater than 15 suggests Convergence Insufficiency";
}
document.getElementById("result").innerHTML = resultText;
}
</script>
</body>
</html>
Adapted from: Borsting et al. Validity and Reliability of the Revised Convergence Insufficiency Symptom Survey in Children Aged 9-18 Years. Optometry and Vision Science 2003;80(12):832-838