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Pena-Verdeal H, Noya-Padin V, Garcia-Queiruga J, Nores-Palmas N, Giraldez MJ, Yebra-Pimentel E. Temporal Variations in Convergence Insufficiency Symptomatic Status among University Students before and after COVID-19: A Longitudinal Analysis from 2018 to 2023. Life (Basel) 2024; 14:800. [PMID: 39063555 PMCID: PMC11278426 DOI: 10.3390/life14070800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
The present study aimed to assess the symptomatic status of Convergence Insufficiency (CI) in university students from 2018 to 2023 considering the educational environment pre- and post-COVID-19 pandemic confinements. A Convergence Insufficiency Symptom Survey (CISS) was conducted annually from 2018 to 2023, excluding 2020, in an initial group of 217 third-year Optics and Optometry degree university student participants. In the final group (178 participants), the statistical differences in CISS scores between years were analysed, both overall and by questionnaire subgroup, along with associations between CISS diagnostic categories before and after 2020. Significant differences were found between years in the subscale and total score analyses (Kruskal-Wallis, both p ≤ 0.049). Pairwise comparisons showed significant differences for the performance subgroup in 2021 vs. 2019 and 2018 (Mann-Whitney, both p ≤ 0.004), while in terms of the total score, there was a statistical difference in 2021 vs. 2018 (Mann-Whitney, p < 0.001). The distribution analysis indicated a significant difference between groups (Chi, p = 0.004), with participants from 2021 or later more likely to exhibit higher CISS scores (OR = 3.47, 95%CI 1.04-8.58). The present study shows significant temporal increments in symptomatic status related to CI among university students from 2018 to 2023, indicating a potential impact of the COVID-19 pandemic educational landscape on these outcomes.
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Affiliation(s)
- Hugo Pena-Verdeal
- Applied Physics Department (Optometry Area), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain; (H.P.-V.)
- Optometry Group, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Veronica Noya-Padin
- Applied Physics Department (Optometry Area), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain; (H.P.-V.)
- Optometry Group, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Jacobo Garcia-Queiruga
- Applied Physics Department (Optometry Area), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain; (H.P.-V.)
- Optometry Group, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Noelia Nores-Palmas
- Applied Physics Department (Optometry Area), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain; (H.P.-V.)
| | - Maria J. Giraldez
- Applied Physics Department (Optometry Area), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain; (H.P.-V.)
- Optometry Group, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Eva Yebra-Pimentel
- Applied Physics Department (Optometry Area), Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, 15705 Santiago de Compostela, Spain; (H.P.-V.)
- Optometry Group, Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
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McBride A, Arblaster G. Schizophrenia and Orthoptic Conditions: A Literature Review. Br Ir Orthopt J 2024; 20:133-145. [PMID: 38681187 PMCID: PMC11049682 DOI: 10.22599/bioj.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 03/25/2024] [Indexed: 05/01/2024] Open
Abstract
Purpose A narrative review of the literature reporting ocular abnormalities in patients with schizophrenia was undertaken to determine the types and prevalence of orthoptic conditions in this patient cohort. Methods A systematic search of multiple databases yielded 1,974 studies published between January 1992 and January 2022. All were screened for relevance based on their title and abstract. Results Seventeen studies were included in the final review. Ocular abnormalities reported in schizophrenia included a high incidence of strabismus, reduced visual acuity and reduced stereopsis compared to controls. Additionally, eye movement abnormalities (including reduced smooth pursuit gain and increased prosaccade latency) were frequently reported. Reduced visual acuity was associated with negative symptoms and reduced quality of life in schizophrenia. Conclusions Orthoptists and eye care professionals should be aware that a higher incidence of strabismus, reduced visual acuity, reduced stereoacuity, and eye movement abnormalities are reported in patients with schizophrenia. Further research is required to determine whether, or to what extent, ocular abnormalities and visual disturbances influence or exacerbate the symptoms of schizophrenia, and whether there is an effect of schizophrenia medication on these orthoptic conditions.
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Affiliation(s)
- Anna McBride
- University of Sheffield (BMedSci Orthoptics), UK
- University Hospitals Dorset, UK
| | - Gemma Arblaster
- School of Allied Health Professions, Nursing and Midwifery, Faculty of Health, University of Sheffield, UK
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Chrobak AA, Rybakowski JK, Abramowicz M, Perdziak M, Gryncewicz W, Dziuda S, Fafrowicz M, Czarnecki P, Soltys Z, Ceglarek A, Ober JK, Marek T, Dudek D, Siwek M. Vergence eye movements impairments in schizophrenia and bipolar disorder. J Psychiatr Res 2022; 156:379-389. [PMID: 36323140 DOI: 10.1016/j.jpsychires.2022.10.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/07/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022]
Abstract
One of the most evaluated eye tracking tasks in schizophrenia (SZ) and bipolar disorder (BD) are smooth pursuit eye movements. They rely on the maintenance of slowly moving object on the fovea. While most of the studies evaluated tracking of a target that moves in the fronto-parallel plane, only two assessed vergence eye movements (VEM), which relies on the pursuit of object that moves in depth. The aim of our study was to compare VEM performance in SZ and BD. We evaluated 28 SZ patients, 32 BD patients and 25 healthy controls (HC). Participants underwent thorough optometric examination before eye tracking task. VEM were measured with the use of infrared eye tracker and dedicated vergence stimuli generator. SZ patients showed higher mean break and recovery points of fusion and shorter correct tracking time than HC. BD individuals revealed tracking accuracy deficits and higher number of saccades than HC. Compared to BD, SZ patients showed decrease of maximal convergence and divergence. Moreover, they presented tracking accuracy deficits of non-dominant eye: altered eyes positioning error during convergence and divergence gain. Exploratory analysis revealed significant gender differences between groups in terms of binocular VEM parameters. In this study we have recognized pattern of eye movement disturbances differentiating abovementioned groups. SZ patients showed decreased vergence tracking range with shorter tracking time and impaired accuracy of non-dominant eye, while BD patients showed higher number of saccades with decreased tracking accuracy. Neuroimaging studies are necessary to identify neuronal underpinnings of VEM impairments in SZ and BD.
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Affiliation(s)
- Adrian Andrzej Chrobak
- Jagiellonian University Medical College, Department of Adult Psychiatry, Kopernika St. 21a, 31-501, Cracow, Poland
| | - Janusz Kazimierz Rybakowski
- Poznan University of Medical Sciences, Department of Adult Psychiatry, Szpitalna St. 27/33, 61-572, Poznań, Poland
| | - Maria Abramowicz
- Poznan University of Medical Sciences, Department of Adult Psychiatry, Szpitalna St. 27/33, 61-572, Poznań, Poland
| | - Maciej Perdziak
- Poznan University of Medical Sciences, Department of Optometry, Chair of Ophthalmology and Optometry, Rokietnicka St. 5D, 60-806, Poznań, Poland
| | - Wojciech Gryncewicz
- Polish Academy of Sciences, Nałęcz Institute of Biocybernetics and Biomedical Engineering, Księcia Trojdena St. 4, 02-109, Warsaw, Poland
| | - Sebastian Dziuda
- Poznan University of Medical Sciences, Department of Adult Psychiatry, Szpitalna St. 27/33, 61-572, Poznań, Poland
| | - Magdalena Fafrowicz
- Jagiellonian University, Institute of Applied Psychology, Department of Cognitive Neuroscience and Neuroergonomics, Łojasiewicza St. 4, 30-348, Cracow, Poland
| | - Paweł Czarnecki
- Polish Academy of Sciences, Nałęcz Institute of Biocybernetics and Biomedical Engineering, Księcia Trojdena St. 4, 02-109, Warsaw, Poland
| | - Zbigniew Soltys
- Jagiellonian University, Institute of Zoology and Biomedical Research, Laboratory of Experimental Neuropathology, Gronostajowa 9, 30-387, Cracow, Poland
| | - Anna Ceglarek
- Jagiellonian University, Institute of Applied Psychology, Department of Cognitive Neuroscience and Neuroergonomics, Łojasiewicza St. 4, 30-348, Cracow, Poland
| | - Jan Krzysztof Ober
- Poznan University of Medical Sciences, Department of Optometry, Chair of Ophthalmology and Optometry, Rokietnicka St. 5D, 60-806, Poznań, Poland
| | - Tadeusz Marek
- Jagiellonian University, Institute of Applied Psychology, Department of Cognitive Neuroscience and Neuroergonomics, Łojasiewicza St. 4, 30-348, Cracow, Poland
| | - Dominika Dudek
- Jagiellonian University Medical College, Department of Adult Psychiatry, Kopernika St. 21a, 31-501, Cracow, Poland
| | - Marcin Siwek
- Jagiellonian University Medical College, Department of Affective Disorders, Kopernika St. 21a, 31-501, Cracow, Poland.
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Kim SY, Moon BY, Cho HG, Yu DS. Comparison of image-based quantification methods in evaluating fixation stability using a remote eye tracker in abnormal phoria. J Int Med Res 2022; 50:3000605221098183. [PMID: 35546441 PMCID: PMC9112722 DOI: 10.1177/03000605221098183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 04/13/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study was performed to establish a quantitative evaluation and comparison of fixation stability, as measured by an eye tracker, using image-based areas determined by the bivariate contour ellipse area (BCEA), kernel density estimation (KDE), and Scanpath methods. METHODS This prospective cross-sectional study included 45 and 20 participants with abnormal and normal phoria, respectively. Eye movements were recorded using a remote eye tracker and were plotted using RStudio software. Image-based areas were evaluated using ImageJ software. RESULTS The image-based areas used to evaluate fixation stability exhibited decreasing stability in the abnormal phoria group in the following order: KDE with ±1 standard deviation (SD), BCEA with ±1 SD, KDE with ±2 SD or Scanpath, and BCEA with ±2 SD. The BCEA tended to be overestimated, and the KDE tended to be underestimated at high density. The Scanpath method had a very high probability area because the area spans all gaze points. CONCLUSIONS Fixation stability could be quantified as image-based areas by the KDE, BCEA, and Scanpath methods. Our findings suggest that fixation stability may be evaluated using one or more methods.
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Affiliation(s)
- Sang-Yeob Kim
- Department of Optometry, Kangwon National University, Samcheok, South Korea
| | - Byeong-Yeon Moon
- Department of Optometry, Kangwon National University, Samcheok, South Korea
| | - Hyun Gug Cho
- Department of Optometry, Kangwon National University, Samcheok, South Korea
| | - Dong-Sik Yu
- Department of Optometry, Kangwon National University, Samcheok, South Korea
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Differential diagnosis of vergence and saccade disorders in dyslexia. Sci Rep 2020; 10:22116. [PMID: 33335200 PMCID: PMC7747706 DOI: 10.1038/s41598-020-79089-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 11/26/2020] [Indexed: 12/03/2022] Open
Abstract
Previous studies suggest vergence and saccade abnormalities in dyslexic adolescents. However, these studies are mainly clinically based and do not provide objective measurements of eye movements, but rather subjectively evaluate vergence using haplosopic conditions in which the two eyes are dissociated (via polarizers, prisms, or intermittent spectacles). Other studies have identified deficits with binocular coordination during reading in dyslexics. Yet, there are few studies that provide objective measurements of eye movements in the dyslexic population to help provide more information regarding if these deficits could be due to an intrinsic motor problem or if they are the consequence of poor reading. 47 dyslexic adolescents (18 female, 29 male; mean age 15.5) and 44 non-dyslexic adolescents (22 female, 22 male; mean age 14.8) wore a head-based eye tracker (PupilCore, Pupil Labs, Berlin) which recorded wide angle saccade and vergence eye movements at 200 Hz. Tests were run using the REMOBI device, which produced a saccade or vergence audiovisual target. Analysis of eye movements was performed with lab-developed software, AIDEAL. The results showed statistically significant abnormalities in vergence and saccades. In vergence, dyslexics displayed a reduced amplitude of the visually driven portion of convergence and a longer duration in the initial phase of divergence. In saccades, dyslexic adolescents demonstrated slower saccades in both directions. They also had an increased disconjugate drift in the first 80 or 160 ms following saccades to the right, suggesting poor binocular coordination. For both vergence and saccades, the peak velocity and time to peak velocity was higher and earlier, respectively, in non-dyslexics compared to dyslexics; yet the average velocity of both movements was lower in dyslexics. Thus, these results indicate peculiar velocity profiles in dyslexics, particularly a slow deceleration phase in both vergence and saccades. The study provides an objective method to diagnose vergence and saccade abnormalities while viewing targets in the real three-dimensional space in a dyslexic population. Vergence abnormalities are demonstrated to be a problem in dyslexics, occurring independently from reading. We hypothesize these disconjugate drifts following saccades are the result of slow vergence capacity. Rehabilitation programs, such as those using REMOBI, should aim to target these deficits in vergence velocity, as this has been shown to improve binocular control.
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Trbovich AM, Sherry NK, Henley J, Emami K, Kontos AP. The utility of the Convergence Insufficiency Symptom Survey (CISS) post-concussion. Brain Inj 2019; 33:1545-1551. [DOI: 10.1080/02699052.2019.1658131] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Alicia M. Trbovich
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Natalie K. Sherry
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jill Henley
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Kouros Emami
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Anthony P. Kontos
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Iraji A, Fu Z, Damaraju E, DeRamus TP, Lewis N, Bustillo JR, Lenroot RK, Belger A, Ford JM, McEwen S, Mathalon DH, Mueller BA, Pearlson GD, Potkin SG, Preda A, Turner JA, Vaidya JG, van Erp TGM, Calhoun VD. Spatial dynamics within and between brain functional domains: A hierarchical approach to study time-varying brain function. Hum Brain Mapp 2018; 40:1969-1986. [PMID: 30588687 DOI: 10.1002/hbm.24505] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/12/2018] [Accepted: 12/19/2018] [Indexed: 12/16/2022] Open
Abstract
The analysis of time-varying activity and connectivity patterns (i.e., the chronnectome) using resting-state magnetic resonance imaging has become an important part of ongoing neuroscience discussions. The majority of previous work has focused on variations of temporal coupling among fixed spatial nodes or transition of the dominant activity/connectivity pattern over time. Here, we introduce an approach to capture spatial dynamics within functional domains (FDs), as well as temporal dynamics within and between FDs. The approach models the brain as a hierarchical functional architecture with different levels of granularity, where lower levels have higher functional homogeneity and less dynamic behavior and higher levels have less homogeneity and more dynamic behavior. First, a high-order spatial independent component analysis is used to approximate functional units. A functional unit is a pattern of regions with very similar functional activity over time. Next, functional units are used to construct FDs. Finally, functional modules (FMs) are calculated from FDs, providing an overall view of brain dynamics. Results highlight the spatial fluidity within FDs, including a broad spectrum of changes in regional associations, from strong coupling to complete decoupling. Moreover, FMs capture the dynamic interplay between FDs. Patients with schizophrenia show transient reductions in functional activity and state connectivity across several FDs, particularly the subcortical domain. Activity and connectivity differences convey unique information in many cases (e.g., the default mode) highlighting their complementarity information. The proposed hierarchical model to capture FD spatiotemporal variations provides new insight into the macroscale chronnectome and identifies changes hidden from existing approaches.
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Affiliation(s)
- Armin Iraji
- The Mind Research Network, Albuquerque, New Mexico
| | - Zening Fu
- The Mind Research Network, Albuquerque, New Mexico
| | | | | | - Noah Lewis
- The Mind Research Network, Albuquerque, New Mexico
| | - Juan R Bustillo
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, New Mexico
| | - Rhoshel K Lenroot
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, New Mexico
| | - Aysneil Belger
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
| | - Judith M Ford
- Department of Psychiatry, University of California San Francisco, San Francisco, California.,Psychiatry Service, San Francisco VA Medical Center, San Francisco, California
| | - Sarah McEwen
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Daniel H Mathalon
- Department of Psychiatry, University of California San Francisco, San Francisco, California.,Psychiatry Service, San Francisco VA Medical Center, San Francisco, California
| | - Bryon A Mueller
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neurobiology, Yale University, School of Medicine, New Haven, Connecticut
| | - Steven G Potkin
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, California
| | - Adrian Preda
- Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, California
| | - Jessica A Turner
- Department of Psychology, Georgia State University, Atlanta, Georgia
| | - Jatin G Vaidya
- Department of Psychiatry, University of Iowa, Iowa, Iowa
| | - Theo G M van Erp
- Clinical Translational Neuroscience Laboratory, Department of Psychiatry and Human Behavior, University of California Irvine, Irvine, California
| | - Vince D Calhoun
- The Mind Research Network, Albuquerque, New Mexico.,Departments of Psychiatry and Neurobiology, Yale University, School of Medicine, New Haven, Connecticut.,Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, New Mexico
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Bolding MS, Lahti AC, White D, Moore C, Gurler D, Gawne TJ, Gamlin PD. Vergence eye movements in patients with schizophrenia. Vision Res 2014; 102:64-70. [PMID: 25088242 PMCID: PMC4180079 DOI: 10.1016/j.visres.2014.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 07/22/2014] [Accepted: 07/23/2014] [Indexed: 11/16/2022]
Abstract
Previous studies have shown that smooth pursuit eye movements are impaired in patients with schizophrenia. However, under normal viewing conditions, targets move not only in the frontoparallel plane but also in depth, and tracking them requires both smooth pursuit and vergence eye movements. Although previous studies in humans and non-human primates suggest that these two eye movement subsystems are relatively independent of one another, to our knowledge, there have been no prior studies of vergence tracking behavior in patients with schizophrenia. Therefore, we have investigated these eye movements in patients with schizophrenia and in healthy controls. We found that patients with schizophrenia exhibited substantially lower gains compared to healthy controls during vergence tracking at all tested speeds (e.g. 0.25 Hz vergence tracking mean gain of 0.59 vs. 0.86). Further, consistent with previous reports, patients with schizophrenia exhibited significantly lower gains than healthy controls during smooth pursuit at higher target speeds (e.g. 0.5 Hz smooth pursuit mean gain of 0.64 vs. 0.73). In addition, there was a modest (r≈0.5), but significant, correlation between smooth pursuit and vergence tracking performance in patients with schizophrenia. Our observations clearly demonstrate substantial vergence tracking deficits in patients with schizophrenia. In these patients, deficits for smooth pursuit and vergence tracking are partially correlated suggesting overlap in the central control of smooth pursuit and vergence eye movements.
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Affiliation(s)
- Mark S Bolding
- Department of Radiology, University of Alabama at Birmingham, 619 19th Street South, GSB 315, Birmingham, AL 35294-0017, USA; Department of Vision Sciences, University of Alabama at Birmingham, 1530 3rd Avenue South, WORB 186, Birmingham, AL 35294-0017, USA
| | - Adrienne C Lahti
- Department of Psychiatry, University of Alabama at Birmingham, 1530 3rd Avenue South, SC 501, Birmingham, AL 35294-0017, USA
| | - David White
- Department of Psychiatry, University of Alabama at Birmingham, 1530 3rd Avenue South, SC 501, Birmingham, AL 35294-0017, USA
| | - Claire Moore
- Department of Radiology, University of Alabama at Birmingham, 619 19th Street South, GSB 315, Birmingham, AL 35294-0017, USA
| | - Demet Gurler
- Department of Radiology, University of Alabama at Birmingham, 619 19th Street South, GSB 315, Birmingham, AL 35294-0017, USA
| | - Timothy J Gawne
- Department of Vision Sciences, University of Alabama at Birmingham, 1530 3rd Avenue South, WORB 186, Birmingham, AL 35294-0017, USA
| | - Paul D Gamlin
- Department of Ophthalmology, 1103 Shelby Building, 1825 University Blvd., University of Alabama at Birmingham, Birmingham, AL 35294, USA.
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Horwood AM, Toor S, Riddell PM. Screening for convergence insufficiency using the CISS is not indicated in young adults. Br J Ophthalmol 2014; 98:679-83. [PMID: 24532798 PMCID: PMC3995238 DOI: 10.1136/bjophthalmol-2013-304533] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM This paper presents Convergence Insufficiency Symptom Survey (CISS) and orthoptic findings in a sample of typical young adults who considered themselves to have normal eyesight apart from weak spectacles. METHODS The CISS questionnaire was administered, followed by a full orthoptic evaluation, to 167 university undergraduate and postgraduate students during the recruitment phase of another study. The primary criterion for recruitment to this study was that participants 'felt they had normal eyesight'. A CISS score of ≥21 was used to define 'significant' symptoms, and convergence insufficiency (CI) was defined as convergence ≥8 cm from the nose with a fusion range <15Δ base-out with small or no exophoria. RESULTS The group mean CISS score was 15.4. In all, 17 (10%) of the participants were diagnosed with CI, but 11 (65%) of these did not have significant symptoms. 41 (25%) participants returned a 'high' CISS score of ≥21 but only 6 (15%) of these had genuine CI. Sensitivity of the CISS to detect CI in this asymptomatic sample was 38%; specificity 77%; positive predictive value 15%; and negative predictive value 92%. The area under a receiver operating characteristic curve was 0.596 (95% CI 0.46 to 0.73). CONCLUSIONS 'Visual symptoms' are common in young adults, but often not related to any clinical defect, while true CI may be asymptomatic. This study suggests that screening for CI is not indicated.
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Affiliation(s)
- Anna M Horwood
- Infant Vision Laboratory, School of Psychology & Clinical Language Sciences, University of Reading, , Reading, UK
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