Frequencies and patterns of symptoms in Chinese adults with accommodative and binocular dysfunctions

PURPOSE

Recent studies have found that children with convergence insufficiency experience higher frequencies of performance-related symptoms (e.g., losing concentration), but data on performance-related symptoms among adults with accommodative dysfunctions (ADs) and/or binocular dysfunctions (BDs) are lacking, which might cause misdiagnosis, diagnostic confusion, or exacerbation of attention deficits. We aimed to describe frequencies and symptom patterns in adults with ADs and/or BDs who were treated at optometric clinics and explore any correlations between visual symptoms and clinical findings.

METHODS

This cross-sectional study divided 235 participants (age: 23.7 ± 2.9 years) into three groups: ADs, BDs, and normal binocular vision (NBV) groups. Convergence Insufficiency Symptom Survey (CISS), refractive examinations, and binocular tests were administered to all participants. After 1-to-1 propensity score matching, outcomes were assessed using Mann‒Whitney U test and Pearson's correlation analysis among three groups.

RESULTS

In this sample, the number (frequency) of individuals with ADs and/or BDs was 117 (49.8%). ADs and BDs groups experienced significantly more performance-related symptoms (feeling sleepy, losing concentration, trouble remembering, reading slowly, losing place, and having to re-read; all P < 0.05) than the NBV group. Significant correlations were observed between performance-related symptoms and clinical findings, including accommodative amplitude (r =  - 0.294), accommodative facility (r =  - 0.452), near phoria (r =  - 0.261), near point of convergence (r = 0.482), and positive fusional vergence (r =  - 0.331) (all P < 0.001).

CONCLUSION

ADs and/or BDs are commonly present in adults treated at optometric clinics, and adults diagnosed with ADs and/or BDs exhibit more performance-related symptoms than participants with NBV.

Impact of strabismus and binocular dysfunctions in the developmental eye movement test and test of visual perception skills: A multicentric and retrospective study

PURPOSE

To compare the performance in the Developmental Eye Movement test (DEM) and the Test of Visual Perceptual Skills (TVPS) between three groups: individuals with strabismus and amblyopia, patients with binocular and accommodative dysfunctions, and subjects with normal binocular and accommodative function.

METHODS

A multicentric, retrospective study including 110 children aged 6-14 years old was conducted to investigate the potential impact of strabismus, amblyopia, and different binocular conditions in DEM results (adjusted time in vertical and horizontal parts) and TVPS (percentiles in the seven sub-skills).

RESULTS

No significant differences were found in the different subtests of the vertical and horizontal DEM and all the sub-skills in the TVPS between the three groups of the study. We found high variability of performance in the DEM test between participants with strabismus and amblyopia compared with binocular and accommodative problems.

CONCLUSION

DEM and TVPS scores have not been found to be influenced by the presence of strabismus with or without amblyopia, nor by binocular and accommodative dysfunctions. A slightly correlation tendency with horizontal DEM and degree of exotropia deviation was observed.

Effect of corneal refractive surgery on accommodative and binocular dysfunctions among civilian pilots in Southwest China

Background

To analyze whether corneal refractive surgery (CRS) is associated with the distribution of different accommodative dysfunctions (ADs) and binocular dysfunctions (BDs) in civilian pilots. A further aim was to analyze the percentages and visual symptoms associated with ADs and/or BDs in this population.

Methods

One hundred and eight civilian pilots who underwent CRS from January 2001 to July 2012 (age: 30.33 ± 4.60 years) were enrolled, the mean preoperative SE was − 1.51 ± 1.15 D (range: − 1.00- − 5.00 D). Ninety-nine emmetropic civilian pilots (age: 29.64 ± 3.77 years) who were age- and sex-matched to the CRS group were also enrolled. Refractive status, accommodative and binocular tests of each subject were performed. Visually related symptoms were quantified using the 19-item College of Optometrists in Vision Development Quality of Life (COVD-QOL) questionnaire. The 19 items were summed to obtain visual symptom scores that might indicate visual dysfunctions. The chi-square test was used to analyze differences in percentages of ADs and/or BDs between the CRS and emmetropic groups. The Mann-Whitney U test was used to compare visual symptom scores between pilots with ADs and/or BDs and pilots with normal binocular vision.

Results

No significant difference was observed between the CRS and emmetropic groups in the overall prevalence of ADs and BDs (15.7% and 15.2% in the CRS and emmetropic groups, respectively; P = 0.185). ADs were present in 4.63% and 3.03% of the CRS and emmetropic group, respectively. BDs were observed in 11.1% and 12.1% of the CRS and emmetropic group, respectively, yielding no significant differences between the groups in the prevalence of ADs or BDs (AD: P = 0.094; BD: P = 0.105). Pilots with ADs and/or BDs had significantly more visual symptoms than pilots with normal binocular vision (p < 0.001).

Conclusions

CRS for civilian pilots with low-moderate myopia might not impact binocular functions. ADs and/or BDs commonly occur in both emmetropia pilots and pilots who undergo CRS, and pilots with ADs and/or BDs are associated with increased symptoms. This study confirms the importance of a full assessment of binocular visual functions in detecting and remedying these dysfunctions in this specific population.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12886-021-01855-0.