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Accommodative insufficiency is the primary source of symptoms in children diagnosed with convergence insufficiency

Lynn F Marran1, Paul N De Land, Andrew L Nguyen

  • 1Southern California College of Optometry, Fullerton, California 92835, USA. lmarran@scco.edu

Optometry and Vision Science : Official Publication of the American Academy of Optometry
|May 16, 2006
PubMed

Insights

Accommodative insufficiency (AI) significantly contributes to symptoms in children, even when convergence insufficiency (CI) is present. Children with CI alone do not report more symptoms than those with normal vision.

Area of Science:

  • Ophthalmology
  • Pediatric Optometry
  • Vision Science

Background:

  • Accommodative insufficiency (AI) and convergence insufficiency (CI) are common visual conditions in children.
  • These conditions often coexist and share similar symptoms.
  • The relationship between the severity of CI and symptom severity has been noted, with increased CI severity correlating with higher AI comorbidity.

Purpose of the Study:

  • To investigate whether AI or CI severity is the primary driver of symptoms in children with CI.
  • To test the hypothesis that AI, rather than CI severity, is responsible for increased symptomatology in children with comorbid CI and AI (CIwAI).

Main Methods:

  • A vision screening was conducted on 299 elementary school children, including tests for CI and AI, and the CISS-V15 symptom survey.
  • Children were categorized into four groups: normal binocular vision (NBV), AI-only, CI-only, and CIwAI.
  • Symptom scores were compared across these groups.

Main Results:

  • Children with AI-only (mean=19.7) and CIwAI (mean=22.8) reported significantly higher symptom scores than children with NBV (mean=10.3).
  • Children with CI-only (mean=12.9) had symptom scores comparable to NBV children.
  • Statistical analysis revealed a significant effect of AI (p < 0.001) on symptom scores, but not of CI (p = 0.16) or the interaction between CI and AI (p = 0.66).

Conclusions:

  • Convergence insufficiency (CI) is a distinct clinical condition that can exist independently of accommodative insufficiency (AI).
  • Elevated symptom scores previously attributed to CI are likely due to the frequent co-occurrence of AI.
  • When AI is absent, children with CI alone do not exhibit significantly more symptoms than children with normal binocular vision.
Abstract

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