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Screening for convergence insufficiency in school-age children.
Anne M Menjivar1, Marjean T Kulp1, G Lynn Mitchell1
1The Ohio State University College of Optometry, Columbus, Ohio, USA.
Clinical & Experimental Optometry
|March 14, 2018
Summary
The near point of convergence (NPC) break test is the most effective screening tool for identifying convergence insufficiency (CI) in school-aged children. This simple test helps detect vision issues impacting near work performance.
Area of Science:
- Ophthalmology and Optometry
- Pediatric Vision Screening
- Binocular Vision Disorders
Background:
- Convergence insufficiency (CI) is a prevalent binocular vision disorder frequently causing symptoms during near work activities.
- The optimal screening method for identifying CI in children remains undetermined.
- This study addresses the need for effective CI screening in school settings.
Purpose of the Study:
- To assess the efficacy of common binocular and accommodative function tests in identifying CI among children.
- To determine the best screening test for convergence insufficiency in a school-based population.
Main Methods:
- Evaluated 282 children aged 9-14 years.
- Assessed tests including positive fusional vergences, near point of convergence (NPC), accommodative amplitude and facility, Modified Thorington, and the Convergence Insufficiency Symptom Survey.
- Utilized receiver operating characteristic (ROC) curve analysis to determine test performance.
Main Results:
- Approximately 20% of children exhibited 2-3 signs of CI, with a significant proportion being symptomatic.
- Symptomatic CI was often associated with low accommodative amplitude.
- NPC break measurements demonstrated the highest diagnostic accuracy, with specific cut-off points identified for CI and symptomatic CI.
Conclusions:
- The near point of convergence (NPC) break test is the most effective method for identifying children with convergence insufficiency.
- NPC break measurements provide a reliable and sensitive screening tool for CI in pediatric populations.
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