Application of the Convergence Insufficiency Symptom Survey in Oculomotor Dysfunction and Accommodative Insufficiency

This study confirmed the application of the Convergence Insufficiency Symptom Survey (CISS) in distinguishing children with oculomotor dysfunction (OMD) from those with normal binocular vision (NBV) but not in distinguishing children with accommodative insufficiency (AI).

The purpose of this study was to determine the application of the CISS for quantifying symptoms in children aged 9 to 18 years with AI or OMD.

All participants (aged 9 to 18 years) underwent comprehensive binocular vision tests including visual acuity, cover test, near point of convergence, fusional vergence, accommodative amplitude, and the Developmental Eye Movement test to ascertain the presence of any vision conditions. According to the examination outcomes, participants were divided into four groups: NBV group, AI group, OMD group, and a group with both AI and OMD (AI-OMD). The CISS was individually administered to each participant. An ANOVA and a receiver operating characteristic curve were performed to evaluate the ability of the CISS to quantify symptoms in AI and OMD.

A total of 82 participants were qualified for this study, with 18 in the NBV group, 21 in AI, 16 in OMD, and 27 in AI-OMD group. The mean CISS score was significantly different among the four groups (F = 4.19, P = .008). Post hoc tests showed significantly higher CISS scores in the OMD group than the NBV (P = .01) and the AI (P = .03) groups, but no differences were detected among other groups. Receiver operating characteristics curve showed a significant effect of the CISS score on predicting an OMD (area under curve = 0.78, P = .006). Using a CISS score of ≥15, good discrimination of OMD was obtained.

Children with OMD (Developmental Eye Movement type II or IV) had higher CISS scores than ones with NBV. Using the CISS, children with AI did not report worse symptoms than children with NBV.