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Creating consistency in the diagnosis of convergence insufficiency: screening methods
Judith B Lavrich1, Jordan L Hamburger2, Karen E Lee1
1Department of Pediatric Ophthalmology and Strabismus, Wills Eye Hospital, Philadelphia, Pennsylvania.
Summary
The near-point of convergence (NPC) measured with a red lens and subjective assessments of the quality of convergence movement (QoCM) and quality of fusional movements (QoFM) are most effective for diagnosing convergence insufficiency.
Area of Science:
- Ophthalmology
- Optometry
- Vision Science
Background:
- Convergence insufficiency is a common binocular vision disorder.
- Accurate diagnosis is crucial for effective management and treatment.
Purpose of the Study:
- To evaluate the diagnostic sensitivity of various clinical tests for convergence insufficiency.
- To identify the most effective screening tools for this condition.
Main Methods:
- 254 patients with convergence problems were assessed.
- Tests included CISS, ocular alignment, fusional amplitudes, NPC, QoCM, and QoFM.
- Sensitivity of each test was calculated.
Main Results:
- Near-point of convergence (NPC) with red lens (93.3%), QoCM (98.4%), and QoFM (94.5%) showed the highest sensitivity.
- CISS score, near convergence fusional amplitude, and near exophoria had lower sensitivities.
- Most patients had small phorias, with few showing significant exophoria increase at near.
Conclusions:
- NPC with red lens and subjective assessments of QoCM and QoFM are the most sensitive diagnostic tools.
- These tests are recommended for screening near symptoms of convergence insufficiency.
