June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Evaluation of Feasibility and Acceptability of the Convergence Insufficiency Symptom Survey for Concussion (CISS-CON) Among Concussed Youth
Author Affiliations & Notes
  • Katherine Weise
    Pediatric Optomtery, University of Alabama at Birmingham, Birmingham, A, Birmingham, Alabama, United States
  • Jennifer B. Christy
    Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Mitchell Scheiman
    Pennsylvania College of Optometry, Salus University, Philadelphia, Pennsylvania, United States
  • Eric Borsting
    Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, California, United States
  • Heath Hale
    Children's of Alabama, University of Alabama at Birmingham Sports Medicine, Birmingham, Alabama, United States
  • Sarah Dille Lee
    Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Sarah Terry
    Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Laura E. Dreer
    Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Footnotes
    Commercial Relationships   Katherine Weise, None; Jennifer Christy, None; Mitchell Scheiman, None; Eric Borsting, None; Heath Hale, None; Sarah Lee, None; Sarah Terry, None; Laura Dreer, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5128. doi:
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      Katherine Weise, Jennifer B. Christy, Mitchell Scheiman, Eric Borsting, Heath Hale, Sarah Dille Lee, Sarah Terry, Laura E. Dreer; Evaluation of Feasibility and Acceptability of the Convergence Insufficiency Symptom Survey for Concussion (CISS-CON) Among Concussed Youth. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5128.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The literature is rich in evidence showing that the vision system is affected in concussion; however, there is no validated instrument that allows for symptom monitoring of visually-related symptoms in concussed children. The Convergence Insufficiency Symptom Survey has been shown to be valid and reliable in children without concussion, and has been used in large-scale clinical trials. We used a survey-based cross-sectional study in a focus-group setting to evaluate the feasibility and acceptability of an adapted version of the Convergence Insufficiency Symptom Survey for use in children with concussion (“CISS-CON”).

Methods : After concussion-management professionals verbally administered the 25-item CISS-CON questionnaire to 8 children (average age = 14, SD = 2.30; 62.5% female) with history of concussion individually, each child completed a written survey containing forced-choice and open-ended questions on patient acceptability of the CISS-CON. Once individually completed, each child convened in a single, hour-long, focus group-style session (4 children per session) to verbally develop and clarify their written feedback.

Results : On a scale ranging from 1 (none) to 10 (extreme), children did not appear to be symptomatic for headaches (M = 2.63, SD = 1.99) or dizziness (M = 1.13, SD = 1.64). The 3 minutes it took to administer the CISS-CON questionnaire was reported as “just about right” by 87.5% and “too long” in 12.5%. Most participants (75%) indicated that questions were “not too difficult to understand” and answers choices were “easy to understand” (100%). 87.5% reported that the CISS-CON did not address too many symptoms. A majority felt that the questions were comprehensive; minor edits were offered. Based on the focus group follow-up discussion, there was consensus that the CISS-CON was easy to understand, an acceptable length, did not exacerbate any concussion-like symptoms, and preferred in its current verbal professional-administered format (vs. electronic, e.g.).

Conclusions : Concussed pediatric patients with convergence insufficiency appear to find the CISS-CON acceptable and feasible. This instrument may be useful in both clinical care and research for professionals managing post-concussion vision symptoms in concussed children, and may have implications in return-to-learn protocols.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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