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G. Whitehead, D. L. Rogers, M. McGregor, A. Serna; Utility of the Convergence Insufficiency Symptom Survey in a Tertiary Care Center. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4355.
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To report the results of the Convergence Insufficiency Symptom Survey (CISS) when administered in a tertiary care setting.
A retrospective chart review of the results of the CISS on patients age 9 and older in a tertiary care center over a 30-day period.
A total of 103 consecutive patients age 9 and older were identified. All patients had been given the CISS. Age range was 9-21 years (mean 12.9 years). There were 58 females. The incidence of convergence insufficiency (CI) was 5.8%. Four patients had untreated CI alone, 2 patients had treated CI. The average CISS score for patients with untreated CI was 34.5; patients without CI had an average score of 9.5. A total of 18 patients (17.5%) had a CISS score >16 with normal near point of conversion (NPC) and positive fusional vergences (PFV). Of these 18 patients, 3 had external corneal or conjunctival disease, 2 had headache, 4 had a constant tropia, 4 had an intermittent exotropia, and 5 had a well-controlled phoria with refractive error.
A CISS score of 16 or greater was found in many patients with medical diagnoses other than CI. Patients with a score of 16 or higher on the CISS should be evaluated for other possible or more prevalent pathology, especially in a tertiary care setting. The CISS has been validated in a setting where the disease prevalence is low and may have limited utility in a clinical population with a high disease prevalence.
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