Association of symptoms and convergence and accommodative insufficiency in school-age children

Optometry. 2003 Jan;74(1):25-34.


Background: The purpose of this article was to investigate the association between convergence insufficiency (CI) and accommodative insufficiency (AI) and symptoms in a group of school-aged children.

Methods: Children ages 8 to 15 years were recruited from two public and 2 private elementary schools in Southern California. The CI Symptom Survey (CISS) was administered to all children before a Modified Clinical Technique vision screening. Children with normal visual acuity, minimal uncorrected refractive error, and no strabismus were tested for CI and Al.

Results: Four hundred sixty nine children were initially screened and 392 participated in testing for CI and AI. Fifty-five percent of the children (218) were classified as having normal binocular vision (NBV), 4.6% (18) had three signs of CI, 12.7% (50) had two signs of CI, 10.5% (41) were classified as AI (with no signs of CI), and 16.6% (65) were classified as other. The symptom score was 3.78 for the NBV group, 4.6 for the two-sign CI group, 6.67 for the three-sign CI group, and 6.37 for the Al group. The three-sign CI and the Al groups scored significantly higher than the NBV group on the CISS (p < or = 0.001).

Conclusion: CI and AI are common conditions in school-age children and are associated with increased symptoms.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accommodation, Ocular*
  • Adolescent
  • Child
  • Convergence, Ocular*
  • Female
  • Humans
  • Male
  • Schools
  • Vision Disorders / diagnosis*
  • Vision Screening
  • Vision, Binocular
  • Visual Acuity