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Comparative Study
. 2009 Apr;86(4):357-63.
doi: 10.1097/OPX.0b013e3181989252.

Validity of the convergence insufficiency symptom survey: a confirmatory study

Michael Rouse  1 , Eric Borsting, G Lynn Mitchell, Susan A Cotter, Marjean Kulp, Mitchell Scheiman, Carmen Barnhardt, Annette Bade, Tomohiko Yamada; Convergence Insufficiency Treatment Trial (CITT) Investigator Group
Collaborators, Affiliations
Comparative Study

Validity of the convergence insufficiency symptom survey: a confirmatory study

Michael Rouse et al. Optom Vis Sci. 2009 Apr.

Erratum in

  • Optom Vis Sci. 2009 Jun;86(6):786. Yamada, Tomohike [corrected to Yamada, Tomohiko]

Abstract

Purpose: The objectives of the present study were to evaluate whether investigator bias influenced the Convergence Insufficiency Symptom Survey (CISS) scores of children with normal binocular vision (NBV) in our original validation study, reevaluate the usefulness of the cutoff score of 16, and reexamine the validity of the CISS.

Methods: Six clinical sites participating in the Convergence Insufficiency Treatment Trial (CITT) enrolled 46 children 9 to <18 years with NBV. Examiners masked to the child's binocular vision status administered the CISS. The mean CISS score was compared with that from the children with NBV in the original, unmasked CISS study and also to that of the 221 symptomatic convergence insufficiency (CI) children enrolled in the CITT.

Results: The mean (+/-standard deviation) CISS score for 46 subjects with NBV was 10.4 (+/-8.1). This was comparable with our prior unmasked NBV study (mean = 8.1 (+/-6.2); p = 0.11) but was significantly different from that of the CITT CI group (mean = 29.8 +/- 9.0; p < 0.001). Eighty-three percent of these NBV subjects scored <16 on the CISS, which is not statistically different from the 87.5% found in the original unmasked study (p = 0.49).

Conclusions: Examiner bias did not affect the CISS scores for subjects with NBV in our prior study. The CISS continues to be a valid instrument for quantifying symptoms in 9 to <18-year-old children. These results also confirm the validity of a cut-point of > or = 16 in distinguishing children with symptomatic CI from those with NBV.

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Figures

Figure 1
Figure 1
Distribution of CI Symptom Survey score, by study sample.
Figure 2
Figure 2
Distributions of CI Symptom Survey score for children with normal binocular vision (NBV) and children with convergence insufficiency (CI).
See this image and copyright information in PMC

References

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