In adults with convergence insufficiency, worse symptom severity is associated with worse reading function quality of life, according to a study published in Optometry and Vision Science.
Researchers enrolled 57 adults with symptomatic convergence insufficiency who were treated with vision therapy or exercises (n=35) or base-in prism (n=22). They used spearman correlation coefficients (R) to evaluate associations among clinical measures and patient-reported outcome measures (Convergence Insufficiency Symptom Survey [CISS], Diplopia Questionnaire, Adult Strabismus-20 questionnaire [AS-20]) before treatment (baseline) and at 10 weeks and 1 year after treatment. Associations were interpreted to exist only when the lower limit of the 95% confidence interval (CI) showed a moderate to strong association [R ≥0.4].
In the multiple exploratory analysis, the only moderate-to-strong baseline association was between worse CISS scores and worse AS-20 reading function scores (R =0.62; 95% CI, 0.43-0.76). A moderate-to-strong association was noted between improved CISS scores and improved AS-20 reading function scores for prism at 10 weeks (R =0.78; 95% CI, 0.52-0.91) and 1 year (R =0.85; 95% CI, 0.65-0.94), and for vision therapy or exercises at 1 year (R =0.78; 95% CI, 0.57-0.89).
“Improvements in symptoms and quality of life with base-in prism appeared to be evident sooner, reflected in gains at 10 weeks (and sustained at 1 year), whereas improvements with vision therapy/exercises appeared to continue after 10 weeks and be more apparent at the 1-year follow-up visit,” according to the researchers. “The present study confirms that adult convergence insufficiency predominantly impacts reading function quality of life (assessed using the AS-20 questionnaire), unlike other, more visually obtrusive types of strabismus that may also impact social and interaction domains.”
Study limitations include a small sample size, inclusion of a majority of participants younger than 35 years in the vision therapy/exercise group, the absence of a control group, and failure to measure treatment compliance.
Lorenzana IJ, Leske DA, Hatt SR, et al. Relationships among clinical factors and patient-reported outcome measures in adults with convergence insufficiency. Optom Vis Sci. Published online August 1, 2022. doi:10.1097/OPX.0000000000001929