Convergence Insufficiency Symptom Survey scores for required reading versus leisure reading in school-age children

Abstract

To compare Convergence Insufficiency Symptom Survey scores for required reading for school versus scores for leisure reading. At a single private practice, we surveyed 100 children with normal binocular vision using modified survey questions specifying either required reading or leisure reading as the near visual activity. Average total symptom scores and subscores for questions about discomfort, fatigue, impaired vision, and cognitive performance were analyzed using t tests; responses to individual questions were analyzed using Mann-Whitney U tests. The average score for the required reading survey was significantly higher than for the leisure reading survey (14.4±9.1 vs 9.8±6.9 [P=0.005]). Significantly higher symptom scores were recorded for 7 of 15 questions and 3 of 4 subscores (discomfort, fatigue, and impaired vision) for the required reading survey, whereas scores for the leisure reading survey highly correlated (R2=0.95) with each child's self-reported reading speed. Convergence Insufficiency Symptom Survey scores vary greatly depending on the type of near activity being surveyed and thus do not accurately isolate and reflect near visual ability. Beginning each survey with the question about self-rated reading speed could eliminate the need for additional questions if a child self-rates his or her reading speed as average or better. Because of the influence of the type of near visual activity on symptoms, survey questions should explicitly specify the near visual activity to prevent a child's interpretation of the question's intent from affecting the symptom score.