Session: Free papers Session VII - Exotropia et misc.
Convergence Insufficiency: Are We Making a Difference in Patients’ Lives or Is It a Waste of Time!
Introduction
Convergence insufficiency (CI) is a common condition that can impair visual performance and comfort during close visual work. This prospective study evaluated the effectiveness of interventions on clinical outcomes and health-related quality-of-life using the adult strabismus quality-of-life questionnaire (AS20) in patients with CI.
Methods
Data was extracted from a database collected at first consultation from 2015 to 2022. Demographics, interventions and outcomes of 80 patients with CI (mean age 46.5±24.6 years) were analysed.
Results
Orthoptic exercises were prescribed to 58% of patients, 31% received prisms, 11% received no treatment, with 3 discharged on the same day. At latest follow-up review, 22.5% were recommended to continue exercises, 20% had prisms, 1 underwent bimedial resection and 2 had botox. The median follow-up was 5.0(0-55) months, 97.5% were discharged with 27.5% following failure to attend and 10% deceased. At the latest follow-up, the attendance failure rate was higher for exercises (36%) than for prisms (15%). Both near prism cover test and near-point of convergence (NPC) improved from a median of 12(95%CI 10-14)D to 8(95%CI 5-10)D, and 17.5(95%CI 15-20)cm to 10.0(95%CI 8.3-12.0)cm respectively (p<0.05). Near prism fusion range also improved from 10(95%CI 8-14)D to 19(95%CI 16-20)D. The median AS20 score at presentation were 100(30-100) and 47.5(0-100), and post-intervention were 100(80-100) and 77.5(12.5-97.5) for psychosocial and functional components, respectively. Improvement was noted in NPC (33%) and mean AS20 scores was 9% higher psychosocially and 32.8% functionally, highlighting the benefits of intervention on patients’ quality-of-life.
Conclusion
This cohort provides valuable insights into the clinical management of CI, as evidenced by improvements in NPC and AS20 scores. However, the study also found that long-term compliance with treatment is intrinsically challenging, emphasising the importance of disease education.
Convergence insufficiency (CI) is a common condition that can impair visual performance and comfort during close visual work. This prospective study evaluated the effectiveness of interventions on clinical outcomes and health-related quality-of-life using the adult strabismus quality-of-life questionnaire (AS20) in patients with CI.
Methods
Data was extracted from a database collected at first consultation from 2015 to 2022. Demographics, interventions and outcomes of 80 patients with CI (mean age 46.5±24.6 years) were analysed.
Results
Orthoptic exercises were prescribed to 58% of patients, 31% received prisms, 11% received no treatment, with 3 discharged on the same day. At latest follow-up review, 22.5% were recommended to continue exercises, 20% had prisms, 1 underwent bimedial resection and 2 had botox. The median follow-up was 5.0(0-55) months, 97.5% were discharged with 27.5% following failure to attend and 10% deceased. At the latest follow-up, the attendance failure rate was higher for exercises (36%) than for prisms (15%). Both near prism cover test and near-point of convergence (NPC) improved from a median of 12(95%CI 10-14)D to 8(95%CI 5-10)D, and 17.5(95%CI 15-20)cm to 10.0(95%CI 8.3-12.0)cm respectively (p<0.05). Near prism fusion range also improved from 10(95%CI 8-14)D to 19(95%CI 16-20)D. The median AS20 score at presentation were 100(30-100) and 47.5(0-100), and post-intervention were 100(80-100) and 77.5(12.5-97.5) for psychosocial and functional components, respectively. Improvement was noted in NPC (33%) and mean AS20 scores was 9% higher psychosocially and 32.8% functionally, highlighting the benefits of intervention on patients’ quality-of-life.
Conclusion
This cohort provides valuable insights into the clinical management of CI, as evidenced by improvements in NPC and AS20 scores. However, the study also found that long-term compliance with treatment is intrinsically challenging, emphasising the importance of disease education.