Validity of the convergence insufficiency symptom survey: A confirmatory study

Michael Rouse, Eric Borsting, G. Lynn Mitchell, Susan A. Cotter, Marjean Kulp, Mitchell Scheiman, Carmen Barnhardt, Annette Bade, Tomohike Yamada, Michael Gallaway, Brandy Scombordi, Mark Boas, Tomohiko Yamada, Ryan Langan, Ruth Shoge, Lily Zhu, Susan Cotter, Raymond Chu, Susan Parker, Rebecca BridgefordJamie Morris, Javier Villalobos, Jeffrey Cooper, Audra Steiner, Marta Brunelli, Stacy Friedman, Steven Ritter, Lyndon Wong, Ida Chung, Ashley Fazarry, Rachel Coulter, Deborah Amster, Gregory Fecho, Tanya Mahaphon, Jacqueline Rodena, Mary Bartuccio, Yin Tea, Marjean Taylor Kulp, Michelle Buckland, Michael Earley, Gina Gabriel, Aaron Zimmerman, Kathleen Reuter, Andrew Toole, Molly Biddle, Nancy Stevens, Kristine Hopkins, Marcela Frazier, Janene Sims, Marsha Snow, Katherine Weise, Adrienne Broadfoot, Michelle Anderson, Catherine Baldwin, Leslie Simms, Susanna Tamkins, Hilda Capo, Mark Dunbar, Craig McKeown, Arlanna Moshfeghi, Kathryn Nelson, Vicky Fischer, Adam Perlman, Ronda Singh, Eva Olivares, Ana Rosa, Nidia Rosado, Elias Silverman, David Granet, Lara Hustana, Shira Robbins, Erica Castro, Cintia Gomi, Brian G. Mohney, Jonathan Holmes, Melissa Rice, Virginia Karlsson, Becky Nielsen, Jan Sease, Tracee Shevlin, Karen Pollack, Richard Hertle, Gladys Lynn Mitchell, Tracy Kitts, Melanie Schray, Linda Barrett, Loraine Sinnott, Kelly Watson, Pam Wessel, Maryann Redford, Marie Diener-West, Andrew Costello, William V. Good, Ron D. Hays, Argye Hillis, Ruth Manny

Research output: Contribution to journalArticle

77 Citations (Scopus)

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 ≥16 in distinguishing children with symptomatic CI from those with NBV.

Original languageEnglish
Pages (from-to)357-363
Number of pages7
JournalOptometry and Vision Science
Volume86
Issue number4
DOIs
StatePublished - Apr 1 2009

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Ocular Motility Disorders
Binocular Vision
Surveys and Questionnaires
Validation Studies

Keywords

  • Children
  • CISS
  • Convergence insufficiency
  • Convergence insufficiency symptom survey
  • Interviewer bias
  • Masking
  • Normal binocular vision
  • Symptoms
  • Validity

ASJC Scopus subject areas

  • Ophthalmology
  • Optometry
  • Medicine(all)

Cite this

Rouse, M., Borsting, E., Mitchell, G. L., Cotter, S. A., Kulp, M., Scheiman, M., ... Manny, R. (2009). Validity of the convergence insufficiency symptom survey: A confirmatory study. Optometry and Vision Science, 86(4), 357-363. https://doi.org/10.1097/OPX.0b013e3181989252

Validity of the convergence insufficiency symptom survey : A confirmatory study. / Rouse, Michael; Borsting, Eric; Mitchell, G. Lynn; Cotter, Susan A.; Kulp, Marjean; Scheiman, Mitchell; Barnhardt, Carmen; Bade, Annette; Yamada, Tomohike; Gallaway, Michael; Scombordi, Brandy; Boas, Mark; Yamada, Tomohiko; Langan, Ryan; Shoge, Ruth; Zhu, Lily; Cotter, Susan; Chu, Raymond; Parker, Susan; Bridgeford, Rebecca; Morris, Jamie; Villalobos, Javier; Cooper, Jeffrey; Steiner, Audra; Brunelli, Marta; Friedman, Stacy; Ritter, Steven; Wong, Lyndon; Chung, Ida; Fazarry, Ashley; Coulter, Rachel; Amster, Deborah; Fecho, Gregory; Mahaphon, Tanya; Rodena, Jacqueline; Bartuccio, Mary; Tea, Yin; Kulp, Marjean Taylor; Buckland, Michelle; Earley, Michael; Gabriel, Gina; Zimmerman, Aaron; Reuter, Kathleen; Toole, Andrew; Biddle, Molly; Stevens, Nancy; Hopkins, Kristine; Frazier, Marcela; Sims, Janene; Snow, Marsha; Weise, Katherine; Broadfoot, Adrienne; Anderson, Michelle; Baldwin, Catherine; Simms, Leslie; Tamkins, Susanna; Capo, Hilda; Dunbar, Mark; McKeown, Craig; Moshfeghi, Arlanna; Nelson, Kathryn; Fischer, Vicky; Perlman, Adam; Singh, Ronda; Olivares, Eva; Rosa, Ana; Rosado, Nidia; Silverman, Elias; Granet, David; Hustana, Lara; Robbins, Shira; Castro, Erica; Gomi, Cintia; Mohney, Brian G.; Holmes, Jonathan; Rice, Melissa; Karlsson, Virginia; Nielsen, Becky; Sease, Jan; Shevlin, Tracee; Pollack, Karen; Hertle, Richard; Mitchell, Gladys Lynn; Kitts, Tracy; Schray, Melanie; Barrett, Linda; Sinnott, Loraine; Watson, Kelly; Wessel, Pam; Redford, Maryann; Diener-West, Marie; Costello, Andrew; Good, William V.; Hays, Ron D.; Hillis, Argye; Manny, Ruth.

In: Optometry and Vision Science, Vol. 86, No. 4, 01.04.2009, p. 357-363.

Research output: Contribution to journalArticle

Rouse, M, Borsting, E, Mitchell, GL, Cotter, SA, Kulp, M, Scheiman, M, Barnhardt, C, Bade, A, Yamada, T, Gallaway, M, Scombordi, B, Boas, M, Yamada, T, Langan, R, Shoge, R, Zhu, L, Cotter, S, Chu, R, Parker, S, Bridgeford, R, Morris, J, Villalobos, J, Cooper, J, Steiner, A, Brunelli, M, Friedman, S, Ritter, S, Wong, L, Chung, I, Fazarry, A, Coulter, R, Amster, D, Fecho, G, Mahaphon, T, Rodena, J, Bartuccio, M, Tea, Y, Kulp, MT, Buckland, M, Earley, M, Gabriel, G, Zimmerman, A, Reuter, K, Toole, A, Biddle, M, Stevens, N, Hopkins, K, Frazier, M, Sims, J, Snow, M, Weise, K, Broadfoot, A, Anderson, M, Baldwin, C, Simms, L, Tamkins, S, Capo, H, Dunbar, M, McKeown, C, Moshfeghi, A, Nelson, K, Fischer, V, Perlman, A, Singh, R, Olivares, E, Rosa, A, Rosado, N, Silverman, E, Granet, D, Hustana, L, Robbins, S, Castro, E, Gomi, C, Mohney, BG, Holmes, J, Rice, M, Karlsson, V, Nielsen, B, Sease, J, Shevlin, T, Pollack, K, Hertle, R, Mitchell, GL, Kitts, T, Schray, M, Barrett, L, Sinnott, L, Watson, K, Wessel, P, Redford, M, Diener-West, M, Costello, A, Good, WV, Hays, RD, Hillis, A & Manny, R 2009, 'Validity of the convergence insufficiency symptom survey: A confirmatory study', Optometry and Vision Science, vol. 86, no. 4, pp. 357-363. https://doi.org/10.1097/OPX.0b013e3181989252
Rouse M, Borsting E, Mitchell GL, Cotter SA, Kulp M, Scheiman M et al. Validity of the convergence insufficiency symptom survey: A confirmatory study. Optometry and Vision Science. 2009 Apr 1;86(4):357-363. https://doi.org/10.1097/OPX.0b013e3181989252
Rouse, Michael ; Borsting, Eric ; Mitchell, G. Lynn ; Cotter, Susan A. ; Kulp, Marjean ; Scheiman, Mitchell ; Barnhardt, Carmen ; Bade, Annette ; Yamada, Tomohike ; Gallaway, Michael ; Scombordi, Brandy ; Boas, Mark ; Yamada, Tomohiko ; Langan, Ryan ; Shoge, Ruth ; Zhu, Lily ; Cotter, Susan ; Chu, Raymond ; Parker, Susan ; Bridgeford, Rebecca ; Morris, Jamie ; Villalobos, Javier ; Cooper, Jeffrey ; Steiner, Audra ; Brunelli, Marta ; Friedman, Stacy ; Ritter, Steven ; Wong, Lyndon ; Chung, Ida ; Fazarry, Ashley ; Coulter, Rachel ; Amster, Deborah ; Fecho, Gregory ; Mahaphon, Tanya ; Rodena, Jacqueline ; Bartuccio, Mary ; Tea, Yin ; Kulp, Marjean Taylor ; Buckland, Michelle ; Earley, Michael ; Gabriel, Gina ; Zimmerman, Aaron ; Reuter, Kathleen ; Toole, Andrew ; Biddle, Molly ; Stevens, Nancy ; Hopkins, Kristine ; Frazier, Marcela ; Sims, Janene ; Snow, Marsha ; Weise, Katherine ; Broadfoot, Adrienne ; Anderson, Michelle ; Baldwin, Catherine ; Simms, Leslie ; Tamkins, Susanna ; Capo, Hilda ; Dunbar, Mark ; McKeown, Craig ; Moshfeghi, Arlanna ; Nelson, Kathryn ; Fischer, Vicky ; Perlman, Adam ; Singh, Ronda ; Olivares, Eva ; Rosa, Ana ; Rosado, Nidia ; Silverman, Elias ; Granet, David ; Hustana, Lara ; Robbins, Shira ; Castro, Erica ; Gomi, Cintia ; Mohney, Brian G. ; Holmes, Jonathan ; Rice, Melissa ; Karlsson, Virginia ; Nielsen, Becky ; Sease, Jan ; Shevlin, Tracee ; Pollack, Karen ; Hertle, Richard ; Mitchell, Gladys Lynn ; Kitts, Tracy ; Schray, Melanie ; Barrett, Linda ; Sinnott, Loraine ; Watson, Kelly ; Wessel, Pam ; Redford, Maryann ; Diener-West, Marie ; Costello, Andrew ; Good, William V. ; Hays, Ron D. ; Hillis, Argye ; Manny, Ruth. / Validity of the convergence insufficiency symptom survey : A confirmatory study. In: Optometry and Vision Science. 2009 ; Vol. 86, No. 4. pp. 357-363.
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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 ≥16 in distinguishing children with symptomatic CI from those with NBV.",
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TY - JOUR

T1 - Validity of the convergence insufficiency symptom survey

T2 - A confirmatory study

AU - Rouse, Michael

AU - Borsting, Eric

AU - Mitchell, G. Lynn

AU - Cotter, Susan A.

AU - Kulp, Marjean

AU - Scheiman, Mitchell

AU - Barnhardt, Carmen

AU - Bade, Annette

AU - Yamada, Tomohike

AU - Gallaway, Michael

AU - Scombordi, Brandy

AU - Boas, Mark

AU - Yamada, Tomohiko

AU - Langan, Ryan

AU - Shoge, Ruth

AU - Zhu, Lily

AU - Cotter, Susan

AU - Chu, Raymond

AU - Parker, Susan

AU - Bridgeford, Rebecca

AU - Morris, Jamie

AU - Villalobos, Javier

AU - Cooper, Jeffrey

AU - Steiner, Audra

AU - Brunelli, Marta

AU - Friedman, Stacy

AU - Ritter, Steven

AU - Wong, Lyndon

AU - Chung, Ida

AU - Fazarry, Ashley

AU - Coulter, Rachel

AU - Amster, Deborah

AU - Fecho, Gregory

AU - Mahaphon, Tanya

AU - Rodena, Jacqueline

AU - Bartuccio, Mary

AU - Tea, Yin

AU - Kulp, Marjean Taylor

AU - Buckland, Michelle

AU - Earley, Michael

AU - Gabriel, Gina

AU - Zimmerman, Aaron

AU - Reuter, Kathleen

AU - Toole, Andrew

AU - Biddle, Molly

AU - Stevens, Nancy

AU - Hopkins, Kristine

AU - Frazier, Marcela

AU - Sims, Janene

AU - Snow, Marsha

AU - Weise, Katherine

AU - Broadfoot, Adrienne

AU - Anderson, Michelle

AU - Baldwin, Catherine

AU - Simms, Leslie

AU - Tamkins, Susanna

AU - Capo, Hilda

AU - Dunbar, Mark

AU - McKeown, Craig

AU - Moshfeghi, Arlanna

AU - Nelson, Kathryn

AU - Fischer, Vicky

AU - Perlman, Adam

AU - Singh, Ronda

AU - Olivares, Eva

AU - Rosa, Ana

AU - Rosado, Nidia

AU - Silverman, Elias

AU - Granet, David

AU - Hustana, Lara

AU - Robbins, Shira

AU - Castro, Erica

AU - Gomi, Cintia

AU - Mohney, Brian G.

AU - Holmes, Jonathan

AU - Rice, Melissa

AU - Karlsson, Virginia

AU - Nielsen, Becky

AU - Sease, Jan

AU - Shevlin, Tracee

AU - Pollack, Karen

AU - Hertle, Richard

AU - Mitchell, Gladys Lynn

AU - Kitts, Tracy

AU - Schray, Melanie

AU - Barrett, Linda

AU - Sinnott, Loraine

AU - Watson, Kelly

AU - Wessel, Pam

AU - Redford, Maryann

AU - Diener-West, Marie

AU - Costello, Andrew

AU - Good, William V.

AU - Hays, Ron D.

AU - Hillis, Argye

AU - Manny, Ruth

PY - 2009/4/1

Y1 - 2009/4/1

N2 - 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 ≥16 in distinguishing children with symptomatic CI from those with NBV.

AB - 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 ≥16 in distinguishing children with symptomatic CI from those with NBV.

KW - Children

KW - CISS

KW - Convergence insufficiency

KW - Convergence insufficiency symptom survey

KW - Interviewer bias

KW - Masking

KW - Normal binocular vision

KW - Symptoms

KW - Validity

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JO - Optometry and Vision Science

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