Amplify EyeCare Chattanooga Logo
Authors
ROUSE, MICHAEL W. OD, MS, FAAO; BORSTING, ERIC OD, MS; DELAND, PAUL N. PhD

Reliability of Binocular Vision Measurements Used in the Classification of Convergence Insufficiency

publication date
Category
see more

Abstract/Introduction

Purpose

To evaluate the reliability of binocular vision measurements used in the classification of convergence insufficiency.

 

Methods

Two examiners tested 20 fifth and sixth graders in a school setting who passed a screening of visual acuity, refraction, and binocularity. The tests, conducted using a standard protocol, consisted of von Graefe near heterophoria (NH), phorometric positive fusional vergence (PFV), nearpoint of convergence (NPC), and monocular pushup accommodative amplitude (AA). Each examiner measured each child three consecutive times for each test, on two separate occasions, spaced approximately 1 week apart. Intraexaminer and interexaminer agreement was assessed using intraclass correlation coefficients (ICC), the median absolute difference (MAD), and the coefficient of repeatability (COR).


Conclusion/Results

Results

The within-session reliability of the NH (ICC: 0.95 to 0.99), NPC (ICC: 0.94 to 0.98), and AA (ICC: 0.88 to 0.95) were good, whereas the PFV was less reliable (ICC: 0.71 to 0.94). The intraexaminer reliability between sessions was good for the NPC (ICC: 0.92 and 0.89), less reliable for NH (ICC: 0.81 and 0.81) and AA (ICC: 0.89 and 0.69), and much less reliable for PFV break (ICC: 0.59 and 0.53). Typical between-session PFV differences (MAD) were between 3 and 4 Δ, whereas the COR differences were as large as 12 Δ.

 

Conclusions

Three of the four measures (NH, NPC, and AA) often used in the classification of convergence insufficiency generally have good within-session and between-session reliability. The PFV break was found to have only fair reliability with clinically significant differences between sessions. The large potential test-retest differences found could complicate clinical decision-making in regards to diagnosis and treatment.


Contact Us To Amplify Your EyeCare

Working Hours

Monday - Thursday
8:00 am - 5:15pm
friday-sunday
Closed
Location
1043 Executive Drive Suite #101 Hixson, TN 37343
Website Accessibility Policy
Safety protocols page
phone-handsetarrow-uparrow-right linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram