Association of Symptoms with Refractive, Accommodative, and Vergence Anomalies in a Sample of Black High School Students in South Africa.

Background: Symptoms in refractive, accommodative, and vergence anomalies are similar, which may pose some challenges with differential diagnosis. The aim of conducting this study was to explore associations among symptoms and refractive, accommodative, and vergence anomalies. Methods: Using a multi...

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Publicado en:Optometry & Visual Performance Vol. 5; no. 1; pp. 36 - 50
Autores principales: Wajuihian, Samuel Otabor, Hansraj, Rekha
Formato: research tables/charts Journal Article
Publicado: Optometric Extension Program Feb2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2017
      vid: 5
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      pub: Optometric Extension Program
      place: Lutherville Timonium, Maryland
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        atl: Association of Symptoms with Refractive, Accommodative, and Vergence Anomalies in a Sample of Black High School Students in South Africa.
      aug:
        au:
          Wajuihian, Samuel Otabor
          Hansraj, Rekha
        affil: PhD, M.Optom, OD, University of KwaZulu-Natal, Durban, South Africa
      sug:
        subj:
          Ocular Physiology Physiology
          Students, High School
          Students, Elementary
          Visual Acuity
          Refractive Errors
          Symptoms
          Cluster Sample
          Multi-Stage Cluster
          Random Sample
          One-Way Analysis of Variance
          Descriptive Statistics
          Logistic Regression
          Reliability and Validity
          Confidence Intervals
          Literature Review
          Male
          Study Design
          Child
          Cross Sectional Studies
          Data Analysis
          Attitude Measures
          Female
          Surveys
          Analysis of Variance
          Questionnaires
          Scales
          Post Hoc Analysis
          Probability
          Child: 6-12 years
          Male
          Female
      ab: Background: Symptoms in refractive, accommodative, and vergence anomalies are similar, which may pose some challenges with differential diagnosis. The aim of conducting this study was to explore associations among symptoms and refractive, accommodative, and vergence anomalies. Methods: Using a multi-stage random cluster sampling, 1211 children (481 males and 730 females) between 13 and 19 years of age, with a median age of 16 years, were selected. The preliminary visual functions evaluated included visual acuity, stereo-acuity, and suppression; refractive errors were measured objectively using the autorefractor and then refined subjectively. Other tests performed included measurement of accommodative (amplitude, accuracy, facility, and relative) and vergence functions (near point of convergence, heterophoria, and fusional vergences). Symptoms were evaluated using the Convergence Insufficiency Symptom Survey. Results: The prevalence of the respective refractive errors were: myopia (≥-0.50 D) 4.4%, hyperopia (≥+0.50 D) 4.8%, and astigmatism (≥-0.75 DC) 3.2%; the prevalence of anisometropia (≥±0.75 D spherical equivalent refraction between both eyes) was 1.3%. The prevalence estimates for accommodative anomalies were: accommodative infacility 12.9%, accommodative insufficiency 4.5%, and accommodative excess 2.8%. Accommodative infacility was associated with more symptoms than accommodative insufficiency, whereas accommodative excess was not associated with any symptoms. The prevalence estimates for convergence insufficiency were: low suspect 11.8%, high suspect 6%, definite 4.3%, and pseudo-convergence insufficiency 1.9%. The prevalence of convergence excess was 5.6%, and that of fusional vergence dysfunction was 3.3%. The mean symptom scores for pseudo-convergence insufficiency, convergence excess, and fusional vergence dysfunction were higher than those for any severity of convergence insufficiency. Overall, the mean symptom scores for accommodative insufficiency, infacility, and pseudo-convergence insufficiency were significantly higher than other anomalies. For all types of anomalies, the mean symptom scores for females were significantly higher than for males (p=0.001), older students were significantly higher than younger students (p=0.001), and higher grade levels were significantly higher than lower grade levels (p=0.001). Conclusion: Our findings suggest that astigmatism is the most symptomatic refractive error, while accommodative infacility, accommodative insufficiency, and pseudoconvergence insufficiency are the most symptomatic accommodative-vergence anomalies. Accommodative excess, convergence insufficiency, convergence excess, and heterophoria are least likely to produce symptoms. Female students are more likely to be symptomatic than males, as are students in upper school grade levels compared to students in lower grade levels. Identification of symptoms that are specific to each anomaly is useful for differential diagnosis and treatment.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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