In most cases, vision problems are not the first thing most people think of when talking about traumatic brain injuries. […]
Purpose
To estimate the frequency of convergence insufficiency (Cl) and its related clinical characteristics among 9- to 13-year-old children. Methods. Fifth and sixth graders were screened in school settings at three different study sites. Eligible children with 20/30 or better visual acuity, minimal refractive error, no strabismus, and exophoria at near were evaluated according to a standardized protocol to determine the presence and severity of Cl. These children were classified according to the presence and number of the following clinical signs: (1) exophoria at near S4A than far, (2) insufficient fusional convergence, and (3) receded nearpoint of convergence. Also, children were classified as accommodative insufficient (AI) if they failed Hofstetter's minimum amplitude formula or had greater than a +1.00 D lag on Monocular Estimate Method retinoscopy.
Results
Of 684 children screened, 468 (68%) were eligible for further evaluation. Of these, 453 had complete data on Cl measurements and were classified as: no Cl (nonexophoric at near or exophoric at near and<4A difference between near and far) (78.6%); low suspect Cl (exophoric at near and one clinical sign: exophoria at near >4A than far) (8.4%); high suspect Cl (exophoric at near and two clinical signs) (8.8%); and definite Cl (exophoric at near and three clinical signs) (4.2%). Cl status varied according to ethnicity and study site (p<0.0005), but not gender. The frequency of AI increased with the number of Cl-related signs. For Cl children with three signs, 78.9% were classified as also having AI.
Conclusions
These findings suggest that Cl (defined as high suspect and definite) is frequent (13%) among fifth and sixth grade children. In addition, there is a high percentage of Cl children with an associated AI
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Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!
I have always found Dr Kavner's work, expertise and wisdom of the highest caliber. As one of the fathers of OT, occupational othomology, his depth and breadth of knowledge about the eyes' health and wellbeing of the patient is exemplary. Cannot say enough good things about him.
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