Validity and reliability of the revised convergence insufficiency symptom survey in children aged 9 to 18 years.
OBJECTIVE
To assess the validity and reliability of the Convergence Insufficiency Symptom Survey (CISS) in children aged 9 to 18 years. The CISS is the primary outcome measure for a pilot study evaluating two different treatments for convergence insufficiency (CI).


METHODS
Children with CI were given the CISS twice to assess reliability. CISS scores for the first administration were also compared with scores from children with normal binocular vision to assess the validity of the CISS.


RESULTS
Forty-seven children with CI and 56 children with normal binocular vision participated in the study. Reliability was assessed using intraclass correlation and 95% limits of agreement for the children with CI. For children with CI, the intraclass correlation was 0.77 (95% confidence interval, 0.613 to 0.873), and the 95% limits of agreement were -10.2 to +12.1. The mean (+/-SD) CISS score was 30.8 +/- 8.4 for the children with CI and 8.4 +/- 6.4 for the children with normal binocular vision. These means were significantly different (p < 0.0001). Good discrimination (sensitivity, 96%; specificity, 88%) was obtained using a score of >/=16.


CONCLUSIONS
Children with CI showed a significantly higher CISS symptom score than children with normal binocular vision. The results of the study indicate that the CISS is a valid and reliable instrument to use as an outcome measure for children aged 9 to 18 who are enrolled in clinical research concerning CI.
Borsting
Eric J
EJ
Southern California College of Optometry, 2575 Yorba Linda Blvd., Fullerton, CA 92831, USA. eborsting@scco.edu
Rouse
Michael W
MW
Mitchell
G Lynn
GL
Scheiman
Mitchell
M
Cotter
Susan A
SA
Cooper
Jeffrey
J
Kulp
Marjean Taylor
MT
London
Richard
R
D000293:Adolescent; D002648:Child; D003290:Convergence, Ocular; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013285:Strabismus / Q000175:diagnosis; D014786:Vision Disorders / Q000175:diagnosis*; D015351:Vision Screening / Q000379:methods*; D015348:Vision, Binocular; D014792:Visual Acuity