title: Nearpoint phorias after nearwork predict ADHD symptoms in college students.
abstract: OBJECTIVE
  Phorometric findings have been observed to change with stress. We test the hypothesis that postnearwork phorias predict symptoms that have been theorized to result from nearwork-induced visual stress.
  
  
  METHODS
  We measured nearpoint and farpoint dissociated phorias in 37 unselected college students with an alternate cover test both before and after a challenging reading comprehension test. We also assessed a broad range of putative attention deficit hyperactivity disorder (ADHD)-related symptoms with the Nadeau College-level ADHD Questionnaire.
  
  
  RESULTS
  For phorias measured at nearpoint after nearwork, greater deviation from the median phoria (three exophoria) predicted higher symptoms (rho (35) = 0.52, p < 0.001), whether that deviation was in a convergent or a divergent direction (both rho's (18) = >0.48, p's < 0.04). An analogous result was obtained for "distance-near" stimulus accommodative convergence to accommodation (AC/A) ratios calculated from phorias, where greater deviation from median postnearwork AC/A ratio predicted higher symptoms (rho (35) = 0.52, p < 0.0001). Symptoms did not correlate with prenearwork phorias, prenearwork AC/A ratios, or postnearwork farpoint phorias (p's > 0.05).
  
  
  CONCLUSIONS
  Phorias postnearwork, but not prenearwork, predicted self-reported ADHD-related symptoms in college students. These results link binocular imbalance immediately after sustained nearwork to symptoms theorized to result from nearwork-induced visual stress.
authors: Department of Vision Sciences, State University of New York (SUNY) College of Optometry, New York, New York. jwilmer@sunyopt.edu
authors: Jeremy B
authors: JB
authors: Wilmer
authors: Gregory M
authors: GM
authors: Buchanan
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology*; D032882:Comprehension; D006801:Humans; D009216:Myopia / Q000175:diagnosis / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011581:Psychological Tests; D011932:Reading; D013334:Students; D011795:Surveys and Questionnaires; D014495:Universities; D014787:Vision Tests