title: The incidence and clinical characteristics of adult-onset convergence insufficiency.
abstract: OBJECTIVE
  The purpose of this study was to describe the clinical characteristics and natural history of convergence insufficiency (CI) in a population-based cohort of adults.
  
  
  METHODS
  Retrospectively reviewed population-based cohort.
  
  
  METHODS
  Adult (age ≥19 years) residents of Olmsted County, Minnesota.
  
  
  METHODS
  The medical records of all adults diagnosed with CI over a 20-year period were reviewed retrospectively.
  
  
  METHODS
  Clinical characteristics and outcomes for adult-onset CI.
  
  
  RESULTS
  A total of 118 adults (annual incidence, 8.44 per 100 000 patients older than 19 years) were diagnosed with CI during the 20-year period, constituting 15.7% of all forms of adult-onset strabismus observed in this population. The median age at diagnosis was 68.5 years (range, 21.7-97.1 years), and 68 (57.6%) were female. The mean initial exodeviation at near was 14.1 prism diopters (PD; range, 1-30 PD) and 1.7 PD (range, 0-10 PD) at distance. The Kaplan-Meier rate of exotropia increasing over time by 7 PD or more at near was 4.2% at 5 years, 13.5% at 10 years, and 24.4% at 20 years. Approximately 88% were managed with prisms, whereas less than 5% underwent surgical correction.
  
  
  CONCLUSIONS
  Adult-onset CI included approximately 1 in 6 adults who were newly diagnosed with strabismus in this 20-year cohort. There was a significant increase in incidence with increasing age. Nearly one-fourth had an increase of their near exodeviation of at least 7 PD by 20 years after their diagnosis, and most patients were managed conservatively.
authors: Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota.
authors: Rafif
authors: R
authors: Ghadban
authors: Mayo Clinic College of Medicine, Rochester, Minnesota.
authors: Jennifer M
authors: JM
authors: Martinez
authors: Division of Biostatistics, Mayo Clinic and Mayo Foundation, Jacksonville, Florida.
authors: Nancy N
authors: NN
authors: Diehl
authors: Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota. Electronic address: mohney@mayo.edu.
authors: Brian G
authors: BG
authors: Mohney
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005139:Eyeglasses; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009216:Myopia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015835:Ocular Motility Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D055815:Young Adult
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