Rafif Ghadban1, Jennifer M Martinez2, Nancy N Diehl3, Brian G Mohney4. 1. Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota. 2. Mayo Clinic College of Medicine, Rochester, Minnesota. 3. Division of Biostatistics, Mayo Clinic and Mayo Foundation, Jacksonville, Florida. 4. Department of Ophthalmology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota. Electronic address: mohney@mayo.edu.
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. DESIGN: Retrospectively reviewed population-based cohort. PARTICIPANTS: 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. MAIN OUTCOME MEASURES: 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.
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. DESIGN: Retrospectively reviewed population-based cohort. PARTICIPANTS: 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. MAIN OUTCOME MEASURES: 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: Mitchell Scheiman; Jeffrey Cooper; G Lynn Mitchell; Land Paul de; Susan Cotter; Eric Borsting; Richard London; Michael Rouse Journal: Optom Vis Sci Date: 2002-03 Impact factor: 1.973
Authors: M W Rouse; E Borsting; L Hyman; M Hussein; S A Cotter; M Flynn; M Scheiman; M Gallaway; P N De Land Journal: Optom Vis Sci Date: 1999-09 Impact factor: 1.973