ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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УЖМБС 2017, 2(6): 164–170
https://doi.org/10.26693/jmbs02.06.164
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Convergence Insufficiency among Schoolchildren of 1-4 Grades and its Importance for Optimizing the Pedagogical Process in Junior School

Vdovychenko O. 1, Kadoshnikova I. 1, Plyska O. 1, Shkrobanets I. 2, Lazoryshynets V. 2
Abstract

Lack of convergence is the condition that is often encountered in the age of becoming an accommodative-vernacular relationship. Convergence insufficiency manifests itself for the first time at school age, when the child is faced with a long work at close range. In future the problem is either compensated or, conversely, aggravated, depending on the visual load and compensatory capabilities of the child's body. They aggravate the problem of lack of sleep, common diseases, and stress. An important aspect is that convergence insufficiency, making it difficult to read and perform tasks, affects the productivity and results of schooling, problems with concentration, attention and memorization of the reading. This side of the problem also requires work with teachers, psychologists and parents of schoolchildren who have convergence insufficiency. The purpose of the research is to familiarize practicing physicians with the problem and suggest additional methods of research in the preventive ophthalmological examination of children. It was found out that younger schoolchildren have problems with binocular vision, in particular, the lack of convergence, the detection and diagnosis of which requires an expansion of the routine examination algorithm. This should pay special attention to ophthalmologists. The presented methods of research are available in the polyclinic conditions. Because of the predominant effect on working capacity near and reading, diagnosis of this condition is important for schoolchildren, especially those who have problems with reading and assiduity when doing homework. Teachers, psychologists and parents should be informed that such children need advice from an ophthalmologist. Taking into account the high efficiency of convergence insufficiency treatment, when correctly diagnosed, it is possible to significantly facilitate the child's homework or to give appropriate recommendations for reducing the fatigue of the visual system. In addition, sighting the work of accommodative and vertex systems allows to determine the approach to the appointment of correction of refractive disorders and to write out the correct prescription. The attention should be also drawn to the fact that if a schoolchild has a problem with convergence insufficiency and because of existing violations he has difficulties with reading and doing homework, the ophthalmologist's task is to explain to parents and teachers the need to reduce the visual load in the school for the period that is being treated. The visual load of the child in school should be limited, replaced by the use of audiobooks or reading by parents. An important factor for successful treatment is also the reaction of parents and teachers to the problem in such children, because their active disapproval or attempts to force the child to perform more tasks only exacerbate the problem. It is necessary to develop an algorithm for convergence insufficiency examination for practicing physicians in eye clinics, as well as educators, who has to be the first paying attention to schoolchildren with convergence insufficiency.

Keywords: convergence insufficiency, sight, vision, age features, children, pedagogy, academic performance

Full text: PDF (Rus) 222K

References
  1. Norn M. Convergencein sufficiency: incidence in ophthalmic practice result soforth optic treatment. ACTA Ophthalmologia. 1966; 44: 132-8. https://doi.org/10.1111/j.1755-3768.1966.tb08011.x
  2. Duke-Elder S. System of ophthalmology. London: Henry Kimpton-Kratka WH, 1973.
  3. Kratka Z. Convergence insufficiency; its frequency and importance. Am Orthopt J .1956; 6: 72-3. https://www.ncbi.nlm.nih.gov/pubmed/13362814
  4. Arnoldi K, Reynolds JD. A Review of Convergence Insufficiency: What Are We Really Accomplishing with Exercises? American Orthoptic Journal. 2007; 57: 123-30. https://www.ncbi.nlm.nih.gov/pubmed/21149167. https://doi.org/10.3368/aoj.57.1.123
  5. Kent PR, Steeve JH. Convergence insufficiency, incidence among military personnel and relief by orthoptic methods. Military Surgeon. 1953; 112 (3): 202-5.
  6. Mahto RS. Eye strain from convergence insufficiency. Br Med J. 1972; 2 (5813): 564-5. https://www.ncbi.nlm.nih.gov/pmc/articles/1788096
  7. Passmore JW, MacLean F. Convergence insufficiency and its managements: an evaluation of 100 patients receiving a course of orthoptics. Am J Ophthalmol. 1957; 43 (3): 448-56. https://www.ncbi.nlm.nih.gov/pubmed/13402853
  8. Mazow M. The convergence insufficiency syndrome. J Pediatr Ophthalmol. 1971; 8: 243-4.
  9. Arnoldi K, Reynolds JD. A Review of Convergence Insufficiency: What Are We Really Accomplishing with Exercises? Am Orthopt J. 2007; 57: 123-30. https://www.ncbi.nlm.nih.gov/pubmed/21149167. https://doi.org/10.3368/aoj.57.1.123
  10. Granet DB, Gomi CF, Ventura R, Miller-Scholte A. The Relationship between Convergence Insufficiency (CI) and ADHD (Attention Deficit Hyperactivity Disorder). Strabismus. 2005 Dec; 13 (4): 163-8. https://www.ncbi.nlm.nih.gov/pubmed/16361187. https://doi.org/10.1080/09273970500455436
  11. Letourneau JE, Ducic S. Prevalence of convergence insufficiency among elementary school children. Can J Optom. 1988; 50: 194–7.
  12. Rouse MW, Borsting E, Hyman L, Hussein M, Cotter SA, Flynn M, Scheiman M, Gallaway M, De Land PN. Frequency of convergence insufficiency among fifth and sixth graders. Optom Vis Sci. 1999; 76: 643–9. https://www.ncbi.nlm.nih.gov/pubmed/10498006
  13. Scheiman M, Kulp MT, Cotter S, Mitchell L, Gallaway M, Boas M, Coulter R, Hopkins K, Tamkins S. Vision Therapy/Orthoptics for Symptomatic Convergence Insufficiency in Children: Treatment Kinetics. Optom Vis Sci. 2010 Aug; 87 (8): 593–603. https://www.ncbi.nlm.nih.gov/pmc/articles/2916019. https://doi.org/10.1097/OPX.0b013e3181e61bad
  14. Scheiman M, Wick B. Clinical Management of Binocular Vision: Heterophoric, Accommodative and Eye Movement Disorders. 2nd ed. Philadelphia: Lippincott, Williams and Wilkins; 2002.
  15. Borsting EJ1, Rouse MW, Mitchell GL, Scheiman M, Cotter SA, Cooper J, Kulp MT, London R. Validity and Reliability of the Revised Convergence Insufficiency Symptom Survey in Children Aged 9 to 18 Years. Optom Vis Sci. 2003 Dec; 80 (12): 832-8. https://www.ncbi.nlm.nih.gov/pubmed/14688547
  16. Scheiman M, Mitchell GL, Cotter SA, Kulp M, Chase C, Borsting E, Arnold E, Denton C, Hertle R. Convergence Insufficiency Treatment Trial – Attention and Reading Trial (CITT-ART): Design and Methods. Vis Dev Rehabil. 2015 Oct; 1 (3): 214–28. https://www.ncbi.nlm.nih.gov/pmc/articles/4772970
  17. Scheiman M, Mitchell GL, Cotter SA, Cooper J, Kulp M, Rouse M, Borsting E, London R, Wensveen J. A Randomized Clinical Trial of Treatments for Convergence Insufficiency in Children. American Medical Association. 2005 Jan; 1: 14-24.
  18. Convergence Insufficiency Treatment Trial Investigator Group. The Convergence Insufficiency Treatment Trial: Design, Methods, and Baseline Data. Ophthalmic Epidemiol. 2008 Jan–Feb; 15 (1): 24–36. https://www.ncbi.nlm.nih.gov/pmc/articles/2782898. https://doi.org/10.1080/09286580701772037
  19. Convergence Insufficiency Treatment Trial Investigator Group. A Randomized Clinical Trial of Treatments for Symptomatic Convergence Insufficiency in Children. Arch Ophthalmol. 2008 Oct; 126 (10): 1336–49. https://www.ncbi.nlm.nih.gov/pmc/articles/2779032. https://doi.org/10.1001/archopht.126.10.1336
  20. Lavrich JB. Convergence insufficiency and its current treatment. Curr Opin Ophthalmol. 2010 Sep; 21 (5): 356-60. https://www.ncbi.nlm.nih.gov/pubmed/20634696. https://doi.org/10.1097/ICU.0b013e32833cf03a