{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:13:05Z","timestamp":1771546385370,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000053","name":"National Eye Institute","doi-asserted-by":"publisher","award":["EY13153"],"award-info":[{"award-number":["EY13153"]}],"id":[{"id":"10.13039\/100000053","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001818","name":"Research to Prevent Blindness","doi-asserted-by":"publisher","award":["EY13153"],"award-info":[{"award-number":["EY13153"]}],"id":[{"id":"10.13039\/100001818","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Ophthalmology"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p><jats:italic>Purpose<\/jats:italic>. To determine rate of convergence insufficiency (CI) and accommodative insufficiency (AI) and assess the relation between CI, AI, visual symptoms, and astigmatism in school-age children.<jats:italic>Methods<\/jats:italic>. 3rd\u20138th-grade students completed the Convergence Insufficiency Symptom Survey (CISS) and binocular vision testing with correction if prescribed. Students were categorized by astigmatism magnitude (no\/low: &lt;1.00\u2009D, moderate: 1.00\u2009D to &lt;3.00\u2009D, and high: \u22653.00\u2009D), presence\/absence of clinical signs of CI and AI, and presence of symptoms. Analyses determine rate of clinical CI and AI and symptomatic CI and AI and assessed the relation between CI, AI, visual symptoms, and astigmatism.<jats:italic>Results<\/jats:italic>. In the sample of 484 students (11.67 \u00b1 1.81 years of age), rate of symptomatic CI was 6.2% and symptomatic AI 18.2%. AI was more common in students with CI than without CI. Students with AI only (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontstyle=\"italic\">0.02<\/mml:mn><\/mml:math>) and with CI and AI (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn fontstyle=\"italic\">0.001<\/mml:mn><\/mml:math>) had higher symptom scores than students with neither CI nor AI. Moderate and high astigmats were not at increased risk for CI or AI.<jats:italic>Conclusions<\/jats:italic>. With-the-rule astigmats are not at increased risk for CI or AI. High comorbidity rates of CI and AI and higher symptoms scores with AI suggest that research is needed to determine symptomatology specific to CI.<\/jats:p>","DOI":"10.1155\/2016\/6963976","type":"journal-article","created":{"date-parts":[[2016,7,20]],"date-time":"2016-07-20T17:03:36Z","timestamp":1469034216000},"page":"1-7","source":"Crossref","is-referenced-by-count":59,"title":["Convergence Insufficiency, Accommodative Insufficiency, Visual Symptoms, and Astigmatism in Tohono O\u2019odham Students"],"prefix":"10.1155","volume":"2016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4814-4786","authenticated-orcid":true,"given":"Amy L.","family":"Davis","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Vision Science, The University of Arizona, Tucson, AZ 85711, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3472-9313","authenticated-orcid":true,"given":"Erin M.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Science, The University of Arizona, Tucson, AZ 85711, USA"},{"name":"Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. Daniel","family":"Twelker","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Science, The University of Arizona, Tucson, AZ 85711, USA"},{"name":"Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph M.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Science, The University of Arizona, Tucson, AZ 85711, USA"},{"name":"Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ 85724, USA"},{"name":"College of Optical Sciences, The University of Arizona, Tucson, AZ 85721, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1401-3462","authenticated-orcid":true,"given":"Tina","family":"Leonard-Green","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Science, The University of Arizona, Tucson, AZ 85711, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Campus","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Science, The University of Arizona, Tucson, AZ 85711, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1097\/01.opx.0000216097.78951.7b"},{"key":"2","year":"2008"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.optom.2014.06.005"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/S1888-4296(10)70028-5"},{"issue":"4","key":"5","first-page":"137","volume":"83","year":"2012","journal-title":"Optometry"},{"key":"6","first-page":"194","volume":"50","year":"1988","journal-title":"Canadian Journal of Optometry"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-199909000-00022"},{"issue":"1","key":"8","first-page":"25","volume":"74","year":"2003","journal-title":"Optometry"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1016\/j.optom.2015.10.006"},{"key":"10","first-page":"42","volume":"38","year":"1950","journal-title":"World Optometry"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.14-14400"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/895803"},{"issue":"4","key":"13","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/00006324-199504000-00002","volume":"72","year":"1995","journal-title":"Optometry & Vision Science"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1097\/01.opx.0000214333.84822.71"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1080\/09286580701772037"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-200312000-00014"}],"container-title":["Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/joph\/2016\/6963976.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/joph\/2016\/6963976.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/joph\/2016\/6963976.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,6,24]],"date-time":"2017-06-24T14:51:18Z","timestamp":1498315878000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.hindawi.com\/journals\/joph\/2016\/6963976\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016]]},"references-count":16,"alternative-id":["6963976","6963976"],"URL":"https:\/\/doi.org\/10.1155\/2016\/6963976","relation":{},"ISSN":["2090-004X","2090-0058"],"issn-type":[{"value":"2090-004X","type":"print"},{"value":"2090-0058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016]]}}}