• Assessing Whiplash-Related Convergence Insufficiency

    Written By: Lynda Seminara
    Selected By: Stephen D. McLeod, MD

    Journal Highlights

    Ophthalmology, June 2018

    Download PDF

    Whiplash related to motor vehicle ac­cidents may cause complaints of visual disturbance and ocular discomfort, including convergence insufficiency (CI). Stiebel-Kalish et al. compared CI findings between patients who expe­rienced whiplash during an accident and age-matched controls. They found that although patients with whiplash had more visual symptoms, they did not have a higher incidence of CI by objective measures.

    For this prospective study, adults with whiplash-associated disorder (WAD) following a motor vehicle acci­dent (n = 57; mean age, 37 years) were recruited from an orthopedic emergen­cy department between July 2014 and March 2017. Control participants (n = 39; mean age, 39 years) were hospital personnel and relatives of the patients with WAD. All participants completed the Convergence Insufficiency Symp­tom Survey (CISS), which is a vali­dated questionnaire, and underwent a detailed visual exam. Assessments included near and distance best-corrected visual acuity and near and distance cover tests, as well as Randot stereopsis and Maddox distance and Maddox-Thorington near heterophoria tests. The CISS score and binocular measure findings of CI were document­ed and analyzed with the Student t test, chi-squared test, and multiple logistic regression; and adjustments were made for age and gender.

    The analyses showed that 26 (45.6%) of the 57 patients with WAD had a pathologic CISS score of at least 16, compared with only 6 (15.4%) of the 39 controls (p = .002). The absolute CISS score was higher for the WAD group (15.3 ± 10.0 vs. 7.7 ± 7.7; p < .001). However, objective findings consistent with CI were similar for the WAD and control groups (7.0% and 7.7%, respectively).

    The original article can be found here.