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Abstract(s)
Para manter uma visão nítida e única durante a realização de tarefas de perto,
ambos os sistemas de focagem e de convergência têm que ser adequados e trabalhar de
forma coordenada. Quando algum destes mecanismos falha, surgem queixas de
desconforto visual, mesmo quando existe uma boa acuidade visual. Uma forma de avaliar
e acompanhar a evolução de sintomas visuais associados a tarefas de perto é o
questionário CISS (Convergence Insufficiency Symptom Survey), que se encontra
cientificamente validado e adaptado a várias línguas.
O presente estudo tem como objetivo avaliar os sintomas de desconforto visual
através do questionário CISS na sua versão portuguesa e inferir sobre as suas relações
com sinais típicos de alterações na visão binocular, assim como analisar os sintomas do
questionário na sua estrutura fatorial e verificar a sua aplicabilidade clínica.
Metodologia: A amostra final contou com 345 participantes com idades compreendidas
entre os 18 e os 35 anos de idade. Foram avaliados sintomas visuais através do
questionário CISS e medidos parâmetros clínicos para classificar a função visual. Os
participantes foram classificados em três grupos: com erros refrativos por corrigir
(Rxhcorr), com visão binocular normal (VBN) e com visão binocular alterada (VBA).
Aplicou-se estatística inferencial não paramétrica (Kruskal-Wallis, Mann Whitney e
Dunn’s Multiple comparisions), para averiguar se a pontuação de sintomas do CISS e do
CISS nas suas dimensões varia segundo as características sociodemográficas (género e
faculdades) e segundo as características clínicas (tipo de refração habitualmente usada,
e estado da função visual).
Resultados: Segundo o nível de sintomatologia reportado pelos voluntários,
verificou-se que mais de 30% (32,46%) são sintomáticos. O estudo revelou não haver
diferenças significativas para nenhum grupo de sintomas, segundo o género e segundo o
tipo de refração habitualmente usada. No entanto, encontraram-se diferenças
estatisticamente significativas segundo o estado da função visual.
Conclusão: A análise do questionário CISS como um todo é equivalente à análise
da dimensão F1 (sensações somáticas), onde sujeitos com visão binocular alterada são
sintomaticamente mais significativas do que sujeitos com visão binocular normal. A
dimensão F2 (visão prejudicada) permite distinguir sujeitos com visão binocular normal
de sujeitos com refração hipocorrigida e de sujeitos com visão binocular alterada. A dimensão F3 (desempenho cognitivo) não revelou diferenças significativas entre os
grupos estudado.
To maintain a clear and simple view during near tasks, both systems of focus and convergence have to be adequate and work in coordinated manner. When any of these mechanisms fail, complaints of visual discomfort arise, even when good visual acuity exists. A way to evaluate and follow the evolution of visual symptoms associated with close tasks is the CISS questionnaire (Convergence Insufficiency Symptom Survey), which is scientifically validated and adapted to various languages. The present study aims to evaluate the discomfort visual symptoms through the CISS questionnaire in its portuguese version and to infer about their relationships with typical signs of changes in binocular vision, as well as the analysis of the symptoms of the questionnaire in its factor structure and verify its clinical applicability. Methods: The final sample had count with 345 participants aged between 18 and 35 years old. Visual symptoms were evaluated using the Convergence Insufficiency Symptom Survey Questionnaire (CISS) and clinical parameters were measured to classify the visual function. The participants were classified in three groups: with uncorrected refractive errors (Rxhcorr), with normal binocular vision (VBN) and with abnormal binocular vision. Non parametric tests were applied (Kruskal-Wallis, Mann Whitney and Dunn’s Multiple comparisions), to verify if the CISS symptom score and the CISS in their dimensions vary according to sociodemographic characteristics (gender and faculties) and according to clinical characteristics (type of refraction usually used and state of visual function). Results: According to the level of symptoms reported by the volunteers, it was found that more than 30% (32,46%) are symptomatic. The study revealed that there were no significant differences (in all dimensions) according to gender and according to the type of refraction usually used. However, there were found statistically significant differences according to the classification of the visual function. Conclusion: The analysis of the CISS questionnaire is equivalent to the F1 dimension (somatic sensations) both allow distinguish subjects with normal binocular vision and abnormal binocular vision. The F2 dimension (impaired vision) allows distinguishing subjects with normal binocular vision from subjects with hypocorrected refraction and altered binocular vision. F3 dimension (cognitive performance) did not reveal differences between the studied groups.
To maintain a clear and simple view during near tasks, both systems of focus and convergence have to be adequate and work in coordinated manner. When any of these mechanisms fail, complaints of visual discomfort arise, even when good visual acuity exists. A way to evaluate and follow the evolution of visual symptoms associated with close tasks is the CISS questionnaire (Convergence Insufficiency Symptom Survey), which is scientifically validated and adapted to various languages. The present study aims to evaluate the discomfort visual symptoms through the CISS questionnaire in its portuguese version and to infer about their relationships with typical signs of changes in binocular vision, as well as the analysis of the symptoms of the questionnaire in its factor structure and verify its clinical applicability. Methods: The final sample had count with 345 participants aged between 18 and 35 years old. Visual symptoms were evaluated using the Convergence Insufficiency Symptom Survey Questionnaire (CISS) and clinical parameters were measured to classify the visual function. The participants were classified in three groups: with uncorrected refractive errors (Rxhcorr), with normal binocular vision (VBN) and with abnormal binocular vision. Non parametric tests were applied (Kruskal-Wallis, Mann Whitney and Dunn’s Multiple comparisions), to verify if the CISS symptom score and the CISS in their dimensions vary according to sociodemographic characteristics (gender and faculties) and according to clinical characteristics (type of refraction usually used and state of visual function). Results: According to the level of symptoms reported by the volunteers, it was found that more than 30% (32,46%) are symptomatic. The study revealed that there were no significant differences (in all dimensions) according to gender and according to the type of refraction usually used. However, there were found statistically significant differences according to the classification of the visual function. Conclusion: The analysis of the CISS questionnaire is equivalent to the F1 dimension (somatic sensations) both allow distinguish subjects with normal binocular vision and abnormal binocular vision. The F2 dimension (impaired vision) allows distinguishing subjects with normal binocular vision from subjects with hypocorrected refraction and altered binocular vision. F3 dimension (cognitive performance) did not reveal differences between the studied groups.
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Keywords
Desconforto Visual Disfunções Visuais Estudantes Questionário Ciss