Translation and Validation of Convergence Insufficiency Symptoms Survey to Arabic Language رسالة ماجستيرا

Abstract

Background:Convergence insufficiency is the most common binocular vision disorder, characterized by decreased ability of the eyes to maintain alignment during near work. One of the most commonly used tools to evaluate the frequency and nature of symptoms associated with convergence insufficiency is the Convergence Insufficiency Symptoms Survey (CISS). Despite the availability of a translated Arabic version of CISS, its validation has been limited to university students, and the translation and validation were conducted without clinical testing to correlate CISS results with clinical diagnoses. Objectives: The primary aim of this study was to translate the Convergence Insufficiency Symptom Survey into Arabic andvalidate its reliability for use in Arabic speaking populations. Methods: The study had two phases. First,the CISS was translated into Arabic following established guidelines.Second, the reliability of the translated survey was assessed by administering itto 151 participants using convenience sampling. Participants were selected from Al-Kemah Optical Center (Yatta), Ibrahim Optical Center (Salfit), and the optometry teaching clinic at the Arab American University (Ramallah) between August and December 2024. Validity was evaluated by comparing survey scores with clinical test results to ensure its accuracy for the Arabic-speaking population. Results:The study found that 7.28% of participants were diagnosed with convergence insufficiency based onclinical tests. The CISS(Arabic Version) demonstrated moderate discriminatory ability (sensitivity = 63.64%, specificity = 66.43%), withthe cutoff set at 21 points for identifying convergence insufficiency. Internal consistency was assessed using Cronbach'salpha (α = 0.95), indicating high reliability.Test-retest reliability showed a strong intraclass correlation coefficient (ICC=0.931,95% CI:0.90-0.95), confirming the survey's stability over time. These findings confirm the validity and reliability of the CISS (Arabic Version) for assessingconvergence insufficiency symptoms in Arabic-speaking populations. CONCLUSION:The validated Arabic CISSis a reliable tool for assessing convergence insufficiency Symptoms in Arabic speakers in the Middle East and North Africa region and can support more effective clinical management.Further studies are needed to confirm its use across different age groups and binocular disorders.