Frequency of oculomotor disorders in adolescents 11 to 17 years of age with concussion, 4 to 12 weeks post injury

Scheiman, Mitchell; Grady, Matthew F.; Jenewein, Erin; Shoge, Ruth; Podolak, Olivia E.; Howell, David M.; Master, Christina L.

doi:10.1016/j.visres.2020.09.011

Cited by 17 publications

(17 citation statements)

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“…Vision and autonomic dysfunctions are common sequelae of concussion in adolescents and may be a driver of both acute and persistent symptoms 5,7,9 . Objective eye tracking technology may quickly identify vision disturbances after concussion to allow for earlier recognition, referral, and treatment, potentially reducing long-term effects 16–18 .…”

Section: Discussionmentioning

confidence: 99%

“…Vision and autonomic dysfunctions are common sequelae of concussion in adolescents and may be a driver of both acute and persistent symptoms. 5,7,9 Objective eye tracking technology may quickly identify vision disturbances after concussion to allow for earlier recognition, referral, and treatment, potentially reducing long-term effects. [16][17][18] To our knowledge, this study is the first to demonstrate the utility of objective eye tracking in distinguishing uninjured adolescents from those with acute or persistent concussion symptoms based on metrics of eye position, saccadic movement, and pupillary dynamics.…”

Section: Discussionmentioning

confidence: 99%

“…deficits frequently occur in adolescents after concussion. [5][6][7] Specifically, nearly 70% of concussed adolescents evaluated in a specialty care setting presented with visual deficits, such as convergence insufficiency, accommodative disorders, and/or saccadic dysfunction. 5 Although most children with concussion achieve symptom recovery within 4 weeks, the presence of visual deficits after injury predicts prolonged symptoms and recovery.…”

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Eye Tracking Metrics Differences among Uninjured Adolescents and Those with Acute or Persistent Post-Concussion Symptoms

et al. 2022

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confidence: 99%

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Eye Tracking Metrics Differences among Uninjured Adolescents and Those with Acute or Persistent Post-Concussion Symptoms

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“… 15 22 The most common oculomotor disorders following a concussion are convergence insufficiency (affecting the ability of eyes to work together to clearly see nearby objects) and accommodative insufficiency (difficulty when focussing on a nearby object). 23 Symptoms associated with oculomotor dysfunction include difficulty tracking objects, motion sensitivity, eye strain or eye fatigue for near vision, and headache. 15 22 Importantly, evidence has shown that these symptoms of vestibular and oculomotor dysfunction are strong predictors of delayed recovery for patients with PPCS.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of non-pharmacological treatments for vestibular and oculomotor dysfunction in patients with persistent post-concussive symptoms: protocol for a systematic review and meta-analysis

et al. 2023

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IntroductionConcussion is a form of mild traumatic brain injury that disrupts brain function. Although symptoms are mostly transient, recovery can be delayed and result in persistent postconcussive symptoms (PPCS). Vestibular and oculomotor dysfunction are among the most debilitating impairments associated with PPCS. However, pharmacological interventions for these impairments are associated with deleterious side effects. Accordingly, increasing research has examined the utility of non-pharmacological interventions for PPCS. The aim of this review is to synthesise and evaluate the effectiveness of non-pharmacological interventions for the treatment of vestibular and oculomotor dysfunction for patients with PPCS.Methods and analysisSystematic searches of MEDLINE, PubMed, Web of Science and Scopus will identify randomised controlled trials employing non-pharmacological treatments for vestibular and/or oculomotor dysfunction for PPCS. Such interventions may include, but are not limited to, vestibular rehabilitation, optokinetic stimulation and vestibulo-ocular reflex exercises. Assessments of oculomotor function will include versional eye movements, vergence eye movements, visual-fixation movements and accommodation response. Assessments of vestibular function will include the Fukuda Step test, functional balance tests, force displacement tests, and subjective reports of balance disruption or vertigo. Where appropriate, meta-analyses of standardised mean differences will be conducted using a random effects model for continuous outcomes. For dichotomous outcomes (improved vs not improved following treatment), effects will be expressed as relative risk. The impact of heterogeneity will be calculated using the I2statistic. The Physiotherapy Evidence Database scale will be used to determine the methodological quality of individual studies and Grading of Recommendations, Assessment, Development and Evaluations used to assess the certainty and quality of evidence for each outcome.Ethics and disseminationEthical approval is not required for this review. Findings will be disseminated through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42021254720.

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“…Overall, 69% had one or more of the following vision diagnoses: accommodative disorders (51%), convergence insufficiency (49%), and saccadic dysfunction (29%). Scheiman et al 2 performed a comprehensive oculomotor evaluation on 113 participants 11 to 17 years old, assessed 4 to 12 weeks following a diagnosed concussion. Seventy percent of the participants had at least one oculomotor diagnosis after concussion, with the most common problems being vergence disorders (60%) and accommodative disorders (57%).…”

Section: Introductionmentioning

confidence: 99%

OculoMotor Assessment Tool: Children Compared with Adults

Eichler¹,

Mivtachi²,

Hershkovitz-Azoulay³

et al. 2022

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Purpose To provide additional normative data for the OculoMotor Assessment Tool (OMAT) for horizontal and vertical saccades and vergence jumps and to compare the results of children to adults. Methods Participants with visual acuity of logMAR ≥0.0 (6/6) and Randot stereopsis of at least 250 sec of arc without binocular disorders were recruited. Horizontal and vertical saccades, near point of convergence (NPC), accommodation and vergence jumps were evaluated using the OMAT. Means and standard deviations were reported for all parameters in children and adults. Results A total of 52 participants (ages 9–34, mean age 17.5 ± 7.2 years) participated in this study. Statistically significant differences were found for horizontal and vertical saccades with lower mean results in children, aged 9–18 (111.5 ± 20.9 and 112.5 ± 22.7, respectively) compared to adults, aged 19–34 (131.6 ± 23.9 and 126.2 ± 24.2, respectively) (P = 0.002 and 0.04, respectively). The mean of the last 30 seconds of both horizontal and vertical saccades were statistically significantly lower in the children’s group (52.5 ± 10.6 and 52.1 ± 11.3, respectively) compared to the adults (63.2 ± 10.2 and 59.3 ± 13.4, respectively) (P = 0.001 and 0.04, respectively). The normative values for horizontal and vertical saccades were 119.6 ± 23.9 and 118.1 ± 24.1 saccades per minute, respectively. NPC break and recovery were 2.3 ± 2.3cm and 3.0 ± 3.3cm, respectively. The vergence jumps assessment was 79.3 ± 21.19 movements per minute. Conclusion Normative values for the OMAT test were found in this study for children and adults. Assessment of endurance found children norms significantly lower for horizontal and vertical saccades compared to adults.

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Frequency of oculomotor disorders in adolescents 11 to 17 years of age with concussion, 4 to 12 weeks post injury

Cited by 17 publications

References 55 publications

Eye Tracking Metrics Differences among Uninjured Adolescents and Those with Acute or Persistent Post-Concussion Symptoms

Eye Tracking Metrics Differences among Uninjured Adolescents and Those with Acute or Persistent Post-Concussion Symptoms

Effectiveness of non-pharmacological treatments for vestibular and oculomotor dysfunction in patients with persistent post-concussive symptoms: protocol for a systematic review and meta-analysis

OculoMotor Assessment Tool: Children Compared with Adults

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