Concussion Testing & Vision
Concussions are defined as direct or indirect impulses to the head or body accompanied with neurological symptoms.
Because concussions can have serious short- and long-term effects, tools to improve assessment and management are critical.
Ventura et al. (2015) reviewed:
[A] Visual findings associated with concussion
[B] Current tests for concussion
[C] Potential for visual performance measures to improve concussion detection and assessment
Concussion is frequently associated with abnormalities of saccades, pursuit eye movements, convergence, accommodation, and the vestibular–ocular reflex. .
Abnormalities found within tested concussion patients include:
Pursuit eye movements (60%)
Convergence abnormalities (47%– 64%) Accommodative amplitude (65%) .
Patients with sports-related concussions often have symptoms associated with convergence or accommodative insufficiency, such as:
Words coming in and out of focus
Current sideline testing for athletes includes:
Sports Concussion Assessment Tool (SCAT3); incorporates cognitive and balance testing.
The SCAT3 takes 15-20 minutes and does not test all areas, such as vision, limiting its use as a sole indicator for concussion diagnosis.
King–Devick (K–D), the athlete rapidly reads numbers on three test cards, with the score being the total time required in seconds.
The K–D test complements components of the SCAT3 and improves the detection of concussions. 📊
Other vision-based tools for diagnosing and for managing concussion include:
Eye movement tracking devices
Eletrophysiologic testing. .
Visual performance measures improve the detection and management of concussion.
Currently, no single test can reliably diagnose concussion or determine when recovery has occurred. .
A combination of testing methods may improve insight of subtle damage and future clinical implications. .
Ventura et al. 2015. Diagnostic Tests for Concussion: Is Vision Part of the Puzzle? J. Neuro-Ophth. 35, pp. 73–81.