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. 2025 Sep 4.
doi: 10.1111/opo.70010. Online ahead of print.

Post-concussion clinical findings of oculomotor function in paediatric patients with persisting symptoms compared to healthy controls

Carissa H Wu  1 , Sophia Marusic  1 , Jennifer X Haensel  2 , Isdin Oke  1 , Kristin E Slinger  2 , Neerali Vyas  1 , Christabel A Ameyaw Baah  2 , Amber Hu  2 , Joellen Leonen  2 , Caitlyn Y Lew  2 , Gayathri Srinivasan  2 , Amir Norouzpour  2 , Erin Jenewein  3 , Siva Meiyeppen  3 , Mitchell Scheiman  3 , Tawna L Roberts  2 , Aparna Raghuram  1
Affiliations

Post-concussion clinical findings of oculomotor function in paediatric patients with persisting symptoms compared to healthy controls

Carissa H Wu et al. Ophthalmic Physiol Opt. .

Abstract

Objective: Oculomotor deficits in vergence and accommodation can arise in paediatric patients with persistent concussion symptoms, although the profile is not well established. This study aimed to describe the frequency of these deficits in persistently symptomatic concussed paediatric patients and identify effective screening tools.

Methods: This was a prospective cohort study conducted at three clinical sites across the United States. Participants aged 8-18 years with diagnosed concussion were recruited within 9 months of injury through concussion clinics or referral to a vision provider. Participants without concussion were recruited through the local community and eye clinics. Clinical measures of ocular alignment, vergence and accommodation were collected. Group comparisons were assessed using Welch's t-test, Mann-Whitney U test and Fisher's exact test with Bonferroni correction. The diagnostic value of near point of convergence (NPC) and accommodative amplitude (AA) for identifying persistently symptomatic concussed participants was evaluated using logistic regression and receiver operating characteristic curve analysis.

Results: Seventy-one participants were recruited, including 34 concussed participants (mean age 14.3 [SD 2.4] years; 74% female, 26% male; median time since concussion 107 [IQR 80-118] days) and 32 controls (mean age, 12.7 [SD 2.1] years; 56% female, 44% male). Concussed participants scored significantly worse or had higher failure rates than controls on all vergence and accommodative tests (p < 0.05) except ocular alignment and monocular accommodative facility. Concussed participants had a higher frequency of diagnoses (vergence: 62% vs. 3%; accommodation: 76% vs. 3%; p < 0.001). NPC and AA were significant predictors for concussion in individual models (NPC: OR = 2.16 [95% CI: 1.52-3.61], p < 0.001, mean AUC [SD] = 0.88 [0.13]; AA: OR = 0.46 [95% CI: 0.29-0.64], p < 0.001, mean AUC [SD] = 0.88 [0.15]).

Conclusion: The oculomotor profile of persistently symptomatic concussed paediatric participants shows a high frequency of vergence and accommodative deficits, for which NPC and AA are effective screening tools. Further investigation should examine oculomotor deficits in acutely concussed paediatric patients.

Keywords: binocular vision disorder; concussion; oculomotor dysfunction; paediatrics.

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References

REFERENCES

    1. Haarbauer‐Krupa J, Lebrun‐Harris LA, Black LI, Veliz P, Daugherty J, Desrocher R, et al. Comparing prevalence estimates of concussion/head injury in U.S. children and adolescents in national surveys. Ann Epidemiol. 2021;54:11–20.
    1. Patricios JS, Schneider KJ, Dvorak J, Ahmed OH, Blauwet C, Cantu RC, et al. Consensus statement on concussion in sport: the 6th international conference on concussion in sport‐Amsterdam, October 2022. Br J Sports Med. 2023;57:695–711.
    1. Silverberg ND, Iverson GL, Cogan A, Dams‐O‐Connor K, Delmonico R, Graf MJP, et al. The American Congress of Rehabilitation Medicine diagnostic criteria for mild traumatic brain injury. Arch Phys Med Rehabil. 2023;104:1343–1355.
    1. Lumba‐Brown A, Teramoto M, Bloom OJ, Brody D, Chesnutt J, Clugston JR, et al. Concussion guidelines step 2: evidence for subtype classification. Neurosurgery. 2020;86:2–13.
    1. Kontos AP, Sufrinko A, Sandel N, Emami K, Collins MW. Sport‐related concussion clinical profiles: clinical characteristics, targeted treatments and preliminary evidence. Curr Sports Med Rep. 2019;18:82–92.

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