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Concussion questionnaires may not detect vision symptoms in children
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Researchers determined that the Post Concussion Symptom Scale may be limited in identifying pediatric patients with vision problems after concussion, according to a recent study in Optometry and Vision Science.
In the retrospective cohort of 275 pediatric patients at the Children’s Hospital of Philadelphia in its subspecialty concussion program, 67 presented with abnormal near point of convergence (NPC). Thirty percent had a previous history of concussion, and 8% had a preexisting history of eye surgery, according to the study.
About 50% of the cohort sustained a sports-related injury, and the remainder experienced trauma-related injuries.
Based on the Post Concussion Symptom Scale, 38% of subjects who presented with abnormal NPC indicated visual problems.
A total of 26 patients recovered with standard clinical care over a median of 4.5 weeks, including cognitive and physical rest with gradual return to school and physical activity, with no formal intervention, researchers said.
In 23 patients, 11 weeks of recovery occurred after referral for formal vestibular therapy and therapies such as Brock string and pencil pushups. Seven patients with persistent abnormal NPC with symptoms that necessitated office-based vision therapy with developmental optometry recovered a median of 23 weeks post-injury and a median of 16 weeks after referral to vision therapy.
The researchers proposed that it is important for doctors caring for children with concussion to recognize NPC as a “diagnostic entity and understand its implications for return-to-learn to best support children as they re-enter the academic setting after a concussion. In light of this, an accurate physical examination that includes an objective measurement of convergence is essential in the evaluation of any pediatric patient with concussion,” they wrote. – by Abigail Sutton
Disclosure: The researchers reported no relevant financial disclosures.
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