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Vergence, accommodation influence sideline concussion testing
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SAN ANTONIO – Researchers found accommodation and vergence deficits in children and adolescents after concussion, which influence sideline concussion testing results and, in turn, may lead to a change in the management of these patients, according to research presented here at the American Academy of Optometry meeting.
Emily Wiecek, OD, PhD, presented a study here at an academy-sponsored press conference that she and her colleagues conducted on patients who presented with prolonged post-concussion symptoms and had seen various specialists, including neurologists and physical therapists.
Wiecek said the study was conducted over the course of 4 years and included 114 patients between the ages of 5 and 23 years, with a median age of 15 years.
“A receded near point of convergence was the most common abnormal finding, in 67 of 114 patients,” she said. “For accommodation, reduced amplitude of accommodation was the most common abnormal finding, in 72 of 114 patients.
“For visual tracking, we found a strong correlation in both vertical and horizontal measures,” she continued. “Patients with a more reduced near point of convergence performed more poorly on both vertical and horizontal portions.”
A strong correlation was found with both vertical and horizontal accommodation, Wiecek said. The patients with more reduced accommodation took longer to complete the visual tracking test.
“This data proves that there’s some correlation between these two measures, but perhaps that’s intuitive and not surprising,” she said. “If you’re not able to accommodate or keep a single image, you’re not going to perform as well on a test.”
Wiecek argued, however, that this point is significant.
“It matters because visual tracking assessments are commonly used in post-concussion assessments on the sideline,” she said. “Similarly, these accommodation and vergence deficits are contributing to performance on these assessments. That means if we train or can improve accommodation and vergence we may be impacting performance on these sideline assessments and changing the management of these patients.” – by Nancy Hemphill, ELS, FAAO
Disclosures: Wiecek and colleagues reported no relevant financial disclosures.