Journal article
Post-concussion clinical findings of oculomotor function in paediatric patients with persisting symptoms compared to healthy controls
Ophthalmic & physiological optics, v 45(7), pp 1597-1607
04 Sep 2025
PMID: 40905935
Featured in Collection : UN Sustainable Development Goals @ Drexel
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.
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Details
- Title
- Post-concussion clinical findings of oculomotor function in paediatric patients with persisting symptoms compared to healthy controls
- Creators
- Carissa H. Wu - Boston Children's HospitalSophia Marusic - Boston Children's HospitalJennifer X. Haensel - Stanford UniversityIsdin Oke - Boston Children's HospitalKristin E. Slinger - Smith-Kettlewell Eye Research InstituteNeerali Vyas - Boston Children's HospitalChristabel A. Ameyaw Baah - Smith-Kettlewell Eye Research InstituteAmber Hu - Smith-Kettlewell Eye Research InstituteJoellen Leonen - Smith-Kettlewell Eye Research InstituteCaitlyn Y. Lew - Smith-Kettlewell Eye Research InstituteGayathri Srinivasan - Smith-Kettlewell Eye Research InstituteAmir Norouzpour - Smith-Kettlewell Eye Research InstituteErin Jenewein - Drexel University, Pennsylvania College of Optometry (PCO)Siva Meiyeppen - Drexel UniversityMitchell Scheiman - Drexel University, Pennsylvania College of Optometry (PCO)Tawna L. Roberts - Stanford UniversityAparna Raghuram - Boston Children's Hospital
- Publication Details
- Ophthalmic & physiological optics, v 45(7), pp 1597-1607
- Publisher
- Wiley
- Number of pages
- 11
- Grant note
- Stanford Maternal and Child Health Research Institute
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- The Eye Institute (TEI) [Historical]; Pennsylvania College of Optometry (PCO)
- Web of Science ID
- WOS:001565253300001
- Scopus ID
- 2-s2.0-105015523402
- Other Identifier
- 991022088463004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Ophthalmology