Annual Baseline King-Devick Oculomotor Function Testing Is Needed Due to Scores Varying by Age

Abstract

Objective: To document baseline King-Devick (K-D) oculomotor function scores for male and female participants aged between 4 and 20 years old. Methods: Utilising a cross section of schools, rugby clubs and gymnastic clubs, 1936 participants (1300 male, 636 female) completed the spiral-bound K-D test for the identification of disturbed oculomotor function. Results: This study identified that overall, the baseline scores of the K-D test became faster by 1.4 (0.3 to 4.5) s per year, when compared with the previous age group in the same number of reading card groups. When comparing normative values of the original K-D validation study with the same age groups of the current cohort, participants aged 6 to 11 years recorded a faster baseline time (range 3.5 to 8.6 s), while those in the 12 to 14 years. age group recorded slower baseline times (range −3.9 to −7.9 s). Discussion: In general, there were age group differences, but not sex differences, for K-D test times in the current cohort. Analysis of single card times, across all age groups, showed changes likely due to improved reading time. Conclusion: The results support the need for individualised annual pre-injury baseline testing of the K-D test.

Reliability of a Smooth Pursuit Eye-Tracking System (EyeGuide Focus) in Healthy Adolescents and Adults

“…The data also showed that, overall, adults performed testing with ~20% less error than adolescents ( Figure 3 ). Similar to studies in other eye-movement tests that show improved performance with age [ 22 ], these differences reflect the tight relationship between neural maturation and the development of visual functions [ 37 ]. For example, adults can accurately pursue moving objects at speeds >30 deg/s [ 38 ].…”

“…Children’s and adolescents’ accurate tracking of increased smooth-pursuit speeds, while not meeting the same standard as adults, does not improve with age [ 38 , 39 ], suggesting that the mechanisms contributing to differences between adolescents and mature oculomotor systems include longer saccade latencies, reduced smooth-pursuit gain, and increased general variability, reflecting maturation differences between groups [ 40 , 41 ]. Based upon these differences and data from other eye-movement studies that have shown changes with age [ 22 ], it is recommended that annual baseline testing be completed in adolescents.…”

“…Therefore, as concussion can affect attentional functioning, oculomotor smooth pursuits are useful to objectively quantify decrements in attention [ 21 ]. An added advantage of smooth-pursuit testing, is that tracking a moving target is not limited by education levels, learning disabilities, socioeconomic status, ethnicity, or other confounding variables that may affect reading ability as per the King–Devick test [ 22 ]. There are emerging studies employing the EyeGuide Focus system, not only across concussion management [ 23 , 24 , 25 ] but also studies in fatigue [ 26 ].…”

Reliability of a Smooth Pursuit Eye-Tracking System (EyeGuide Focus) in Healthy Adolescent and Adults

“…Children's and adolescents' accurate tracking of increased smooth-pursuit speeds, while not meeting the same standard as adults, does not improve with age [38,39], suggesting that the mechanisms contributing to differences between adolescents and mature oculomotor systems include longer saccade latencies, reduced smooth-pursuit gain, and increased general variability, reflecting maturation differences between groups [40,41]. Based upon these differences and data from other eye-movement studies that have shown changes with age [22], it is recommended that annual baseline testing be completed in adolescents.…”

In-Season Test–Retest Reliability of Visual Smooth-Pursuit (EyeGuide Focus) Baseline Assessment in Female and Male Field-Sport Athletes

“…Age-related differences in EyeGuide Focus scoring between adults and adolescents have been observed [ 24 ]. Such differences in ocular assessments of young athletes are not uncommon and emphasize the need for periodical baseline assessments [ 29 , 30 ]. It is currently unclear if further differences in EyeGuide Focus scoring exist between adults of different age groups at this time.…”