Convergence Insufficiency Associated with Migraine: A Case Series

Singman, Eric L.; Matta, Noelle S.; Silbert, David I.

doi:10.3368/aoj.64.1.112

Cited by 12 publications

(5 citation statements)

References 13 publications

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“…11 A recent case series suggested that CI may result from migraines. 37 However, our findings suggest that CI after an SRC may be independent of any preexisting conditions known to influence concussion risk and outcomes.…”

Section: Discussionmentioning

confidence: 59%

Near Point of Convergence After a Sport-Related Concussion

et al. 2015

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Background Convergence insufficiency (CI) is a common binocular vision deficit after a sport-related concussion (SRC). CI may result in visual discomfort and vision-mediated functional difficulties such as slowed reading and compromised attention, leading to impaired academic, work, and sport performance. Purpose To test the reliability of repeated near point of convergence (NPC) measurements in a sample of athletes after an SRC; compare the symptoms and cognitive impairment of athletes with normal NPC to those with CI after an SRC; and explore the relationship among age, sex, learning disability, migraine history, and CI. Study Design Cross-sectional study; Level of evidence, 3. Methods A total of 78 athletes (mean age, 14.31 ± 2.77 years) who were seen a mean 5.79 ± 5.63 days after an SRC were administered 3 trials of an NPC assessment, along with neurocognitive (Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT]) and symptom assessments. Patients were divided into normal NPC (NPC ≤5 cm; n = 45) and CI (NPC >5 cm; n = 33) groups. Intraclass correlation coefficients (ICCs) and repeated-measures analyses of variance (ANOVAs) assessed the consistency of NPC across the 3 trials. The ANOVAs were employed to examine differences on neurocognitive composites and symptoms between the normal NPC and CI groups. Stepwise regressions (controlling for age and symptom scores on the Post-Concussion Symptom Scale [PCSS]) were conducted to evaluate the predictive utility of the NPC distance for neurocognitive impairment. Results Groups did not differ on demographic or injury characteristics. NPC differed between trial 1 and trials 2 (P = .02) and 3 (P = .01) for the CI group but not the normal NPC group. Internal consistency was high across NPC measurements (ICC range, 0.95–0.98). Patients with CI performed worse on verbal memory (P = .02), visual motor speed (P = .02), and reaction time (P = .001, η2 = .13) and had greater total symptom scores (P = .02) after the injury. Results of hierarchical regression revealed that the NPC distance contributed significantly to the model for reaction time (P < .001). Conclusion CI was common (~42%) in athletes evaluated within 1 month after an SRC. Athletes with CI had worse neurocognitive impairment and higher symptom scores than did those with normal NPC. Clinicians should consider routinely screening for NPC as part of a comprehensive concussion evaluation to help inform treatment recommendations, academic accommodations, and referrals for vision therapy.

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Section: Discussionmentioning

confidence: 59%

Near Point of Convergence After a Sport-Related Concussion

et al. 2015

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“…Convergence insufficiency is observed to be worsen with increased migraine frequency. Migraine worsens convergence insufficiency by causing the patient to avoid close tasks, and as a result, they develop atrophy of convergence capacities [18]. The mean near point of convergence is seen to be reduced in migraine patients.…”

Section: Migraine and Binocular Vision Functionmentioning

confidence: 95%

Binocular Vision Function and Migraine: A Review

-¹,

-²,

-³

et al. 2022

IJFMR

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Migraine is a multifactorial disease characterized by recurrent headaches and has complex neuronal and vascular mechanisms, including a wide range of clinical symptoms and other ocular findings. During migraine attacks in migraine sufferers, the accommodative response increases significantly. Migraine sufferers are predisposed to have a subtle deficit in binocular vision coordination, reduced stereopsis, reduced fixation disparity, slightly higher prevalence of heterophoria, and reduced stereopsis. Convergence insufficiency can be associated with migraine and may be the persistent cause of reduced visual functioning. Binocular vision coordination difficulties are the most common findings among migraine sufferers.

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“…Neurologic complications of hEDS are protean ( 53 ). Migraine is more common in patients with hEDS and that can be not only associated with reduced vision from aura but postdromal effects such as glare sensitivity and possibly convergence insufficiency ( 54 ). Chiari malformation has been reported as comorbid with hEDS; abnormally low cerebellar tonsillar descent can interfere with cerebrospinal fluid (CSF) hydrodynamics leading to intracranial hypertension and vision-threatening papilledema.…”

Section: Hypermobile Ehlers-danlos Syndromementioning

confidence: 99%

Ehlers-Danlos syndromes and their manifestations in the visual system

Asanad

Bayomi²,

Brown³

et al. 2022

Front. Med.

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Ehlers-Danlos syndrome (EDS) is a rare, genetically variable, heterogenous group of (currently recognized) thirteen connective tissue disorders characterized by skin hyperextensibility, tissue fragility, and generalized joint hypermobility. In addition to these commonly recognized phenotypes, recent studies have notably highlighted variable ophthalmic features in EDS. In this review, we comprehensively gather and discuss the ocular manifestations of EDS and its thirteen subtypes in the clinical setting.

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Convergence Insufficiency Associated with Migraine: A Case Series

Cited by 12 publications

References 13 publications

Near Point of Convergence After a Sport-Related Concussion

Near Point of Convergence After a Sport-Related Concussion

Binocular Vision Function and Migraine: A Review

Ehlers-Danlos syndromes and their manifestations in the visual system

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