Effectiveness of computerized oculomotor vision screening in a military population: Pilot study

Abstract

Abstract-The prevalence of oculomotor dysfunctions associated with blast-induced mild traumatic brain injury (mTBI) in warfighters has increased as a consequence of recent conflicts. This study evaluated the effectiveness of computerized oculomotor vision screening (COVS) in a military population. Oculomotor functions were assessed with COVS and by conventional methods in 20 U.S. military personnel with and 20 without mTBI. The validity of COVS was determined by Pearson correlation and Bland-Altman method or the kappa coefficient. The repeatability of the COVS was assessed with the coefficient of repeatability or the kappa coefficient. The results showed that COVS had high sensitivity and specificity for screening near oculomotor functions. Overall, the COVS showed excellent validity and repeatability for assessing near lateral and vertical phorias, Worth 4 Dot, and fixation, as well as pursuit and saccadic eye movements. Despite the strong Pearson correlation, the Bland-Altman analysis identified minor to moderate discrepancies for both positive and negative fusional vergence and their associated recovery as well as for the monocular accommodative facility measurements. This study demonstrated that non-eye-care professionals may be able to use the COVS as a tool to efficiently screen oculomotor functions in a military population with or without mTBI.

Effect of oculomotor rehabilitation on vergence responsivity in mild traumatic brain injury

“…While convergence insufficiency (CI) was the main clinical vergence dysfunction (42.5%), other vergence deficits that were also found with a relatively high frequency included binocular instability (10.0%), convergence excess (2.5%), basic exophoria (2.5%), and divergence insufficiency (<2.0%) [7]. These general findings have been confirmed in four recent related investigations [26][27][28][29].…”

Pupillary Light Reflex as an Objective Biomarker for Early Identification of Blast-Induced mTBI

“…All subjects, in both groups, had normal pupil response and no afferent pupil defect with the manual penlight examination. Additional clinical data and demographics for these participants were recently reported [25,28]. Figure 3 shows images of the typical pupillary response curve for the right and left eye for a subject with blast-induced mTBI and an agematched control.…”

Near Point of Convergence Deficits and Treatment Following Concussion: A Systematic Review

“…All of the studies were prospective and included the following designs: case-control, 9,32 cohort, 34,37 controlled observational, 35 cross sectional, 7,36,38 and repeated measures. 17,31,33 While Capó-Aponte et al 31 used a repeated-measures -Acute concussed group performed worse than healthy control group (P = .02) -Prolonged recovery group performed worse than healthy control group (P = .04) -No significant differences between the acute concussed group and prolonged recovery group (P = .11)…”

“…Ten studies compared individuals' performance on NPC break following concussion to healthy controls, and one study used a pretest-posttest design, where participants acted as his/her own control. The studies had various patient populations, including military personnel (n = 3), 9,31,32 athletes (n = 4), 7,17,33,36 and the general population (n = 4). 34,35,37,38 The majority of the studies assessed young adults or adults (n = 10), and one study assessed the youth population.…”