Oculomotor examination and treatment for concussion

Abstract

Background: Individuals who have sustained concussion frequently develop impairments in oculomotor function. Some providers have attempted to improve these impairments and aid the overall recovery from concussion by prescribing vision therapy.Objective: To review and assess the validity of common clinical oculomotor findings and subsequent vision therapy for concussion.Methods: A literature review was conducted via OVID MEDLINE and ePub databases. Three hundred and sixty-three records were obtained. Results were pared down to include only those with adequate power and relevance to the study questions. Eleven studies on examination and 2 studies on treatments met inclusion criteria.Results: There is reasonable evidence to support the use of near-point convergence, pursuits, and saccades (when computerized) aiding the diagnosis of concussion. Adequately powered randomized controlled trials do not exist to support of the use of vision therapy for the treatment of concussion. Conclusions:Oculomotor examination findings are useful in clinical practice to aid the diagnosis of concussion, but further research using adequately powered randomized controlled trials are required to clarify the efficacy of vision therapy in the treatment of concussion.