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Vision and Concussion: Symptoms, Signs, Evaluation, and Treatment

Christina L Master1,2,3, Darron Bacal4,5, Matthew F Grady1,3

  • 1Department of Pediatrics, University of Pennsylvania Perelman School of Medicine.

Pediatrics
|July 17, 2022
PubMed

Insights

Visual symptoms are common after concussion in children. Early screening and management of vision problems like convergence insufficiency are crucial for recovery and returning to school and play.

Area of Science:

  • Pediatric neurology
  • Sports medicine
  • Ophthalmology

Background:

  • Concussion is a common childhood injury with frequent visual symptoms in children and adolescents.
  • Visual deficits can significantly impact a child's ability to return to school and physical activities.
  • Spontaneous recovery occurs in most cases within 4 weeks, but some require specialist intervention.

Purpose of the Study:

  • To highlight the importance of screening, identifying, and managing visual symptoms post-concussion in pediatric patients.
  • To guide clinicians on necessary assessments and potential interventions for visual disturbances after concussion.
  • To emphasize the role of early management in mitigating long-term effects on quality of life.

Main Methods:

  • A comprehensive review of vision-specific history taking.
  • Detailed examination of the visual system, including acuity, ocular alignment, smooth pursuit, saccades, vestibulo-ocular reflex, near point of convergence, and accommodation.
  • Discussion of potential specialist referrals for persistent symptoms.

Main Results:

  • Visual symptoms are prevalent after concussion in pediatric populations.
  • Specific visual functions like convergence and accommodation are frequently disturbed.
  • Early identification of deficits can inform necessary learning accommodations and interventions.

Conclusions:

  • A thorough visual assessment is warranted for children and adolescents following a concussion.
  • Prompt management of visual symptoms, such as convergence or accommodative insufficiency, is vital for optimal recovery.
  • Addressing visual deficits can improve a child's quality of life and facilitate return to daily activities.

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