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Objectively Assessing Sports Concussion Utilizing Visual Evoked Potentials
Published on: April 27, 2021
Evaluation of the Visual System by the Primary Care Provider Following Concussion
Christina L Master1,2, Darron Bacal3, Matthew F Grady1,4
1Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Insights
Pediatricians should recognize and evaluate vision problems after childhood concussion. Early assessment and referral improve management for children with visual issues following concussion.
Area of Science:
- Pediatric neurology
- Ophthalmology
- Sports medicine
Background:
- Concussion is a frequent childhood injury with significant quality of life implications.
- Visual disturbances are increasingly identified as common post-concussion symptoms in children.
- Pediatricians are often the first point of care, necessitating their proficiency in identifying concussion-related visual issues.
Purpose of the Study:
- To support vision and concussion policy recommendations.
- To define the physiology of the visual system in relation to concussion.
- To detail clinically feasible testing for assessing visual function after concussion.
Main Methods:
- Review of current literature and clinical guidelines.
- Description of physiological aspects of the visual system relevant to concussion.
- Outline of practical bedside testing methodologies for visual assessment.
Main Results:
- Visual issues are a common and significant sequela of pediatric concussion.
- Clinically feasible methods exist for pediatricians to assess visual function post-concussion.
- Guidance is provided for managing visual symptoms and facilitating return to activities.
Conclusions:
- Pediatricians play a crucial role in the initial evaluation of concussion-related visual problems.
- Standardized assessment aids in directing clinical management and referral decisions.
- Timely identification and management of visual issues are essential for optimal recovery and return to daily life.
Abstract:
Concussion is a common injury in childhood and has the potential for substantial impact on quality of life. Visual issues have been increasingly recognized as a common problem after concussion. Many children initially seek care for concussion with their pediatrician, making it even more important for pediatricians to recognize, evaluate, and refer children with visual issues after concussion. This clinical report is intended to support the recommendations in the companion policy statement on vision and concussion and provides definitions of some of the physiologic aspects of the visual system as they relate to concussion. A description of clinically feasible testing methodologies is provided in more detail to aid the clinician in assessing the visual system in a focused fashion after concussion. This guidance helps direct clinical management, including support for return to school, sports, and other activities, as well as potential referral for subspecialty care for the subset of those with persistent symptoms.
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