Sowjanya Gowrisankaran1, Ankoor S Shah1,2,3, Tawna L Roberts4, Emily Wiecek1,3, Ryan N Chinn1, Karameh K Hawash5,6, Michael J O'Brien7,8, David R Howell9,10, William P Meehan7,8,11, Aparna Raghuram1,3. 1. Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, USA. 2. Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA. 3. Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA. 4. Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, California, USA. 5. Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA. 6. Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA. 7. Micheli Center for Sports Injury Prevention, Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA. 8. Brain Injury Center, Boston Children's Hospital, Boston, Massachusetts, USA. 9. Sports Medicine Center, Children's Hospital Colorado, Aurora, Colorado, USA. 10. Department of Orthopedics, University of Colorado Denver School of Medicine, Aurora, Colorado, USA. 11. Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
PURPOSE: To examine the association between Post-Concussion Symptom Scale (PCSS) scores, Convergence Insufficiency Symptom Survey (CISS) scores, and oculomotor deficits post-concussion. METHODS: Records of adolescent patients examined in a multidisciplinary concussion clinic between July 2014 and May 2019 were reviewed. PCSS and CISS scores, results of eye examination and oculomotor assessment, concussion history, and demographics were abstracted. RESULTS: One hundred and forty patient records (median age, 15.3 years; 52 males, presented 109 days (median) from their most recent concussion) met inclusion criteria. Mean total scores on PCSS and CISS were 46.67 ± 25.89 and 27.13 ± 13.22, respectively, and were moderately correlated with each other (r = 0.53, p < .001). Oculomotor deficits were observed in 123 (88%) patients. Step-wise linear regression identified increased PCSS total score to be significantly associated with decreased amplitude of accommodation (p < .001). Increased CISS total score was significantly associated with receded near point of convergence, developmental eye movement test error scores, and cause of concussion. CONCLUSION: High PCSS scores may indicate an accommodation deficit and thus prompt an oculomotor assessment in patients following a concussion. Using the CISS and a detailed oculomotor assessment may reveal underlying oculomotor deficits, which may benefit from treatment.
PURPOSE: To examine the association between Post-Concussion Symptom Scale (PCSS) scores, Convergence Insufficiency Symptom Survey (CISS) scores, and oculomotor deficits post-concussion. METHODS: Records of adolescent patients examined in a multidisciplinary concussion clinic between July 2014 and May 2019 were reviewed. PCSS and CISS scores, results of eye examination and oculomotor assessment, concussion history, and demographics were abstracted. RESULTS: One hundred and forty patient records (median age, 15.3 years; 52 males, presented 109 days (median) from their most recent concussion) met inclusion criteria. Mean total scores on PCSS and CISS were 46.67 ± 25.89 and 27.13 ± 13.22, respectively, and were moderately correlated with each other (r = 0.53, p < .001). Oculomotor deficits were observed in 123 (88%) patients. Step-wise linear regression identified increased PCSS total score to be significantly associated with decreased amplitude of accommodation (p < .001). Increased CISS total score was significantly associated with receded near point of convergence, developmental eye movement test error scores, and cause of concussion. CONCLUSION: High PCSS scores may indicate an accommodation deficit and thus prompt an oculomotor assessment in patients following a concussion. Using the CISS and a detailed oculomotor assessment may reveal underlying oculomotor deficits, which may benefit from treatment.
Authors: Christina L Master; Mitchell Scheiman; Michael Gallaway; Arlene Goodman; Roni L Robinson; Stephen R Master; Matthew F Grady Journal: Clin Pediatr (Phila) Date: 2015-07-07 Impact factor: 1.168
Authors: M W Rouse; E Borsting; L Hyman; M Hussein; S A Cotter; M Flynn; M Scheiman; M Gallaway; P N De Land Journal: Optom Vis Sci Date: 1999-09 Impact factor: 1.973
Authors: David R Howell; Peter Kriz; Rebekah C Mannix; Tyler Kirchberg; Christina L Master; William P Meehan Journal: Clin J Sport Med Date: 2019-09 Impact factor: 3.638
Authors: Jon L Pertab; Tricia L Merkley; Alex J Cramond; Kelly Cramond; Holly Paxton; Trevor Wu Journal: NeuroRehabilitation Date: 2018 Impact factor: 2.138