Association between post-concussion symptoms and oculomotor deficits among adolescents

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.

KEYWORDS:

• Concussion
• symptom surveys
• vision
• adolescent

Acknowledgments

We thank Jane Patrick for editing the manuscript and Alicia Wang for helping with data retrieval, managing and updating the multidisciplinary concussion database.

Financial disclosures

The authors have no financial relationships relevant to this article to disclose.

Additional information

Funding

Children’s Hospital Ophthalmology Foundation Award (AR); American Academy of Optometry Career Starter Grant (AR); Research to Prevent Blindness Award (Stanford University – TLR); and National Eye Institute P30-EY026877 (Stanford University-TLR) National Eye Institute, National Institutes of Health, Department of Health and Human Services