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Vision Therapy for Post-Concussion Vision Disorders

Gallaway, Michael ; Scheiman, Mitchell ; Mitchell, G Lynn

Optometry and vision science, 2017-01, Vol.94 (1), p.68-73 [Periódico revisado por pares]

United States: American Academy of Optometry

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  • Título:
    Vision Therapy for Post-Concussion Vision Disorders
  • Autor: Gallaway, Michael ; Scheiman, Mitchell ; Mitchell, G Lynn
  • Assuntos: Accommodation, Ocular - physiology ; Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Ocular Motility Disorders - physiopathology ; Ocular Motility Disorders - therapy ; Post-Concussion Syndrome - diagnosis ; Post-Concussion Syndrome - therapy ; Retrospective Studies ; Treatment Outcome ; Vision Disorders - diagnosis ; Vision Disorders - physiopathology ; Vision Disorders - therapy ; Vision Tests ; Vision, Binocular - physiology ; Young Adult
  • É parte de: Optometry and vision science, 2017-01, Vol.94 (1), p.68-73
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
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  • Descrição: PURPOSETo determine the frequency and types of vision disorders associated with concussion, and to determine the success rate of vision therapy for these conditions in two private practice settings. METHODSAll records over an 18-month period of patients referred for post-concussion vision problems were reviewed from two private practices. Diagnoses of vergence, accommodative, or eye movement disorders were based on pre-established, clinical criteria. Vision therapy was recommended based on clinical findings and symptoms. RESULTSTwo hundred eighteen patient records were found with a diagnosis of concussion. Fifty-six percent of the concussions were related to sports, 20% to automobile accidents, and 24% to school, work, or home-related incidents. The mean age was 20.5 years and 58% were female. Eighty-two percent of the patients had a diagnosis of an oculomotor problem [binocular problems (62%), accommodative problems (54%), eye movement problems (21%)]. The most prevalent diagnoses were convergence insufficiency (CI, 47%) and accommodative insufficiency (AI, 42%). Vision therapy was recommended for 80% of the patients. Forty-six per cent (80/175) either did not pursue treatment or did not complete treatment. Of the 54% (95/175) who completed therapy, 85% of patients with CI were successful and 15% were improved, and with AI, 33% were successful and 67% improved. Clinically and statistically significant changes were measured in symptoms, near point of convergence, positive fusional vergence, and accommodative amplitude. CONCLUSIONSIn this case series, post-concussion vision problems were prevalent and CI and AI were the most common diagnoses. Vision therapy had a successful or improved outcome in the vast majority of cases that completed treatment. Evaluation of patients with a history of concussion should include testing of vergence, accommodative, and eye movement function. Prospective clinical trials are necessary to assess the natural history of concussion-related vision disorders and treatment effectiveness.
  • Editor: United States: American Academy of Optometry
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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