Concussion-Related Visual Dysfunction Linked to Longer Recovery Time

In a recent study, investigators from Australia found that visual dysfunction was associated with more than 25% of concussions in children and may be linked to lengthier recovery time.

Investigators found that children who experience visual dysfunction after a concussion have a recovery time that is nearly a month longer than those who did not, which could cause issues when attempting to perform day-to-day tasks.

After examining a cohort of 142 children who attended the concussion clinic at Children’s Hospital Institute of Sports Medicine in New South Wales and 138 were chosen for the study and all had a medical diagnosis of sport or physical activity related concussion. Investigators extracted information including age, sex, duration of symptomology, loss of consciousness, amnesia symptoms, activity withdrawal and number of previous concussion. Investigators used a Vestibular/Ocular Motor Screening (VOMS) to determine concussion-related visual dysfunction.

Their findings showed that children who experienced visual dysfunction and a longer mean recovery time (63.67 days) compared to those who had not (39.24 days). The investigators found no association between age and VOMS outcome and age, occurrence of multiple concussion, or number of previous concussions. Investigators noted that females (42.4%) were almost twice as likely to have a positive VOMS result compared to males (23.3%) examined.

Premkumar Gunasekaran, the study’s lead investigator, sat down with MD Magazine® after presenting his findings at the 2019 Annual Meeting of the Association for Research in Vision and Ophthalmology.

MD Mag: What were the results of your study and what are the real-world implications?

Gunasekaran: From the eye point of view, we find a lot of people that have suffered a concussion don’t actually get their eyes checked and the problems with that is we're also finding that a lot of these people do have some form of visual dysfunction. Whether that's problems with their accommodation, with their convergence, or just eye tracking in general. So, it's really important that people that do have some form of concussion or brain trauma do get tested for their eyes.

In terms of a physician point of view, it's really important that if they do have someone coming in with some form of visual-related concussion problems that they get referred accordingly to their eye specialist.

So, in terms of the pediatric group that we looked at, if those children are going to take over a month longer to recover, that means that's another month longer they're symptomatic. another month longer that they're going to struggle at school, struggle to do their homework, struggle to read, to write — anything that involves their vision and at that crucial age that's going to set them back in the education system. So, it's really important that that people such as principals, the teachers, the parents, coaches, anyone around that child is aware that these problems are going on and so we can manage that and help them accordingly.

The main thing I just really wanted to highlight, that is it's really important that we do test vision following a concussion. Anyone that does have a concussion, it's important to remove them from the activity immediately and make sure they get appropriate treatment and management and rest and if they do have visual problems, it's really important that we manage that appropriately help them out with whatever they may need to do. If it's a child, they might need a bit more attention with their schoolwork and the activities. If it's an adult, perhaps a bit more help in their work or whatever they need their vision for as well.