title: Ocular motor assessment in concussion: Current status and future directions.
abstract: Mild head injury such as concussions and subconcussive repetitive impact may lead to subtle changes in brain function and it is imperative to find sensitive and reliable tests to detect such changes. Tests involving the visual system, in particular eye movements, can incorporate higher cortical functioning and involve diffuse pathways in the brain, including many areas susceptible to head impact. With concussions, the clinical neuro-ophthalmic exam is important for detecting abnormalities in vergence, saccades, pursuit, and visual fixation. On the sidelines, the King-Devick test has been used as a visual performance measure that incorporates eye movements and increases the sensitivity in detecting possible concussions in conjunction with standard sideline tests of cognition, symptom checklists, and balance. Much promise lies in the eye movement laboratory to quantitate changes in saccades and pursuit with concussions using video-oculography. A combination of eye movement tasks coupled with neuroimaging techniques and other objective biomarkers may lead to a better understanding of the anatomical and physiological consequences of concussion and to better understand the natural history of this condition.
authors.affiliation: New York University School of Medicine, Department of Neurology, United States. Electronic address: rachel.ventura@nyumc.org.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Ventura
authors.affiliation: New York University School of Medicine, Department of Neurology, United States; New York University School of Medicine, Department of Population Health, United States; New York University School of Medicine, Department of Ophthalmology, United States.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Balcer
authors.affiliation: New York University School of Medicine, Department of Neurology, United States; New York University School of Medicine, Department of Ophthalmology, United States.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Galetta
authors.affiliation: New York University School of Medicine, Department of Neurology, United States.
authors.forename: Janet C
authors.initials: JC
authors.lastname: Rucker
mesh_terms: D001924:Brain Concussion / Q000175:diagnosis* / Q000503:physiopathology; D053483:Eye Movement Measurements / Q000639:trends*; D005133:Eye Movements; D006801:Humans
keywords: Concussion; Head impact; Neuro-ophthalmology; Testing; Vision