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Preethi Thiagarajan, Kenneth Ciuffreda, Diana Ludlam, Neera Kapoor, Jose Capo-Aponte; Effect of oculomotor rehabilitation on basic versional eye movements and reading in mild traumatic brain injury (mTBI). Invest. Ophthalmol. Vis. Sci. 2013;54(15):1920.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate a range of objective measures of basic versional and related reading eye movements before and after conventional oculomotor rehabilitation in individuals with mTBI and oculomotor-based, reading-related vision symptoms. The results were also compared with SHAM training.
All laboratory-based basic two-dimensional, versional eye movements (binocular fixation, saccades, simulated reading) were recorded objectively using the Arrington ViewPoint Binocular EyeTracker. The clinically-based, horizontal reading eye movements were recorded objectively using the Visagraph system. All measures were performed in 12 non-strabismic individuals with mTBI (mean age: 29 [± 3] years), who had oculomotor-based reading-related symptoms, before and after oculomotor (fixation, predictable saccades, and simulated reading eye movements) and SHAM training (6 weeks each, 2 sessions/week, 45 minutes/session). In addition, near vision symptoms using the convergence insufficiency symptom survey (CISS) scale and subjective visual attention using the visual search and attention test (VSAT) were assessed.
Following the oculomotor training, fixational errors both along the horizontal (p<0.05) and vertical (p = 0.06) directions reduced by ~35%. Similarly, horizontal and vertical saccadic gain increased significantly (p<0.05) by 10-15%. The number of extraneous saccades executed during simulated reading reduced significantly (p<0.05) by 20%. However, saccadic latency and peak velocity were normal both at baseline and following training. With respect to the Visagraph findings, reading rate improved by 25% (from 142 to 177 words/min), and the number of fixations reduced by 20% (164 to 135), both of which were significant (p<0.05). In addition, the increased reading rate correlated with reduction in nearvision symptoms (r = -0.4, p<0.05) and increased subjective attention (r = 0.35, p<0.05). However, SHAM training did not have an effect on any of the parameters tested.
The versional-based, oculomotor training had a significant positive effect on both basic versional tracking and related reading ability. Such an overall improvement is suggestive of improved rhythmicity, accuracy, and sequencing of saccades following oculomotor-based vision rehabilitation in mTBI as a result of oculomotor learning. In addition, it suggests oculomotor visual system plasticity.
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