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Premkumar Gunasekaran, Christopher Hodge, Gary Browne, Clare Fraser, Kathryn Ailsa Rose; Concussion-Related Visual Dysfunction in Children: A Retrospective Study. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3126.
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© ARVO (1962-2015); The Authors (2016-present)
This retrospective study aims to establish the prevalence of concussion-related visual dysfunction in children and to examine associations with age, sex, and previous history of concussion.
Medical records from the Children's Hospital Institute of Sports Medicine, Sydney of patients aged 5 to 18 seen at the concussion clinic from November 2015 to May 2018 were identified (n=142) and of these 138 contained sufficient information for inclusion. All had a medical diagnosis of sport or physical activity related concussion. Information extracted included age, sex, duration of symptomology, loss of consciousness (LOC), amnesia symptoms, activity withdrawal, and number of previous concussions. The Vestibular/Ocular Motor Screening (VOMS) test was used to determine concussion-related visual dysfunction. A Pearson’s Chi Square was used to discriminate between groups and VOMS outcome. A Mann-Whitney test for non-parametric data was performed to determine the relationship between continuous variables and VOMS outcome.
The mean age of participants was 13.17 ± 2.6 years with 103 males, 35 females and of these 28% had a positive result on the VOMS test. Almost double the proportion females (42.4%) had a positive VOMS result compared to males (23.2%, p=0.034). No association was found between VOMS outcome and age (p=0.091), occurrence of multiple concussions (p=0.222), or number of previous concussions (p=0.187). LOC or amnesia individually were not associated with visual dysfunction (p=0.373 and p=0.973, respectively), nor when combined (p=0.234). Ninety-three patients recovered from their concussion symptoms (median=33 days, IQR=21-71) while those with a positive VOMS had a longer mean recovery time (days=63.67) than those with a negative VOMS (39.24 days, p<0.001).
Visual dysfunction as measured by VOMS occurred in over a quarter of children suffering activity-related concussion, and may impact school work. Dysfunction was more common in females, though we are unable to speculate as to why from the data available. Visual dysfunction may be an important indicator of the time to recovery from concussion-related symptoms.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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