Comparison of Visual Symptom Frequency and Occupational Issues Between Patients With and Without Concussion.

IMPORTANCE

Occupational therapy practitioners' knowledge of and advocacy for clients with visual symptoms postconcussion can have a considerable impact on recovery.

OBJECTIVE

To compare the frequency of vision symptoms and occupational performance deficits in a sample of participants with and without concussion.

DESIGN

Cross-sectional study.

SETTING

Sports medicine clinic.

PARTICIPANTS

Adolescents and adults with concussion (n = 20) and musculoskeletal injuries (n = 19).

OUTCOMES AND MEASURES

Measures included monocular amplitude of accommodation, near point of convergence, Binocular Vision Assessment (BVA) computerized screening for phoria, BVA computerized screening for fusional vergence, the Developmental Eye Movement Test, the Canadian Occupational Performance Measure, and the Convergence Insufficiency Symptom Survey-Concussion Version (CISS-CON).

RESULTS

We found significant differences between participants with and without concussion using the CISS-CON (p = .001), positive fusional vergence (p = .02), and near point of convergence (p = .02). Participants with concussion scoring above cutoffs on multiple measures reported poorer performance (p = .005) and satisfaction (p = .004) with valued occupations.

CONCLUSIONS AND RELEVANCE

Concussion has a detrimental effect on vision and occupation, and occupational therapy practitioners are well-positioned to assess and address issues arising from this relationship. Plain-Language Summary: Vision symptoms commonly experienced after a concussion are associated with reduced occupational performance and satisfaction and can have a considerable impact on recovery. Occupational therapy assessment for clients with concussion should include screening for vision difficulties.