Eye tracking in concussion cases has the attention of both scientists and doctors. Eye tracking plays a roll in both the diagnosis of concussions and the treatment following a concussion.
The visual system is often impacted in a concussion or mild traumatic brain injury. Evaluation of visual skills, specifically eye tracking, is incorporated into several concussion screeners and concussion evaluation protocols. Evaluating vision and eye movements is a critical component in the diagnosis of a concussion. A few examples of concussion-related testing include:
King-Devick Test: This is a short test of eye tracking ability that can be used to assist in the diagnosis of concussions. It is quick (taking 1-2 minutes to administer) and easily portable (available as a paper test or in electronic form on a tablet). This allows the King-Devick Test to be used as a sideline screener for concussions by coaches and trainers. Sideline assessment helps coaches and trainers make the decision to pull a player from the game.
Eye-Trac Advance: Traumatic brain injury is the hallmark injury of the current military conflict. The Department of Defense has used the Eye-Trac Advance to study eye tracking and how it relates to attention and reaction time in concussions and other forms of traumatic brain injury.
Vestibular Ocular Motor Screener (VOMS): The VOMS utilizes a series of tests to evaluate oculomotor (tracking), vergence (eye teaming), vestibular-ocular reflex and visual motion sensitivity. Researches have found these measures to be sensitive to change secondary to a concussion or traumatic brain injury.
While eye tracking screening techniques are beneficial in the diagnosis of concussions, it is also important that you be evaluated by an eye doctor following a concussion. Not all eye doctors evaluate post trauma vision changes, so it is important to work with an eye doctor who has specialized training in post trauma vision changes. An optometrist whom has completed a residency in neuro-optometry or binocular vision has the advanced training necessary to diagnose and manage post concussion vision changes. Dr. Ryan C Johnson completed his residency in binocular vision and neuro-optometry at the University of California, Berkeley. He is the first optometrist in Idaho to receive residency training in these sub-specialties of optometry. This makes Dr. Johnson uniquely qualified to diagnose and manage post trauma vision changes. Early diagnosis of post concussion vision conditions, such as eye tracking deficits, is important to the overall recovery of the person. Failure to properly diagnose and manage vision conditions can delay a return to play, return to the classroom, or one's progress in other rehabilitative efforts.
When a concussion alters the visual system, it is important that prompt and appropriate intervention be initiated. While some visual symptoms and conditions may be present immediately, others have a delayed onset – occurring hours or days after the concussion. For some people, their visual symptoms may self-resolve over a short period of time. For others, their vision conditions can last months or years.
Just as it is important to be evaluated by a Residency-Trained Neuro-Optometrist following a concussion, it is important that treatment of your vision conditions be performed under the direction of an eye doctor with specialized training. There are several vision conditions that can result from a concussion, and understanding each of these vision conditions allows the doctor to plan your visual recovery. Some patients, for example, may present with 'eye tracking difficulties' that are actually due to a larger underlying visual condition. Attempting to treat these patients with simple eye tracking exercises will have limited effectiveness and can leave the patient extremely symptomatic and frustrated.
There are several treatment options available for post-concussion vision changes, including:
Glasses: A concussion, like any form of acquired brain injury, can weaken the visual system. For many people this makes their current glasses or contacts less comfortable. In other cases, someone who has not previously needed glasses may need to wear them on a part-time or full-time basis. A doctor with residency-training in neuro-optometry is able to prescribe glasses, and even specific lens designs, to enhance visual comfort.
Prism: In cases of eye teaming deficits (which can cause eye tracking difficulties), prism can sometimes be used to stabilize the visual system. When prescribed by a Residency-Trained Neuro-Optometrist, prism has the potential to alleviate double vision, eye strain and headaches.
Neuro-Optometric Vision Rehabilitation: A program of vision rehabilitation is the most effective way to address the multitude of post concussion vision changes. Unlike physical therapy or occupational therapy, neuro-optometric vision rehabilitation is performed under the direction of a Residency-Trained Neuro-Optometrist and is specifically designed to address the visual conditions the patient is experiencing. This allows for a more targeted treatment by professionals who are trained to treat vision conditions. This in turn allows for greater success in a shorter amount of time.
So while scientists continue to explore new ways to use eye tracking to identify concussions, you can already take advantage of several techniques to treat post-concussion eye tracking deficits. Treating these deficits allows for a faster return to play, but also a faster return to the classroom or work. While the visual demands of sports are extremely high, the visual demands of school or work consume hours of your week.