Guidance issued for managing visual disorders after pediatric concussion

In a policy statement issued by the American Academy of Pediatrics and published online July 18 in Pediatrics, guidance is presented for the management of visual disorders following a concussion among children.

Christina L. Master, M.D., from the University of Pennsylvania Perelman School of Medicine in Philadelphia, and colleagues developed recommendations for screening, identifying, and initiating clinical management of visual symptoms in pediatric patients after concussion.

The authors note that most children and adolescents with visual symptoms after concussion will recover by four weeks; however, a subset does not have spontaneous recovery and should be referred to a specialist with experience in comprehensive concussion management for assessment and treatment. A vision-specific history and thorough visual examination should be carried out, including assessment of visual acuity, ocular alignment in all gaze positions, smooth pursuit, saccades, vestibulo-ocular reflex, near point of convergence, and accommodation, all of which can be affected by concussion. These deficits may contribute to difficulty returning to play and to school. Identification of these problems soon after injury is important so that relevant learning accommodations can be provided.

"Children are not always able to describe their symptoms clearly, and so these screening and diagnostic tools will help guide physicians when evaluating patients with concussions," Master said in a statement. "It's important that we identify any problems with vision. They can have an enormous impact on a child or teen's daily routines and quality of life."

One author disclosed an intellectual property relationship with Rebion involving a patent application for a pediatric vision screener.

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