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Research Lecture Series Visual Dysfunction in a Multidisciplinary Concussion Clinic

Please join Dr. Emily Wiecek as she presents, “Visual Dysfunction in a Multidisciplinary Concussion Clinic.” The lecture will take place on February 27, 2018 as part of the Research Lecture Series in Lecture Hall 2. All are welcome to attend. One hour of Mass CE will be awarded. You are invited to join us for a light reception in Conference Room 1 following the lecture.

Abstract: Recent estimates suggest approximately 2.8 million traumatic brain injury (TBI) emergency department visits, hospitalizations, and deaths occurred in the United States in a single year and young adults aged 15–24 years old were observed have one of highest incidence rates. Mild TBI (commonly referred to as concussion) patients often report symptoms such as blurry vision, double vision, visual fatigue, difficulty reading, and light sensitivity. This lecture will review detailed sensorimotor examination data collected on 100 adolescents seen in the setting of a multidisciplinary concussion clinic at Boston Children’s Hospital by Dr Raghuram. The clinical data shows quantifiable accommodative and vergence deficits in over 75% of the patients and provides evidence that there is significant visual dysfunction contributing to symptoms.

 There are widespread interactions between the frontal, occipital, parietal lobes, cerebellum and brainstem that play a role in linking the accommodative and vergence systems. The post-concussion data challenges predicted relationships between accommodative and vergence deficits and the data often contrasts patterns observed in visual dysfunction with no history of concussion. Furthermore, accommodative and vergence clinical findings can predict subjective symptom scores on two previously validated questionnaires - the post-concussion symptom survey and the convergence insufficiency symptom survey -using a simple regression model. These findings serve as a foundation for future research that links subjective visual symptoms and clinical findings. Future work that evaluates the patterns of these visual function deficits, as well as following the resolution of clinical findings with subjective symptoms, may lead to improved management strategies for post-concussion patients.