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Rachel Eichler,1 Gila Mivtachi,1 Dina Hershkovitz-Azoulay,1 Mitchell Scheiman,2 Hadas Ben-Eli1,3 1Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel; 2Pennsylvania College of Optometry, Salus University, Elkins Park, PA, USA; 3Department of Ophthalmology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelCorrespondence: Hadas Ben-Eli, Department of Optometry and Vision Science, Hadassah Academic College, Neviim St. 37, Jerusalem, 9101001, Israel, Tel +972-50-4638006, Email hadasben@hac.ac.ilPurpose: To provide additional normative data for the OculoMotor Assessment Tool (OMAT) for horizontal and vertical saccades and vergence jumps and to compare the results of children to adults.Methods: Participants with visual acuity of logMAR ≥ 0.0 (6/6) and Randot stereopsis of at least 250 sec of arc without binocular disorders were recruited. Horizontal and vertical saccades, near point of convergence (NPC), accommodation and vergence jumps were evaluated using the OMAT. Means and standard deviations were reported for all parameters in children and adults.Results: A total of 52 participants (ages 9– 34, mean age 17.5 ± 7.2 years) participated in this study. Statistically significant differences were found for horizontal and vertical saccades with lower mean results in children, aged 9– 18 (111.5 ± 20.9 and 112.5 ± 22.7, respectively) compared to adults, aged 19– 34 (131.6 ± 23.9 and 126.2 ± 24.2, respectively) (P = 0.002 and 0.04, respectively). The mean of the last 30 seconds of both horizontal and vertical saccades were statistically significantly lower in the children’s group (52.5 ± 10.6 and 52.1 ± 11.3, respectively) compared to the adults (63.2 ± 10.2 and 59.3 ± 13.4, respectively) (P = 0.001 and 0.04, respectively). The normative values for horizontal and vertical saccades were 119.6 ± 23.9 and 118.1 ± 24.1 saccades per minute, respectively. NPC break and recovery were 2.3 ± 2.3cm and 3.0 ± 3.3cm, respectively. The vergence jumps assessment was 79.3 ± 21.19 movements per minute.Conclusion: Normative values for the OMAT test were found in this study for children and adults. Assessment of endurance found children norms significantly lower for horizontal and vertical saccades compared to adults.Keywords: OculoMotor Assessment Tool, OMAT, oculomotor abilities, saccadic dysfunction, endurance

The purpose of the study was to determine the frequency of vision diagnoses after concussion in adolescents and evaluate the sensitivity and specificity of physician-administered screening for detecting convergence and accommodative disorders post-concussion. We enrolled participants 11 to 17 years old, assessed 4 to 12 weeks following a diagnosed concussion. During the initial concussion examination, a sports medicine physician measured the near point of convergence (NPC), monocular accommodative amplitude (AA), and symptoms using the Convergence Insufficiency Symptom Survey (CISS). A comprehensive oculomotor evaluation was performed by an optometrist. One hundred and thirteen adolescents were enrolled, with a mean age of 15.2 years. Seventy-nine of the 113 (70%) participants had at least one oculomotor diagnosis after concussion, with the most common problems being vergence disorders (60%) and accommodative disorders (57%). The most common vergence disorder was convergence insufficiency (35%). Among accommodative disorders, the most common problem was accommodative insufficiency (35%). In all, 47% of the participants had more than one oculomotor diagnosis following concussion. The sensitivity of physician screening using measures of NPC, AA, and CISS for detecting convergence and accommodative insufficiency was 63%, 43%, 48%, respectively. The results of this study provide additional evidence that vision problems are common in adolescents with persistent concussion symptoms in the sub-acute phase 4 to 12 weeks post-concussion, and current physician screening methods using the NPC, AA, or the CISS underperform. Thus, it is prudent that adolescents with post-concussion symptoms lasting more than 4 weeks post injury receive a comprehensive oculomotor examination. [ABSTRACT FROM AUTHOR]

Background: Saccadic eye movements and visual information processing play an important role in reading success. Vision therapy can be a successful tool in the treatment of these conditions, but there is a variety of reasons why patients chose not to continue with this recommended treatment. Case Report: A nine-year-old male presented due to poor language arts performance on the ISTEP standardized test. He was diagnosed with saccadic dysfunction and reduced figure-ground, which made reading on the computer difficult. The patient was given educational accommodations based on the findings. Vision therapy was recommended, but his mother declined the treatment. Conclusion: This non-ideal case outlines the testing and assessment for oculomotor dysfunction and visual information processing and draws attention to issues surrounding vision therapy that may contribute to increased patient drop-out. By providing flexible office hours, increasing insurance coverage, and working with other eye care professionals to change the professional opinion regarding vision therapy, optometrists can increase the capture rate of patients in need of vision therapy services. [ABSTRACT FROM AUTHOR]