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Analysis of Central and Peripheral Vision Reaction Times in Patients With Postconcussion Visual Dysfunction

Clark, Joseph F. PhD*; Ellis, James K. OD; Burns, Timothy M. DO; Childress, John M. MD; Divine, Jon G. MD

Clinical Journal of Sport Medicine: September 2017 - Volume 27 - Issue 5 - p 457–461
doi: 10.1097/JSM.0000000000000381
Original Research

Objective: To determine whether central and peripheral vision reaction times (PVRTs) are prolonged in patients with visual dysfunction after sustaining a concussion.

Design: Comparison of Dynavision D2 central and PVRTs in patients with postconcussion visual dysfunction were compared with control data from a normative patient database. Concussion patients without visual dysfunction were not included in this study.

Setting: National Collegiate Athletic Association Division 1 college training room and university based, academic health center.

Participants: Patients were selected for inclusion based on diagnosis of new visual dysfunction as indicated either by physical examination of the team physician or by patient self-report of symptoms. Patients included college athletes, college students, and concussion patient's presenting to a university based, academic health center.

Intervention: Measurement of central and PVRTs using a Dynavision D2 reaction time program were used as the dependent variables. Evaluations were conducted from 3 days to 11 months postconcussion, depending on the temporal development of visual symptoms after the concussion. No intervention was used.

Main Outcome Measures: Average central and PVRTs for patients with postconcussion visual symptoms were compared with an asymptomatic control group with no history of concussion.

Results: Both central and PVRTs were significantly prolonged in patients with postconcussion visual symptoms compared with patients with no history of concussion.

Conclusions: Central and PVRTs are both prolonged in patients with postconcussion visual dysfunction with PVRT being disproportionately prolonged. The percent change from central to PVRT was also increased in patients with postconcussion visual dysfunction.

*Department of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio;

Department of Athletics, Sports Medicine, University of Cincinnati, Cincinnati, Ohio; and

Division of Sports Medicine, Department of Orthopedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio.

Corresponding Author: Joseph F. Clark, PhD, Department of Neurology and Rehabilitation Medicine, ML 0536, University of Cincinnati, Cincinnati, OH 45267-0536 (Joseph.clark@uc.edu).

Supported in part, by a donation from Geraldine Warner for the purchase of the Dynavision D2 systems.

The authors report no conflicts of interest.

Received March 30, 2016

Accepted June 28, 2016

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.