The Influence of Binocular Vision Symptoms on Computerized Neurocognitive Testing of Adolescents With Concussion

Clin Pediatr (Phila). 2020 Jun 1;9922820927477. doi: 10.1177/0009922820927477. Online ahead of print.


Binocular vision disorders are commonly found postconcussion and associated with high symptom burden. We investigated the relationship between binocular vision symptoms and neurocognitive test performance. Thirty-four adolescents with concussion and 18 without concussion were assessed for cognitive performance using the CogState Brief Battery. Binocular vision disorders were determined using clinical examination and vision symptoms with the Convergence Insufficiency Symptoms Survey (CISS). A cutoff CISS score of 13 had high predictive accuracy for identifying individuals with a binocular vision disorder. CogState scores for processing speed and attention were significantly lower in the concussion group compared with the control group. Within the concussion group, scores for attention, learning, and working memory were significantly lower in those with vision symptoms. The presence of vision symptoms did not significantly affect CogState scores within the control group. The presence of vision symptoms in individuals with concussion is associated with significantly reduced scores on individual components of the CogState.

Keywords: binocular vision; cognitive performance; convergence insufficiency; sport-related concussion; sports medicine.