A receded near point of convergence in patients with chronic concussion-related symptoms is not a diagnostic of convergence insufficiency, according to a study published in the American Journal of Ophthalmology.
“Our findings support prior observations that receded NPC [near point of convergence] is a common sequela in young patients after concussion and demonstrate that a receded NPC can persist for many months to even years after injury,” the authors wrote.
“However, our data illustrate that a receded NPC post-concussion is not synonymous with the diagnosis of convergence insufficiency,” they said.
Researchers conducted a retrospective review of data from patients diagnosed with concussions between August 2012 and January 2016. Eighty-three patients 21 years old and younger who had chronic concussion-related symptoms, normal visual acuity and received a complete sensorimotor evaluation were considered.
Of these 83 patients, 74 (89%) had receded NPC. Seventy patients with receded NPC (95%) also had an oculomotor disorder. Researchers found that 45% of patients with receded NPC had deficient near convergence ability, but only 36% were diagnosed with convergence insufficiency. Most patients with receded NPC also displayed an oculomotor disorder affecting accommodation, vergence or both (95%).
The authors concluded that receded NPC is associated with underlying oculomotor dysfunctions but cannot be considered diagnostic of convergence insufficiency. Data showed that some patients with receded NPC had only accommodative disorders or even convergence excess.
“Persistent symptomatic post-concussion patients with receded NPC should be referred to an eye care specialist for a comprehensive sensorimotor evaluation so that any underlying vergence or accommodative dysfunctions can be identified and the most appropriate treatment prescribed,” they wrote. – by Julia Lowndes
Disclosure: The authors report no relevant financial disclosures.