The Short Answer Educational content only. Any suspected concussion warrants medical evaluation. Consult vestibular-trained physical therapist, neuro-optometrist, or concussion specialist for individualized guidance. Oculomotor dysfunction after concussion involves impaired eye movement control including saccades, smooth pursuit, vergence, and gaze stability (Silverberg et al., 2020). Oculomotor dysfunction affects 50-90% of concussion patients making it one of the most common concussion-related visual problems. Symptoms include eye strain, reading difficulty, headache with visual tasks, screen intolerance, print blur, losing place while reading, and difficulty tracking moving objects. Diagnosis includes VOMS (Vestibular/Ocular Motor Screening), King-Devick test, developmental eye movement (DEM) test, and comprehensive neuro-optometric evaluation. Treatment includes vision therapy addressing specific oculomotor deficits, prism lenses, and behavioral optometry techniques. Oculomotor dysfunction affects 50-90% of concussions. Affects 50-90% of concussions. Multiple eye movement systems affected. Multiple eye movement systems affected. Vision therapy addresses specific deficits. Vision therapy addresses deficits. Eye Movement Systems Affected Saccades (fast eye movements). Saccades fast eye movements. Smooth pursuit (tracking). Smooth pursuit tracking. Vergence (convergence and divergence). Vergence convergence and divergence. Fixation (steady gaze). Fixation steady gaze. Vestibulo-ocular reflex (VOR). Vestibulo-ocular reflex VOR. Optokinetic reflex. Optokinetic reflex. Accommodative-vergence coupling. Accommodative-vergence coupling. Types of Oculomotor Dysfunction Saccadic dysfunction (50-70% of PCS). Saccadic dysfunction 50-70%. Smooth pursuit dysfunction (40-60%). Smooth pursuit dysfunction 40-60%. Convergence insufficiency (60-90%). Convergence insufficiency 60-90%. Accommodative dysfunction (40-60%). Accommodative dysfunction 40-60%. Fixation instability. Fixation instability. VOR dysfunction. VOR dysfunction. Antisaccade impairment. Antisaccade impairment. Saccadic Dysfunction Hypometric saccades (undershoot). Hypometric saccades undershoot. Hypermetric saccades (overshoot). Hypermetric saccades overshoot. Increased saccade latency. Increased saccade latency. Impaired antisaccade. Impaired antisaccade. Difficulty scanning text. Difficulty scanning text. Losing place while reading. Losing place while reading. Skipping words or lines. Skipping words or lines. Reduced reading speed. Reduced reading speed. Smooth Pursuit Dysfunction Reduced smooth pursuit gain. Reduced smooth pursuit gain. Saccadic intrusions during pursuit. Saccadic intrusions during pursuit. Difficulty tracking moving objects. Difficulty tracking moving objects. Difficulty following ball in sports. Difficulty following ball in sports. Motion sickness with tracking. Motion sickness with tracking. Difficulty watching scrolling text. Difficulty watching scrolling text. Symptoms of Oculomotor Dysfunction Eye strain (asthenopia). Eye strain asthenopia. Reading difficulty. Reading difficulty. Headache with visual tasks. Headache with visual tasks. Screen intolerance. Screen intolerance. Print blur. Print blur. Double vision. Double vision. Losing place while reading. Losing place while reading. Difficulty tracking moving objects. Difficulty tracking moving objects. Motion sickness with scrolling. Motion sickness with scrolling. Fatigue with reading. Fatigue with reading. Reduced reading speed. Reduced reading speed. Reduced reading comprehension. Reduced reading comprehension. Diagnostic Testing VOMS (Vestibular/Ocular Motor Screening). VOMS. King-Devick test. King-Devick test. Developmental eye movement (DEM) test. Developmental eye movement DEM test. Near point of convergence. Near point of convergence. Accommodative testing. Accommodative testing. Saccadic testing. Saccadic testing. Smooth pursuit testing. Smooth pursuit testing. Reading assessment. Reading assessment. Neuro-optometric evaluation. Neuro-optometric evaluation. Vision Therapy Approach Saccadic training (Wayne saccadic fixator). Saccadic training Wayne saccadic fixator. Smooth pursuit training. Smooth pursuit training. Convergence training (Brock string, vectograms). Convergence training Brock string vectograms. Accommodative training (flippers). Accommodative training flippers. Fixation training. Fixation training. Antisaccade training. Antisaccade training. Visual processing training. Visual processing training. Home exercise program. Home exercise program. Prognosis Improvement within 8-16 weeks. Improvement within 8-16 weeks. Vision therapy resolves 70-85%. Vision therapy resolves 70-85%. Home exercise program essential. Home exercise program essential. Combined with cervical treatment. Combined with cervical treatment. Screen management supports recovery. Screen management supports recovery. Supporting Mobility Routine These exercises support oculomotor rehabilitation through cervical mobility and nervous system regulation. JME 155 Diaphragmatic breathing supports vagal tone and parasympathetic regulation during concussion recovery. 10 breaths every 60-90 minutes. JME 14 Chin tucks reduce upper cervical tension common in concussion injury. 10 repetitions with 5-second holds. JME 1 Cervical rotation supports cerebral blood flow and nervous system regulation. 10 repetitions each direction. JME 150 Thoracic rotation restores breathing depth shallow during concussion recovery. 8 repetitions per direction. Start your 3-day free trial for joint-specific mobility programs that support nervous system regulation through concussion recovery. What is the difference between oculomotor dysfunction and refractive error? Oculomotor dysfunction involves eye movement control not visual clarity. Refractive error (nearsightedness, farsightedness, astigmatism) involves visual clarity correctable by glasses. Standard vision exam identifies refractive error but often misses oculomotor dysfunction. Neuro-optometric evaluation identifies oculomotor problems. Glasses do not fix oculomotor dysfunction requiring vision therapy. How do I know if I have oculomotor dysfunction after concussion? Symptoms of eye strain, reading difficulty, headache with visual tasks, screen intolerance, losing place while reading, and difficulty tracking moving objects suggest oculomotor dysfunction. VOMS testing at concussion evaluation can identify problems. Neuro-optometric evaluation confirms diagnosis with objective testing including saccadic testing, smooth pursuit testing, and near point of convergence measurement. Can oculomotor dysfunction resolve without treatment? Some mild oculomotor dysfunction resolves spontaneously in first 4-6 weeks after concussion. Persistent oculomotor dysfunction lasting beyond 4-6 weeks typically requires vision therapy for resolution. Untreated oculomotor dysfunction contributes to persistent symptoms including reading difficulty and screen intolerance. Vision therapy improves function 70-85% of the time. How long does vision therapy take for oculomotor dysfunction? Vision therapy for oculomotor dysfunction typically 8-16 weeks. Weekly office-based sessions with daily home exercise program. Improvement often noticed within 4-6 weeks. Complete resolution 8-16 weeks. Complex dysfunction 16-24 weeks. Home exercise program essential for progress. Not completing home program reduces effectiveness. Should I see a regular optometrist or neuro-optometrist for post-concussion oculomotor dysfunction? Neuro-optometrist with training in vision therapy for concussion. Standard optometrist provides vision exam and prescription glasses but often does not evaluate or treat oculomotor dysfunction. Look for Neuro-Optometric Rehabilitation Association (NORA) fellowship or College of Optometrists in Vision Development (COVD) certification. Vision therapy for concussion is specialized skill. References Patricios, J. S., et al. (2023). Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022. British Journal of Sports Medicine, 57(11), 695-711. PubMed Silverberg, N. D., et al. (2020). Management of concussion and mild traumatic brain injury: a synthesis of practice guidelines. Archives of Physical Medicine and Rehabilitation, 101(2), 382-393. PubMed