The Short Answer Educational content only. Any suspected concussion warrants medical evaluation. Consult neuro-optometrist, vestibular-trained physical therapist, or concussion specialist for individualized guidance. Saccadic dysfunction after concussion is impaired ability to make rapid, accurate eye movements between visual targets, affecting 50-70% of concussion patients (Silverberg et al., 2020). Saccades are the fastest movements in the human body reaching 700 degrees per second. Types of post-concussion saccadic dysfunction include hypometric saccades (undershoot target), hypermetric saccades (overshoot target), increased saccadic latency (slower initiation), and antisaccade impairment (difficulty looking away from target). Symptoms include reading difficulty, losing place in text, skipping words or lines, difficulty scanning, reduced reading speed, and headache with visual tasks. Diagnosis includes King-Devick test, Developmental Eye Movement (DEM) test, and video oculography. Treatment includes saccadic training exercises with Wayne saccadic fixator, Hart chart, and computer-based saccadic training. Saccadic dysfunction affects 50-70% of concussions. Affects 50-70% of concussions. Multiple saccadic dysfunction types possible. Multiple types possible. King-Devick test screens saccadic function. King-Devick screens. Normal Saccade Physiology Fastest movements in the body. Fastest movements in the body. Reach 700 degrees per second. Reach 700 degrees per second. Brainstem burst neurons generate saccades. Brainstem burst neurons generate saccades. Cerebellum ensures accuracy. Cerebellum ensures accuracy. Frontal eye fields initiate voluntary saccades. Frontal eye fields initiate voluntary. Parietal cortex directs attention. Parietal cortex directs attention. Superior colliculus coordinates. Superior colliculus coordinates. Types of Saccadic Dysfunction Hypometric saccades (undershoot). Hypometric saccades undershoot. Hypermetric saccades (overshoot). Hypermetric saccades overshoot. Increased saccadic latency. Increased saccadic latency. Antisaccade impairment. Antisaccade impairment. Saccadic intrusions during fixation. Saccadic intrusions during fixation. Reduced saccadic velocity. Reduced saccadic velocity. Increased error rate. Increased error rate. How Concussion Causes Saccadic Dysfunction Brainstem burst neuron injury. Brainstem burst neuron injury. Cerebellar injury reduces accuracy. Cerebellar injury reduces accuracy. Frontal eye field disruption. Frontal eye field disruption. Parietal cortex processing changes. Parietal cortex processing changes. Diffuse axonal injury affecting saccadic circuits. Diffuse axonal injury. Executive function impairment affects antisaccade. Executive function affects antisaccade. Symptoms of Saccadic Dysfunction Reading difficulty. Reading difficulty. Losing place in text. Losing place in text. Skipping words or lines. Skipping words or lines. Rereading same lines. Rereading same lines. Difficulty scanning. Difficulty scanning. Reduced reading speed. Reduced reading speed. Reduced reading comprehension. Reduced reading comprehension. Difficulty with sports requiring scanning. Difficulty with sports requiring scanning. Difficulty copying from board. Difficulty copying from board. Headache with reading. Headache with reading. Eye strain. Eye strain. Diagnostic Testing King-Devick test. King-Devick test. Developmental Eye Movement (DEM) test. Developmental Eye Movement DEM test. Visagraph reading assessment. Visagraph reading assessment. Video oculography. Video oculography. Anti-saccade task. Anti-saccade task. Memory-guided saccade task. Memory-guided saccade task. Prosaccade latency measurement. Prosaccade latency measurement. Neuro-optometric evaluation. Neuro-optometric evaluation. King-Devick Test Rapid number reading task. Rapid number reading task. Three test cards with numbers. Three test cards with numbers. Times to read each card. Times to read each card. Sideline concussion screening tool. Sideline concussion screening tool. Baseline comparison useful. Baseline comparison useful. Slower times suggest saccadic dysfunction. Slower times suggest saccadic dysfunction. Widely used in concussion assessment. Widely used in concussion assessment. Vision Therapy for Saccadic Dysfunction Wayne saccadic fixator. Wayne saccadic fixator. Hart chart saccadic exercises. Hart chart saccadic exercises. Chalkboard saccadic exercises. Chalkboard saccadic exercises. Ann Arbor saccadic tracking. Ann Arbor saccadic tracking. Computer-based saccadic training. Computer-based saccadic training. Antisaccade training. Antisaccade training. Reading rehabilitation. Reading rehabilitation. 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. Reading rehabilitation supports return-to-school. Reading rehabilitation supports return-to-school. Supporting Mobility Routine These exercises support saccadic 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. How is saccadic dysfunction different from smooth pursuit dysfunction? Saccadic dysfunction affects rapid eye movements between fixed targets. Smooth pursuit dysfunction affects tracking moving targets. Saccades used for scanning text and looking between objects. Smooth pursuit used for following moving objects. Different neural pathways. Different diagnostic tests. Different treatment approaches. Often coexist after concussion. What does the King-Devick test measure? King-Devick test measures rapid number reading speed reflecting saccadic function, attention, and language processing. Three test cards with progressively varied number spacing. Times to read each card. Slower times than baseline suggest saccadic dysfunction. Widely used in concussion sideline assessment. Baseline testing before season supports return-to-play decisions. How long does saccadic training take for post-concussion dysfunction? Saccadic training typically 8-16 weeks. Weekly office-based vision therapy sessions with daily home exercise program. Improvement often noticed within 4-6 weeks. Complete resolution 8-16 weeks. Complex dysfunction 16-24 weeks. Reading speed and comprehension improvement notable outcome. Home program essential. Can saccadic dysfunction resolve without vision therapy? Some mild saccadic dysfunction resolves spontaneously in first 4-6 weeks after concussion. Persistent saccadic dysfunction lasting beyond 4-6 weeks typically requires vision therapy for resolution. Untreated saccadic dysfunction contributes to persistent reading difficulty and academic challenges. Vision therapy improves function 70-85% of the time. Should students with saccadic dysfunction get school accommodations? Yes. Students with post-concussion saccadic dysfunction benefit from school accommodations including extended time on reading assignments and tests, audio versions of textbooks, reduced reading load, breaks from reading tasks, note-taker assistance, and vision therapy during school day when possible. 504 plan or IEP supports accommodations. Vision therapist letter documents need. 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