{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:08:57Z","timestamp":1789042137673,"version":"build-2803163510"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Child Neurol"],"abstract":"<jats:p>Perinatal brain trauma, including hypoxic-ischemic encephalopathy and mechanical injury during pregnancy, labor, or delivery, represents an early-acquired brain injury that disrupts the identical subcortical, brainstem, cerebellar, and emerging cortical visual, oculomotor, and vestibulo-ocular pathways commonly impaired in mild traumatic brain injury (mTBI) or concussion. This topical review examines five key neonatal reflexes: optomotor (optokinetic nystagmus [OKN], head-turning, fix-and-follow), oculomotor (reflexive saccades, doll's eye), vestibulo-ocular (VOR), pupillary light (PLR including relative afferent pupillary defect and alpha-omega pupil), and protective blink reflexes, as rapid, non-invasive biomarkers of pathway integrity in newborns. These hardwired reflexes, robust at birth but cortically refined by 3-6 months, are highly vulnerable to perinatal trauma; their absence, asymmetry, or failure to mature signals risk for cortical visual impairment and gaze instability that mirror post-concussion symptoms. We highlight syndromic red-flag clusters, behavioral state considerations for testing, and immediate infant-adapted visual rehabilitation strategies (fixation\/pursuit training, OKN stimulation, vestibular exercises) during the critical 0- to 6-month sensitive period. By linking neonatal reflex assessment to mTBI rehabilitation frameworks, this review supports proactive, life span\u2013oriented intervention in pediatric neurology and neuro-optometry\/ophthalmology.<\/jats:p>","DOI":"10.1177\/08830738261480397","type":"journal-article","created":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T07:13:56Z","timestamp":1788678836000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Neonatal Oculomotor, Optomotor, Vestibulo-ocular, Protective Blink, and Pupillary Light Reflexes Following Perinatal Brain Trauma: Implications for Early Visual Rehabilitation in Mild Traumatic Brain Injury and Concussion"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8753-2633","authenticated-orcid":false,"given":"Tamara","family":"Petrosyan","sequence":"first","affiliation":[{"name":"Primary Care, Pediatrics, and Vision Rehabilitation Departments, State University of New York College of Optometry"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suelen Abril","family":"Cruz","sequence":"additional","affiliation":[{"name":"Estereoptik, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,6]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-3782(97)00088-1"},{"issue":"11","key":"e_1_3_3_3_2","first-page":"2183","article-title":"First glances: the vision of infants","volume":"38","author":"Teller DY","year":"1997","unstructured":"Teller DY. First glances: the vision of infants. Invest Ophthalmol Vis Sci. 1997;38(11):2183-2203.","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.visres.2011.02.018"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0039-6257(94)90073-6"},{"key":"e_1_3_3_6_2","volume-title":"Neurology of the Newborn","author":"Volpe JJ","year":"2019","unstructured":"Volpe JJ. Neurology of the Newborn. 6th ed. Elsevier; 2019."},{"key":"e_1_3_3_7_2","first-page":"343","article-title":"The optokinetic response in primates and its possible neuronal substrate","volume":"5","author":"Fuchs AF","year":"1993","unstructured":"Fuchs AF, Mustari MJ. The optokinetic response in primates and its possible neuronal substrate. Rev Oculomot Res. 1993;5:343-369.","journal-title":"Rev Oculomot Res"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1159\/000100350"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2023.11.002"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.1907026"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000000579"},{"key":"e_1_3_3_12_2","first-page":"1","volume-title":"The Pupil: Anatomy, Physiology, and Clinical Applications","author":"Bremner F","year":"1999","unstructured":"Bremner F. The pupil. In: Bremner F, ed. The Pupil: Anatomy, Physiology, and Clinical Applications. Butterworth-Heinemann; 1999:1-34."},{"key":"e_1_3_3_13_2","volume-title":"Neuro-ophthalmology: Diagnosis and Management","author":"Mitchell PR","year":"2012","unstructured":"Mitchell PR. Neuro-ophthalmology: Diagnosis and Management. 2nd ed. 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