{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:16:27Z","timestamp":1791764187260,"version":"4.3.4"},"reference-count":143,"publisher":"SAGE Publications","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NRE"],"published-print":{"date-parts":[[2022,5,10]]},"abstract":"<jats:p>BACKGROUND: Individuals who have suffered a concussion\/mild traumatic brain injury (mTBI) frequently report symptoms associated with vestibular and\/or oculomotor dysfunction (VOD) like dizziness, nausea, fatigue, brain fog, headache, gait and neurocognitive impairments which are associated with the development of chronic symptoms. The Vestibular\/Ocular Motor Screening (VOMS) tool has been established as a reliable and clinically relevant complement to use alongside a battery of post-concussion tests to improve screening and referral for further evaluation and treatment of VOD. OBJECTIVES: This paper will review the pathoanatomy and symptomatology of common vestibular and oculomotor disorders after concussion, as well as the utility of the VOMS to assist in diagnosis, referral, and management. METHODS: Primary articles were identified using a search via PubMed, Google Scholar, OneSearch, and CINAHL. Search key terms were combinations of \u201cmild traumatic brain injury\u201d or \u201cconcussion\u201d or \u201cpursuit\u201d or \u201caccommodation\u201d or \u201cvergence\u201d or \u201cconvergence insufficiency\u201d or \u201csaccades\u201d or \u201cvestibulo-ocular reflex\u201d or \u201cvestibular ocular motor screen\u201d or \u201cvestibular rehabilitation\u201d, or \u201cvision rehabilitation\u201d including adult and pediatric populations that were published in print or electronically from 1989 to 2021 in English. Classic papers on anatomy of eye movements, vestibular system and pathological changes in mTBI were also included, regardless of publication date. RESULTS: Objective impairments are commonly found during testing of smooth pursuit, saccades, vergence, accommodation, vestibular ocular reflex, and visual motion sensitivity after mTBI. These deficits can be actively treated with vestibular physical therapy and oculomotor\/neuro-optometric vision therapy. VOMS is an efficient and reliable tool that can be used by all healthcare and rehabilitation providers to aid in diagnosis of post-concussion VOD, to help facilitate the decision to refer for further evaluation and treatment to expedite symptomatic post-concussion recovery. CONCLUSIONS: VOD is common after concussion in acute, post-acute, and chronic phases. Once areas of impairments are identified through proper assessment, clinicians can maximize recovery by referring to vestibular physical therapy and\/or neuro-optometry to design a targeted treatment program to address individual deficits.<\/jats:p>","DOI":"10.3233\/nre-228012","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T12:28:21Z","timestamp":1647606501000},"page":"279-296","source":"Crossref","is-referenced-by-count":22,"title":["Vestibulo-ocular dysfunction in mTBI: Utility of the VOMS for evaluation and management \u2013 A review"],"prefix":"10.1177","volume":"50","author":[{"given":"Cristen","family":"Kaae","sequence":"first","affiliation":[{"name":"Kaiser Permanente Medical Center, Vallejo, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Cadigan","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Medical Center, Vallejo, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Lai","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Medical Center, Oakland, CA, USA"},{"name":"Herbert Wertheim School of Optometry & Vision Science at the University of California, Berkeley, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Theis","sequence":"additional","affiliation":[{"name":"Herbert Wertheim School of Optometry & Vision Science at the University of California, Berkeley, CA, USA"},{"name":"Virginia Neuro-Optometry at Concussion Care Centre of Virginia, Richmond VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"issue":"9","key":"10.3233\/NRE-228012_ref1","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1080\/02699052.2017.1288928","article-title":"Vestibular consequences of mild traumatic brain injury and blast exposure: a review","volume":"31","author":"Akin,","year":"2017","journal-title":"Brain injury"},{"issue":"1","key":"10.3233\/NRE-228012_ref2","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1148\/radiol.14132670","article-title":"Detection of central white matter injury underlying vestibulopathy after mild traumatic brain injury","volume":"272","author":"Alhilali,","year":"2014","journal-title":"Radiology"},{"key":"10.3233\/NRE-228012_ref3","doi-asserted-by":"crossref","first-page":"83","DOI":"10.3389\/fneur.2012.00083","article-title":"Recovery of vestibular ocular reflex function and balance control after a unilateral peripheral vestibular deficit","volume":"3","author":"Allum","year":"2012","journal-title":"Frontiers in Neurology"},{"issue":"2","key":"10.3233\/NRE-228012_ref4","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/NPT.0b013e3181dde568","article-title":"Vestibular rehabilitation for dizziness and balance disorders after concussion","volume":"34","author":"Alsalaheen,","year":"2010","journal-title":"Journal of Neurologic Physical Therapy: JNPT"},{"issue":"2","key":"10.3233\/NRE-228012_ref5","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1002\/pri.1532","article-title":"Exercise prescription patterns in patients treated with vestibular rehabilitation after concussion","volume":"18","author":"Alsalaheen,","year":"2013","journal-title":"Physiotherapy Research International: The Journal for Researchers and Clinicians in Physical Therapy"},{"issue":"4","key":"10.3233\/NRE-228012_ref6","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/PEP.0000000000000729","article-title":"Changes in Vestibular\/Ocular-Motor Screen Scores in Adolescents Treated With Vestibular Therapy After Concussion","volume":"32","author":"Alsalaheen,","year":"2020","journal-title":"Pediatric Physical Therapy: The Official Publication of the Section on Pediatrics of the American Physical Therapy Association"},{"issue":"12","key":"10.3233\/NRE-228012_ref7","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1097\/OPX.0b013e3182772dce","article-title":"Concurrent vision dysfunctions in convergence insufficiency with traumatic brain injury","volume":"89","author":"Alvarez,","year":"2012","journal-title":"Optometry and vision science: official publication of the American Academy of Optometry"},{"key":"10.3233\/NRE-228012_ref8","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.visres.2021.03.014","article-title":"Disparity vergence differences between typically occurring and concussion-related convergence insufficiency pediatric patients","volume":"185","author":"Alvarez,","year":"2021","journal-title":"Vision Research"},{"key":"10.3233\/NRE-228012_ref9","unstructured":"Anderson, M.N. , Elbin, R.J. , Anderson, M.N. , Dobbs, E.M. , & Schatz, P. 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