what is near point of convergence

Preliminary evidence for improvement in symptoms, cognitive, vestibular, and oculomotor outcomes following targeted intervention with chronic mTBI patients. Jump convergence - assessment of the convergence quality of fixation when moving quickly from distance to the near target. doi:10.1093/milmed/usx166, Cheever KM, McDevitt J, Tierney R, Wright WG. 2008;15(1):2436. Patients with visual deficits that go unidentified or unaddressed could have a prolonged recovery. document.write("

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"); Context: Convergence dysfunction following concussion is common. Epub 2022 Dec 30. Consensus statement on concussion in sportthe 5th international conference on concussion in sport held in Berlin, October 2016. PubMed ID: 25820456 doi:10.1007/s40279-015-0325-8, Kontos AP, Sufrinko A, Elbin RJ, Puskar A, Collins MW. Future research should continue to explore factors affecting convergence following concussion and include randomized, controlled studies to determine whether or not performing vision therapy improves visual measures to promote recovery following concussion. The QATQS resulted in 0strong, 9moderate, and 9weak articles (Table4). We depend on this skill for distance activities such as reading the board at school, driving and watching TV. Near point of convergence - SlideShare 2021 Jul 26;12:642457. doi: 10.3389/fneur.2021.642457. doi:10.1001/archopht.126.10.1336, Scheiman M, Mitchell GL, Cotter S, etal. Future studies should determine factors that affect whether or not individuals experience abnormal NPC following concussion. The VOMS uses a standardized approach to measure NPC; however, methods of screening for NPC are not standardized. Incidence of Remote Near-Point of Convergence in University Athletes After Sport-Related Concussion. PubMed ID: 24458963 doi:10.1682/JRRD.2012.12.0235, Accommodative and vergence dysfunctions in mTBI: treatment effects and systems correlations, Short-term persistence of oculomotor rehabilitative changes in mild traumatic brain injury (mTBI): a pilot study of clinical effects, . Generally, these impairments resolve over several weeks, as the brain recovers. Bethesda, MD 20894, Web Policies 2018;183(suppl 1):917. Convergence and Divergence - Vivid Vision If there were conflicts or disagreements about whether or not an article should be included, a meeting was held to obtain a consensus. Optom Vis Sci. Near point of convergence norms measured in elementary school - PubMed Brain Inj. Br J Sports Med. A normal NPC can be as little as 1 cm or even all the way to the nose. Evidence synthesis: NPC - Near Point of Convergence Flashcards | Quizlet PubMed ID: 24933717 doi:10.1682/JRRD.2013.01.0027, Assessment of study quality for systematic reviews: a comparison of the cochrane collaboration risk of bias tool and the effective public health practice project quality assessment tool: methodological research, . Near point of convergence after concussion in children. 1. assessment of the nearpoint of convergence (NPC) iswidely used by eye care practitioners in the routine primarycare examination1, 2and is often included as a test procedurefor vision screenings.3-7The NPC is also considered an importantdiagnostic finding in the assessment of convergence insufficien-cy.8 -13For example, Daum10reviewed 58 studies . PubMed ID: 13444415 doi:10.1016/0002-9394(57)90012-0, Cap-Aponte JE, Urosevich TG, Temme LA, Tarbett AK, Sanghera NK. Therefore, it has been suggested that clinicians should use vision or oculomotor assessments to aid in the diagnosis and treatment of concussion.7. Neurobehavioral concomitants of chronic post-concussion syndrome. 2012;49(9):13771398. Accommodative and vergence dysfunctions in mTBI: treatment effects and systems correlations. NPC values reported in the literature and in this systematic review vary greatly. PubMed ID: 24337463 doi:10.1007/s00167-013-2791-6, COACH CV: the seven clinical phenotypes of concussion, . 5. 2009;44(7):929936. PubMed ID: 28387693 doi:10.3233/VES-170607, In-office vision therapy for the treatment of post-concussion syndrome: is it beneficial? HHS Vulnerability Disclosure, Help PubMed ID: 17400136 doi:10.1016/j.optm.2006.11.011, Master CL, Scheiman M, Gallaway M, etal. In comparison, the preinjury values or control group values for NPC ranged from 1.6317 to 8.18cm32 and were considered normal in most of the studies. In-office vision therapy for the treatment of post-concussion syndrome: is it beneficial? 2014;22(2):235246. Study selection process. (2) In patients diagnosed with concussion, what is the effect of oculomotor/vision therapy on NPC break measurements? Evidence Acquisition: The search was conducted in CINAHL, SPORTDiscus, MEDLINE, and PubMed using terms related to concussion, mild traumatic brain injury, convergence, vision, and rehabilitation. 3. PubMed ID: 12539890, Storey EP, Master SR, Lockyer JE, Podolak OE, Grady MF, Master CL. Near point of convergence (NPC) is a quick and easy assessment that may detect oculomotor dysfunction such as convergence insufciency (CI), but NPC measurements are rarely reported. Carlson NB, Kurtz D, Heath DA. Near point of convergence (NPC) is a quick and easy assessment that may detect oculomotor dysfunction such as convergence insufficiency (CI), but NPC measurements are rarely reported. 2015;29(12):14751479. This article is about a measure of an individual's ability to see close (near) objects as clear and in focus. 2017;94(1):7488. In recent years, convergence insufficiency (CI) has been identified in patients following concussion. 2005;123(1):1424. A brief Vestibular/Ocular Motor Screening (VOMS) assessment to evaluate concussions: preliminary findings. PDF THE TESTS 1. NEAR POINT OF CONVERGENCE - Ray Gottlieb sharing sensitive information, make sure youre on a federal Copy this link, or click below to email it to a friend. Optom Vis Sci. An official website of the United States government. 2015;29(2):238248. Near Points of Convergence and Accommodation in a Population of 2014;2(6):280288. Near point of convergence - Gold Standard eye examination - 1Library All of the means of the control groups were considered normal (<5cm), except for in 2 of the studies, in which they were 8.18cm32 and 7.03cm.37, Summary of Studies Examining the Effect of Concussion on NPC. 2017;45(10):23882393. Four studies did not specify how long following injury the assessments were conducted. Currently, the recommendation is to use a multitude of assessments, including a clinical examination, symptoms, neurocognitive, and balance assessments.3 Several researchers and clinicians have suggested that instead of categorizing concussion as a single diagnosis, health care professionals may be able to identify specific clinical trajectories or subtypes of concussion.46 Proposed subtypes of concussion include cervical, cardiovascular, cognitive/fatigue, mood/affective, headache/migraine, vestibular, and visual/oculomotor.46 In order to identify these various trajectories, a comprehensive evaluation including assessments in several clinical domains must be used. PubMed ID: 14688547 doi:10.1097/00006324-200312000-00014, Borsting E, Rouse MW, Deland PN, etal. = Ophthalmic Physiol Opt. PubMed ID: 29635578 doi:10.1093/milmed/usx172, Thiagarajan P, Ciuffreda KJ. Near Point of Convergence Deficits and Treatment Following - PubMed Digital Trust World Conference: A Fabulous Convergence of - ISACA Nearpoint of convergence: test procedure, target selection, and All of the studies demonstrated improvements in NPC break measures following treatment. Matuseviciene etal35 demonstrated a significant improvement in the mTBI group between baseline and follow-up, but no statistically significant difference between or within the control groups. PubMed ID: 27505624 doi:10.1097/OPX.0000000000000935, Kontos AP, Collins MW, Holland CL, etal. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Literature considered for review included original research publications that collected measures of NPC break in concussion patients, with a pretest-posttest comparison or comparison with a healthy control group. Longitudinal changes in oculomotor function in young adults with mild traumatic brain injury in Sweden: an exploratory prospective observational study. PubMed ID: 20698919 doi: 10.1111/jep.2012.18.issue-1, Effectiveness of computerized oculomotor vision screening in a military population: pilot study, Validation of visual objective biomarkers for acute concussion, Concussion recovery phase affects vestibular and oculomotor symptom provocation, . Overall, we rated the quality of evidence regarding performance on NPC break in patients diagnosed with a concussion as moderate and the evidence regarding the effect of oculomotor or vision therapy on NPC break measurements as low using GRADE. These findings should be cautiously evaluated; the studies are limited by weak/moderate quality, small sample sizes, varied methodology, and nonrandomized treatment groups. Background: The purpose of this study was to help determine the most appropriate target to be used for the assessment of the nearpoint of convergence, normative data for the break and recovery in adults, and the diagnostic value of the red-glass modification and repetition of the nearpoint of convergence. PubMed ID: 28742610 doi:10.1097/JSM.0000000000000439, Raghuram A, Cotter S, Gowrisankaran S, etal. Identifying domains of impairment following concussion can lead to establishment of targeted active interventions. Date Published: 25 May 2023. The distribution of near point of convergence and its - PubMed 0:00 / 4:17 Near Point of Convergence Test: Diagnosing Convergence Insufficiency (CI) | Wow Vision Therapy Wow Vision Therapy 7.83K subscribers Subscribe 48K views 5 years ago. 2017;7(9):119. Arch Ophthalmol. While the sensitivity and specificity of NPC as a single measure in evaluating concussion is unclear, an NPC break of 5cm has a high rate (84%) of identifying concussions and an area under the curve of 0.73.7 McDevitt etal36 recently reported that a battery including signs and symptoms scores for 2 vision tests (optokinetic stimulation and gaze stabilization tests) and NPC was a sensitive model for discriminating concussed athletes from healthy controls (accuracy=94.4%). Convergence Insufficiency Symptoms and Treatment - Verywell Health PubMed ID: 27391530 doi:10.1097/OPX.0000000000000910, Halstead ME, Mcavoy K, Devore CD, Carl R, Lee M, Logan K. Returning to learning following a concussion. 4. Near point of convergence. Vergence - Wikipedia Vestibular and oculomotor assessments may increase accuracy of subacute concussion assessment. In patients diagnosed with concussion, what is the effect of oculomotor or vision therapy on NPC break measurements? belief convergence vanishes near point-mass beliefs. Validation of visual objective biomarkers for acute concussion. Vision profile of patients with mild brain injury. Near Point of Convergence Deficits and Treatment Following Concussion Additionally, the effect of age on NPC measures should be further established. While we were able to include 18 articles in this review, the majority of articles did not meet requirements for blinding. official website and that any information you provide is encrypted The measurement of NPC is an important criterion for diagnosis and management of convergence insufficiency. For example a normal eye would have a near point of Near point of convergence (NPC) - measurement of the point where the visual axes intersect under the maximum effort of the convergence. PubMed ID: 24284470 doi:10.3233/NRE-131025, Visual skills of athletes versus nonathletes: development of a sports vision testing battery, Objective assessment of vergence after treatment of concussion-related CI: a pilot study, . Sport Med. Study with Quizlet and memorize flashcards containing terms like refers to eye movements tested for by near point of convergence in which the two eyes move toward one another or away from one another, Which type of movement does NPC evaluate: conjugate or disjunctive?, Disjunctive eye movements, such as near point of convergence, are ____ eye movements. Near Point of Convergen ce Definition: Convergence Is the only disjunctive movement that is under conscious control. It was three days jam-packed with riveting keynotes, inspiring speakers and boisterous parties. Near point of convergence after a sport-related concussion. to save searches and organize your favorite content. Quality Appraisal of Included Studies According to the Quality Assessment Tool for Quantitative Studies. PubMed ID: 24933717 doi:10.1682/JRRD.2013.01.0027. Only the studies that reported means and SDs were included, as mean difference could otherwise not be calculated. Unauthorized use of these marks is strictly prohibited. The calculation can be further improved by taking into account the distance between the spectacle lens and the human eye, which is usually about 1.5cm: For example, if a person has NP = 1 m and the typical near point distance at their age is D = 25 cm, then the optical power needed is P = +3.24 diopters where one diopter is the reciprocal of one meter. The patient or participant sample (number, sex, age, and health status), study design, instrumentation, or intervention used, and main results were extracted from each article. Optom Vis Sci. Near Point of Convergence Test: Diagnosing Convergence - YouTube The treatment of CI is beneficial, with 85% of patients having a successful outcome.40 Treatment of accommodative insufficiency was only successful in 33% of patients, and treatment of saccadic dysfunction was successful in 83% of patients.40 Therefore, concurrent or underlying oculomotor dysfunctions associated with receded NPC may play a role in how a patient responds to therapy. These findings should be cautiously evaluated; the studies are limited by weak/moderate quality, small sample sizes, varied methodology, and nonrandomized treatment groups. It is suggested that a history of ocular motor dysfunction, such as nystagmus or strabismus may be risk factors for poor outcomes following concussion.5 Therefore, future studies should take these potential confounding variables into account when evaluating NPC postconcussion. Evidence acquisition: 2016;44(6):14001406. According to a new study, pot can offset the effects of . Objectives: The purpose of this article was to systematically review the literature and answer the following clinical questions: (1)Is performance on NPC negatively affected in patients diagnosed with a concussion compared with pre-injury levels or healthy controls? Am J Ophthalmol. J Rehabil Res Dev. All searches were conducted between February 15, 2019 and April 1, 2019. PubMed ID: 23341281 doi:10.1682/JRRD.2010.07.0129, Visual-vestibular processing deficits in mild traumatic brain injury, . Deficits in NPC can lead to vision- and oculomotor-related symptoms, such as blurred vision, headaches, difficulty in reading, eyestrain, sleepiness, and difficulty concentrating.45,46 Visual dysfunction following concussion is also associated with decreased reading speed and comprehension.22 Athletes with CI following a sport-related concussion have worse neurocognitive impairment and higher symptoms scores than concussion patients with normal NPC.16 Specifically, athletes with CI had lower scores on measures of verbal memory, visual motor speed, and reaction time.16 The symptoms and combination of visual and cognitive deficits caused by receded NPC can result in difficulty returning to school or working, especially when completing tasks that require reading and writing.47 Clinicians should monitor NPC throughout the recovery process. Howell DR, OBrien MJ, Raghuram A, Shah AS, Meehan WP. [2] From the thin lens formula, the required lens will have optical power P given by[3][4]. Optometry. PubMed ID: 26444405 doi:10.1055/s-00000071, Nearpoint of convergence: test procedure, target selection, and normative data, . PubMed ID: 28511593 doi:10.1177/0363546517705640, Thiagarajan P, Ciuffreda KJ, Cap-Aponte JE, Ludlam DP, Kapoor N. Oculomotor neurorehabilitation for reading in mild traumatic brain injury (mTBI): an integrative approach. 2015;35(5):599606. PubMed ID: 28446457 doi:10.1136/bjsports-2017-097699, Physiological, vestibulo-ocular and cervicogenic post-concussion disorders: an evidence-based classification system with directions for treatment, . J Neurol Phys Ther. J Vestib Res Equilib Orientat. eCollection 2021. Before 2017;94(1):96100. Physical Activity and Intermittent Postconcussion Symptoms After a Period of Symptom-Limited Physical and Cognitive Rest. Divergence is the opposite of convergence and is the ability to turn the two eyes outwards to look at a distant object. PubMed ID: 25106780 doi:10.1177/0363546514543775, Evaluation of research on effects of visual training on visual functions, . PubMed ID: 26980845 doi:10.1177/0363546516632754, Thiagarajan P, Ciuffreda KJ. 2017;51(11):877887. A case report, Vision therapy for post-concussion vision disorders, . PubMed ID: 24284470 doi:10.3233/NRE-131025, Christenson G, Winkelstein A. diopters Means and SDs for NPC break measurements were obtained if available. The length of reported interventions ranged from 9 to 20 hours over 6 to 12 weeks.24,27 In individuals diagnosed with CI who are otherwise healthy, oculomotor therapy administered over 12 weeks resulted in a normalization of scores.52 This may suggest that receded NPC in concussed patients may be due to a different mechanism than in an otherwise healthy population.27 However, the improvements in NPC following oculomotor therapy were still present 6 months following therapy in concussion patients.44 The persisting effect of oculomotor therapy suggests that mechanisms of neuroplasticity and motor relearning remain intact in concussion patients.44 There are a variety of treatments available for addressing impaired NPC, including both office- and home-based programs. J Rehabil Res Dev. PubMed ID: 29864101 doi:10.1097/NPT.0000000000000230. Cap-Aponte JE, Tarbett AK, Urosevich TG, Temme LA, Sanghera NK, Kalich ME. J Athl Train. A randomized clinical trial of treatments for convergence insufficiency in children. Abbreviations: BESS, Balance Error Scoring System; CISS, Convergence Insufficiency Symptom Survey; mTBI, mild traumatic brain injury; NCAA, National Collegiate Athletic Association; NPC, near point of convergence; mTBI, mild traumatic brain injury; VOMS, Vestibular/Ocular-Motor Screening. The patient population should be considered when determining the timing of referral. 1 PubMed ID: 27176886 doi:10.1055/s-0042-100470, Vergence in mild traumatic brain injury: a pilot study, . *Santo and Race are with the Department of Kinesiology, Towson University, Towson, MD. Points of convergence - The Free Dictionary Brain Inj. [1] [2] It is synkinesis which consists of the convergence of both eyes, contraction of the ciliary muscle resulting in a change of lens shape ( accommodation ), and pupillary constriction. The act, condition, quality, or fact of converging. Therefore, only articles published from database inception to April 1, 2019 were included in this review. and M.L.R.) What is the definition of sports-related concussion: a systematic review, . BMJ Open. PubMed ID: 20698919 doi: 10.1111/jep.2012.18.issue-1. Clin J Sport Med. Objectives: PubMed ID: 31004592 doi:10.1016/j.ajo.2019.04.008, Duprey KM, Webner D, Lyons A, Kucuk CH, Ellis JT, Cronholm PF. Study with Quizlet and memorize flashcards containing terms like What is convergence?, What 4 components is convergence driven by?, What is near point of convergence? Storey EP, Master SR, Lockyer JE, Podolak OE, Grady MF, Master CL. Focus on the Near Point of Convergence. gence the point to which the visual lines are directed when convergence is at its maximum. Thiagarajan P, Ciuffreda KJ. [ 11 ] An overall or global rating is assigned to the paper as follows: weak (2 or more weak ratings on first 6 components), moderate (one weak rating on first 6 components), or strong (no weak ratings on first 6 components). Convergence Insufficiency (CI) is characterized by a decreased ability to converge the eyes and maintain binocular fusion while focusing on a near target. Office-based treatments are typically administered by a vision therapist (O.D., M.D., orthoptists, or vision therapytrained technicians) and often includes the use of Brock Strings, Barrel Cards, Vectograms, and Life-Saver cards.26 Home-based therapy is often prescribed by optometrists and ophthalmologists, and it provides a cost-effect option.53 Home-based therapies typically include simple exercises, such as pencil push-ups and computer-based software. Methods: In this cross-sectional study, samples were randomly selected from the population of Mashhad city in the northeast of Iran through stratified cluster sampling. Clipboard, Search History, and several other advanced features are temporarily unavailable. PubMed ID: 16460567 doi:10.1186/1471-2377-6-7, Consensus statement on concussion in sportthe 5th international conference on concussion in sport held in Berlin, October 2016, . 2017 Jan;94(1):74-88. doi: 10.1097/OPX.0000000000000936. Purpose 2003;80(3):214225. This literature review discusses the effects of concussion on NPC and the efficacy of oculomotor and vision therapy in the treatment of CI following concussion. Norwalk, CT: Appleton & Lange; 1990. Trajectories of Visual and Vestibular Markers of Youth Concussion. Influence of target type and RAF rule on the measurement of near point of convergence. This systematic review is not without its limitations. Scores were agreed upon by 2 reviewers consistent with the instructions for the QATQS.28 Finally, we graded our recommendations using Grading of Recommendations, Assessment, Development and Evaluations (GRADE).30 The GRADE is a framework for summarizing evidence and providing clinical recommendations.30 An overall GRADE rating was applied to the outcome for each of our clinical questions. Additionally, future studies should focus on the best timeline for implementing visual rehabilitation.
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