How the Oculomotor System Is Tested During a Concussion Exam in Kansas City

How the Oculomotor System Is Tested During a Concussion Exam in Kansas City

After a concussion, one of the most common — and most disruptive — symptoms patients report is visual discomfort. Blurred vision, eye strain, difficulty reading, and sensitivity to motion or screens are all signs of oculomotor dysfunction.

At our Kansas City injury clinic, Dr. Lance Stevenson, DC evaluates every concussion patient for oculomotor problems, especially those injured in car accidents around North Kansas City, Lee’s Summit, Liberty, and Overland Park. A thorough eye movement exam is essential for diagnosing the cause of symptoms and tailoring an effective rehab plan.

What Is the Oculomotor System?

Your oculomotor system controls how your eyes move, focus, and work together. It includes:

• Smooth pursuit (tracking moving objects)

• Saccades (quick, targeted eye movements)

• Vergence (both eyes moving inward together)

• Accommodation (focusing on near and far targets)

• Vestibulo-ocular reflex (VOR) (stabilizing your gaze during head motion)

Even small disruptions in this system after a concussion can cause big symptoms — especially when trying to read, drive, work on screens, or walk in visually busy environments.

How We Test the Oculomotor System After a Concussion

A standard eye chart is not enough. Our functional oculomotor evaluation includes:

1. Smooth Pursuits

We have the patient follow a slowly moving target with their eyes, looking for jerky or broken movements, which suggest poor tracking ability.

2. Saccades

We ask the patient to rapidly shift their gaze between two fixed points. Overshooting, undershooting, or delayed responses indicate oculomotor control issues.

3. Near Point of Convergence (NPC)

This measures how close a patient can bring a target toward their nose before seeing double or losing focus. A “normal” NPC is within 5 cm. Anything farther may point to convergence insufficiency, which affects reading and depth perception.

4. Vestibulo-Ocular Reflex (VOR) Testing

By moving the head while keeping the eyes fixed on a target, we can assess how well the eyes compensate for motion. Poor VOR can result in motion sensitivity and blurry vision during walking or driving.

5. Visual Motion Sensitivity

This evaluates how well a patient tolerates visual environments like scrolling screens, crowded stores, or moving traffic. Many post-concussion patients develop visual vertigo or anxiety triggered by motion.

6. Cover/Uncover and Cross-Cover Tests

These screen for subtle eye misalignments (phorias or tropias) that can cause visual fatigue, double vision, or balance problems — especially in dim light or when tired.

Symptoms Linked to Oculomotor Dysfunction

If your oculomotor system is not working properly after a concussion, you may experience:

• Headaches after screen use or reading

• Eye strain or fatigue

• Blurry or double vision

• Difficulty focusing on moving objects

• Light sensitivity

• Poor depth perception

• Feeling overwhelmed in visually complex environments

What Happens Next? Oculomotor Rehabilitation

If we identify oculomotor dysfunction in your post-concussion exam, your rehab plan may include:

• Eye tracking and convergence exercises

• Visual motion tolerance training

• Integration with vestibular and cervical spine rehab

• Modified work or school accommodations during recovery

• Gradual re-exposure to visual stimuli (screens, stores, traffic)

This multi-system approach is especially effective for students, professionals, and drivers across Kansas City, Parkville, Shawnee, and Independence who rely heavily on visual function.

Get the Right Concussion Testing in Kansas City

Don’t let eye strain, headaches, or visual fog keep you from healing. At our Kansas City clinic, Dr. Lance Stevenson, DC performs full concussion evaluations that include the cervical spine, vestibular, and oculomotor systems — because all three work together.

If you've been in a car accident or are still experiencing symptoms from a recent concussion, call 816-226-7476 today to schedule your consultation with Kansas City’s trusted concussion chiropractor.

Special thanks to Complete Concussions for their training and educational resources. To learn more about comprehensive concussion treatment options, visit completeconcussions.com.

Disclaimer:

This blog is for educational purposes only and is not intended to diagnose, treat, or replace medical advice. If you have experienced a concussion or other injury, please consult a qualified healthcare provider. Always follow the advice and treatment plan given by your medical professional.

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