Diagnosing and treating concussions with the dynamic visual acuity test

After a concussion, patients may experience
a wide spectrum of symptoms, such as blurred vision or dizziness with head movements as
well as difficulty reading and concentrating. One typical complaint we usually hear from
our patients is that they feel foggy or dizzy when breathing or when looking back and forth
between the board of their nose. One simple test we do here is called the Dynamic
Visual Acuity Test. We have a patient read an eye chart down to the lowest line possible
while still being able to read each letter in that line. We repeat the test while moving the patient’s
head, side to side, as they’re reading. If there’s a difference of two lines or more
between the static and the dynamic tests then we consider that test abnormal or positive
for a functional gaze instability. For a gaze stabilization exercise, we usually
give patients times when viewing. For this exercise, we give the patients a card with
a letter on it and have them put at arm’s distance away and ask the patient to move
their heads side to side, or up and down as quickly as they can, while still keeping the
letter clear or in focus. This exercise usually lasts between 30 seconds
and 2 minutes, depending on the patient’s tolerance.


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