@article {1435413,
	title = {Post-Concussion: Receded Near Point of Convergence is Not Diagnostic of Convergence Insufficiency},
	journal = {Am J Ophthalmol},
	year = {2019},
	month = {2019 Apr 17},
	abstract = {PURPOSE: To determine the frequency of receded near point of convergence (NPC) in patients with chronic concussion-related symptoms, and among those with receded NPC to enumerate the frequency of convergence insufficiency and other oculomotor disorders. STUDY: Design: Retrospective cross-sectional study METHODS: Clinic charts were retrospectively reviewed for the prior 3.5 years to identify all patients \&lt;21 years old who were \&gt;28 days post-concussion, had chronic concussion-related symptoms, had normal visual acuity, and received a comprehensive sensorimotor examination. The frequency of receded NPC and oculomotor diagnoses were determined. RESULTS: Of the 83 eligible patients, 74 (89\%) had receded NPC. Of these, 70 (95\%) had oculomotor disorders; 30 (41\%) had disorders of accommodation only, 21 (28\%) had convergence insufficiency and accommodation deficits, and 6 (8\%) had convergence insufficiency only. Six (8\%) had a convergence deficit other than convergence insufficiency (all with concurrent accommodative disorders), 4 (5\%) had both a non-specific vergence dysfunction and accommodation deficits, 2 (3\%) had convergence excess only, and 1 (1\%) had both convergence excess and accommodative deficits. CONCLUSION: A receded NPC was present in the majority of young patients with chronic post-concussion symptoms. Associated with numerous underlying oculomotor dysfunctions, the clinical finding of a receded NPC is not synonymous with the diagnosis of convergence insufficiency. Because treatment options for the various oculomotor dysfunctions differ, it is prudent that these patients undergo a thorough examination of their vergence and accommodative systems so that an accurate diagnosis can be made and appropriate treatment prescribed.},
	issn = {1879-1891},
	doi = {10.1016/j.ajo.2019.04.008},
	author = {Raghuram, Aparna and Cotter, Susan and Gowrisankaran, Sowjanya and Kanji, Jameel and Howell, David R and Meehan, William P and Shah, Ankoor S}
}
