Clinical patterns of ocular motor and vestibular impairments in professional athletes after sport-related concussion (SRC) and diagnostic challenges: a narrative review
DOI:
https://doi.org/10.12775/QS.2026.56.71978Keywords
sport-related concussion, ocular motor impairment, vestibular impairment, objective diagnostics, diagnostic toolsAbstract
Background. Sport-related concussions (SRC) are complex injuries often involving ocular motor and vestibular impairments. While standardized acute tools, such as the SCAT6, are essential for initial evaluation, they lack clinical sensitivity after the first 72 hours. Furthermore, subacute subjective clinical screening is heavily limited by elite athletes frequently minimizing or concealing symptoms.
Aim. The aim of this narrative review is to summarize the existing literature on the clinical patterns of ocular motor and vestibular impairments in professional athletes following SRC, and to highlight the critical need for an objective, multimodal diagnostic approach.
Material and methods. A comprehensive literature review was conducted using PubMed and ScienceDirect,incorporating recent clinical studies, international consensus statements, and literature reviews published between 2014 and 2025. The analysis focused on the limitations of traditional subjective symptom reporting and evaluated the clinical utility of objective technological instruments in assessing ocular motor and vestibular impairments in SRC management.
Results. The problem with standard concussion tests is that they rely on athletes telling the truth about their symptoms - which they often don't. Technologies like the vHIT and iVOMS get around this issue completely by providing raw, computer-recorded metrics. Because a player has absolutely no conscious control over these automatic physical responses, these tests are a much more reliable way to detect deficits.
Conclusions. The management of SRC in professional athletes requires a transition from subjective evaluations to targeted, objective diagnostics. Adding objective technologies to standard clinical screening provides an accurate, data-driven way to track brain recovery. This solves the issue of subjective symptom reporting and ensures proper recovery.
References
[1] Collins MW, Kontos AP, Okonkwo DO, et al. Statements of Agreement From the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015. Neurosurgery. 2016 Dec;79(6):912-929. doi: 10.1227/NEU.0000000000001447.
[2] Weike L, Reeschke R, Reinsberger C. Clinical symptom clusters, neurocognitive function, balance and vestibulo-ocular function in athletes with sport-related concussion. BMJ Open Sport Exerc Med. 2025 Jul 31;11(3):e002447. doi: 10.1136/bmjsem-2024-002447.
[3] Kontos AP, Deitrick JM, Collins MW, Mucha A. Review of Vestibular and Oculomotor Screening and Concussion Rehabilitation. J Athl Train. 2017 Mar;52(3):256-261. doi: 10.4085/1062-6050-51.11.05.
[4] Elbin RJ, Sufrinko A, Anderson MN, Mohler S, Schatz P, Covassin T, Mucha A, Collins MW, Kontos AP. Prospective Changes in Vestibular and Ocular Motor Impairment After Concussion. J Neurol Phys Ther. 2018 Jul;42(3):142-148. doi: 10.1097/NPT.0000000000000230.
[5] Echemendia RJ, et al. Sport Concussion Assessment Tool 6 (SCAT6). British Journal of Sports Medicine Vol 57 No 11. doi: https://doi.org/10.1136/bjsports-2023-107036.
[6] Patricios JS, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. Br J Sports Med. 2023 Jun;57(11):695-711. doi: 10.1136/bjsports-2023-106898
[7] Mucha A, Collins MW, Elbin RJ, Furman JM, Troutman-Enseki C, DeWolf RM, Marchetti G, Kontos AP. A Brief Vestibular/Ocular Motor Screening (VOMS) assessment to evaluate concussions: preliminary findings. Am J Sports Med. 2014 Oct;42(10):2479-86. doi: 10.1177/0363546514543775.
[8] Walshe A, Daly E, Ryan L. Clinical Utility of Ocular Assessments in Sport-Related Concussion: A Scoping Review. J Funct Morphol Kinesiol. 2024 Sep 4;9(3):157. doi: 10.3390/jfmk9030157
[9] Graham L, Powell D, Campbell KR, Morris R, Vitorio R, Parrington L, Antonellis P, Godfrey A, King LA, Stuart S. iVOMS: Instrumented Vestibular / Ocular motor screen in healthy controls and mild traumatic brain injury. Med Eng Phys. 2024 Jul;129:104180. doi: 10.1016/j.medengphy.2024.104180
[10] Svenstrup M, Hougaard DD. Do high-risk head trauma sports athletes have impaired vestibular function? Am J Otolaryngol. 2024 Nov-Dec;45(6):104429. doi: 10.1016/j.amjoto.2024.104429.
[11] Kelly KM, Kiderman A, Akhavan S, et al. Oculomotor, Vestibular, and Reaction Time Effects of Sports-Related Concussion: Video-Oculography in Assessing Sports-Related Concussion. J Head Trauma Rehabil. 2019 May/Jun;34(3):176-188. doi: 10.1097/HTR.0000000000000437
[12] Symons GF, Clough M, Mutimer S, et al. Cognitive ocular motor deficits and white matter damage chronically after sports-related concussion. Brain Commun. 2021 Sep 14;3(3):fcab213. doi: 10.1093/braincomms/fcab213
[13] Alkathiry AA, Kontos AP, Furman JM, Whitney SL, Anson ER, Sparto PJ. Vestibulo-Ocular Reflex Function in Adolescents With Sport-Related Concussion: Preliminary Results. Sports Health. 2019 Nov/Dec;11(6):479-485. doi: 10.1177/1941738119865262
[14] Glaser J, Jaeckle S, Beblo T, Mueller G, Eidenmueller AM, Schulz P, Schmehl I, Rogge W, Hollander K, Toepper M, Gonschorek AS. The effect of repeated concussions on clinical and neurocognitive symptom severity in different contact sports. Scand J Med Sci Sports. 2024 Apr;34(4):e14626. doi: 10.1111/sms.14626.
[15] Romeu-Mejia R, Giza CC, Goldman JT. Concussion Pathophysiology and Injury Biomechanics. Curr Rev Musculoskelet Med. 2019 Jun;12(2):105-116. doi: 10.1007/s12178-019-09536-8.
[16] Rowson S, Bland ML, Campolettano ET, Press JN, Rowson B, Smith JA, Sproule DW, Tyson AM, Duma SM. Biomechanical Perspectives on Concussion in Sport. Sports Med Arthrosc Rev. 2016 Sep;24(3):100-7. doi: 10.1097/JSA.0000000000000121.
[17] Tierney G. Concussion biomechanics, head acceleration exposure and brain injury criteria in sport: a review. Sports Biomech. 2024 Nov;23(11):1888-1916. doi: 10.1080/14763141.2021.2016929
[18] Corwin DJ, Wiebe DJ, Zonfrillo MR, Grady MF, Robinson RL, Goodman AM, Master CL. Vestibular Deficits following Youth Concussion. J Pediatr. 2015 May;166(5):1221-5. doi: 10.1016/j.jpeds.2015.01.039.
[19] Brown DA, Leung FT, Evans K, Grant G, Hides JA. Vestibular and oculomotor function in male combat sport athletes. J Sci Med Sport. 2022 Jun;25(6):524-528. doi: 10.1016/j.jsams.2022.02.004
[20] Womble MN, McAllister-Deitrick J, Marchetti GF, Reynolds E, Collins MW, Elbin RJ, Kontos AP. Risk Factors for Vestibular and Oculomotor Outcomes After Sport-Related Concussion. Clin J Sport Med. 2021 Jul 1;31(4):e193-e199. doi: 10.1097/JSM.0000000000000761.
[21] Bliss RA, Carr WD. KNOWLEDGE OF VESTIBULAR OCULAR DYSFUNCTION AND UTILIZATION OF VESTIBULAR OCULAR MOTOR SCREENING (VOMS) TOOL COMPONENTS AMONG PROFESSIONAL SPORTS LEAGUE ATHLETIC TRAINERS. Int J Sports Phys Ther. 2020 Aug;15(4):603-610. PMID: 33354393; PMCID: PMC7735692.
[22] Balaban C, Hoffer ME, Szczupak M, Snapp H, Crawford J, Murphy S, Marshall K, Pelusso C, Knowles S, Kiderman A. Oculomotor, Vestibular, and Reaction Time Tests in Mild Traumatic Brain Injury. PLoS One. 2016 Sep 21;11(9):e0162168. doi: 10.1371/journal.pone.0162168.
[23] Shamim AS, Warner E, Mendis MD, Hides JA, Rahmann A, Leung FT. The relationship between vestibulo-ocular function and sports injuries in adolescent rugby union players. Musculoskelet Sci Pract. 2025 Aug;78:103361. doi: 10.1016/j.msksp.2025.103361.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Kinga Zofia Papciak, Urszula Zofia Jabłońska, Michał Radliński, Aleksandra Gardzielik, Michał Głaszczka, Karolina Korowaj, Maciej Piotr Dercz, Alicja Fitas, Jakub Paweł Palacz, Klaudia Woźniak
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 85
Number of citations: 0
