Two-Minute Sideline Test Could Be Best Way to ID Concussions

Concussions can cause short and long-term brain/vision issues-problems on young, developing brains. While most kids and teens with a concussion recover quickly and fully, some will have symptoms that last for weeks, or even months, and a more serious concussion can last longer.

Even a seemingly minor blow to the head of the developing brain can cause significant symptoms the most serious head injury for our youth are repeat concussions or the second injury that occurs before the brain recovers from the first—usually within a short period of time (hours, days, or weeks)—can slow recovery or increase the likelihood of having long-term problems. 

Contributing to the second injury problem is that most parents and few coaches understand the risk that repeat concussions hold for our young athletes. Up until recently a coach had to rely on observation and a few cognitive questions to assess the players likelihood of a concussion. This method misses more than half of all concussions. Adding to the problem of missed concussion is that players want to stay in the game, “playing at all costs” that contributes to keeping the injured player in the game.

Since greater than 55% of the brain is dedicated to vision, a head injury is usually associated with a high probability of visual consequences.

  • 90% of all concussions have some degree of visual motor impact


  • Traumatic brain injuries generally don’t affect acuity and the eye is not damaged. Most of the visual symptoms are related to ocular motor skills, focus, eye movement skills and fusion or eye teaming.


  • Eye movement skills are complex neurological skills that require multiple areas of the brain to function in order to make these precise eye movements. Each concussion or traumatic brain injury by its nature can impact different brain areas but there is a high probability it will affect eye movement skills.


  • Regardless of the type and severity of a concussion, the concussion often affects the oculomotor skills - vision and these ocular motor skills are highly predictive or sensitive to impact and recovery of normal brain function.


  • One of the biggest recent discoveries is that even minor concussions can have a profound impact on our visual performance skills.

The federal Centers for Disease Control and Prevention's "Heads-Up" campaign teaches signs of concussion — which may not appear right away — and what steps to take. Symptoms include confusion, double vision, appearing dazed or stunned, lack of coordination, mood or behavior changes, new difficulty in reading and even a brief loss of consciousness. Recent guidelines say anyone suspected of having a concussion should be taken out of play immediately and not allowed back until cleared by a trained professional.

We now have the knowledge and tools to identify the concussion a on the sideline.
Concussion Quick Facts

Recognizing that the second head injury puts the young athlete at greater risk for prolonged and profound effects of the concussion there has been emphasis by the sports medicine community to develop a side-line screening tool that accurately and quickly identifies individuals who have likely sustained a concussion. Until recently most sideline tests used a cognitive skills assessment. These highly reliable tests require that a trained health professional administer the tests and take 20-30 minutes to administer, which is not practical as a sideline screening.

Vision and concussion - why the strong association? (seeing the connection)

If you suspect your athlete has had a concussion where do you go?

King-Devick Test

Concussions from all sports can cause immediate and long-term brain/vision issues-problems that if not quickly identified and appropriately managed can have immediate and lingering affect all aspects of a students life.

  • 90+ of all concussions have strong ocular motor signs.

  • Concussions are generally “soft tissue” injuries, so MRI and imaging is not a valid test to identify most concussions.

  • Concussions can have a serious effect on young, developing brains, and can cause short- and long-term problems affecting how a child thinks, acts, learns, and feels.

  • It's not just football; concussions occur in a range of sports, from hockey and lacrosse to soccer and wrestling. Children and teens, with their still developing brains, appear at special risk.

Vision Issues for Young, Developing Brains

"The King-Devick Test is vastly superior as a sideline determinant of concussion in mixed martial arts fighters" - American Academy of Neurology 2014 Annual Meeting.

"Parents and coaches need to be prepared and educated about what the nature of this injury is," advised neuropsychologist Gerard Gioia of Children's National Medical Center in Washington and medical adviser to USA Football.

What You Should Know

While the Concussion Crisis in the NFL has grabbed most of the recent media attention and headlines - youth sports related concussions continue to be an epidemic medical issue for young athletes regardless of sport.

Tracy's Story

SAT, MAR 28, nbcnews.com
A simple test can be done after a head injury and is a reliable way to quickly diagnose a concussion.

Our goal is to quickly and accurately identify all potential concussions in Bend youth sports in order to reduce dramatically the number of repeat concussions which are potentially more harmful. To reach this goal every athlete in Central Oregon - from Park and Rec soccer, to our high school athletes should obtain a simple and quick baseline K-D screening and that each team have a team parent, coach, or representative who can administer the sideline test and assess the baseline results.

Fortunately, an oculomotor visual screening test from the field of Optometry has been validated and shown in a number of studies to quickly and accurately identify those individuals who have sustained a sports related concussion. In numerous studies this test known as the King-Devick (K-D) test accurately identified real-time symptomatic concussions in adolescents.

If child has definite signs of concussion go to Central Oregon Pediatric Associates (COPA) or Now Care at The Center to see a physician trained in concussion diagnosis and management.

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Integrated Eyecare of Bend, Oregon