VOMS may help detect concussions in more patients, especially athletes.
VOMS may help detect concussions in more patients, especially athletes. Click image to enlarge.

“Concussions are a type of mild traumatic brain injury, a growing public health concern for both military and civilian sectors,” Lyndsey Ferris, OD, explained. “They are common, and you’re going to see these patients in your community.” For this reason, Dr. Ferris recently investigated the clinical significance and diagnostic ability of preseason and acute (48 hours or less) post-injury scores with a sport-related concussion assessment—vestibular oculomotor screening (VOMS). This evaluation is often used in combination with the sport concussion assessment tool (SCAT) and may be a more efficient way to identify acute concussion.

“The emerging clinical assessment tool VOMS has shown high diagnostic accuracy for identifying acute concussions,” Dr. Ferris said. “It consists of four oculomotor taps and three vestibular taps, and it’s primarily functioned by accessing patients’ symptoms after conducting these tests.”

The study showed that every VOMS component helps in identifying concussed athletes and can be a useful addition to SCAT. It also found that reducing screening to four parts shortens administration time while maintaining high predictive utility even in the case of an acute concussion.

“VOMS demonstrated high accuracy on its own and also when added to existing domains such as SCAT,” Dr. Ferris said. “In contrast to more moderate or severe forms of traumatic brain injury or mild traumatic brain hemorrhage, concussions lack objective biomarkers. If you were to place these individuals in an MRI or CT scan, the brain would look fine. That’s why it’s so important to start accessing symptoms surrounding these entries. We don’t have the objective biomarkers, so we look for what we can see and what we can access—those are the symptoms.”

“You could cut this tool in half in any direction, and it would perform just as well as the full version,” Dr. Ferry continued. “What does this mean for clinicians? When you are conducting VOMS and are short on time, you can reduce the test in half without sacrificing clinical utility. All clinicians should consider incorporating this screening procedure into their concussion toolkit.”

Ferris L, Anthony K, Eagle S, et al. Utility of VOMS, SCAT, and ImPACT baselines for acute concussion identification in collegiate athletes: findings from the NCAA-DoD CARE Consortium. AAO Meeting 2021.