Identification and Progression of Oculomotor Impairments in Acute Sport-Related Concussion

Sport-related concussion (SRC) can disrupt visual and oculomotor functions, yet many clinical assessments remain subjective and may miss subtle deficits, especially in the acute injury window. This dissertation examined whether SRC is associated with measurable impairments in eye movement control and visual perception, with particular attention to the first 48 hours after injury and the transition to clinical recovery. Across a series of studies, student-athletes with diagnosed acute SRC were compared with themselves once symptom free and healthy controls using objective eye-tracking and clinical measures of SRC. Novel oculomotor assessments with saccade and smooth pursuit trials assessed National Collegiate Athletic Association (NCAA) student-athletes, once while in acute SRC and once when the student-athlete was symptom-free. Each experiment chapter represents the progression of the analysis and the evolving stimulus, cumulating to incorporate radial and linear smooth pursuit pathways and horizontal and vertical saccades. Results showed that SRC-related oculomotor dysfunction was present, but not uniformly across all tasks or time points. In acute SRC, participants demonstrated altered saccadic performance, including changes in peak velocity, duration, amplitude, and latency, with some deficits persisting even after clinical symptom resolution. Smooth pursuit performance was more selective: group differences were limited for gain measures, but acute SRC was associated with increased catch-up saccades during radial pursuit and persisting vertical saccade measures. These trends remained altered when comparing symptom-free student-athletes with healthy controls. These findings suggest that SRC affects timing and coordination of eye movements more than producing a global reduction in visual performance. Overall, this dissertation supports the use of objective oculomotor assessment as a complement to standard SRC evaluation. The findings indicate that some eye movement metrics may be sensitive to acute injury and recovery, while others may reflect lingering dysfunction beyond symptom resolution. Future work should use larger sample sizes, baseline testing, and more ecologically valid tasks to determine which oculomotor measures are most clinically useful for diagnosis and return-to-play decisions.

Level thesis:degree_level

Doctorate Degree

Year dc:date.issued

2026

Author dc:creator

• Fenner, Madison

Advisor dc:contributor.advisor

• Murray, Nicholas G

Committee members dc:contributor.committeemember

• Berryhill, Marian E
• Jiang, Fang
• Mathew, Dennis
• Constantino, Nora

Language dc:language.iso

en_US, English

Repository record dc:identifier.uri

https://scholarwolf.unr.edu/handle/11714/11905

OAI identifier oai:identifier

oai:scholarwolf.unr.edu:11714/11905