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Vestibular/Ocular Motor Screening (VOMS) for Concussion
Availability
Please visit this website for more information about the instrument: Vestibular/Ocular Motor Screening Assessment.
Classification
Supplemental–Highly Recommended: Sport-Related Concussion (SRC) Subacute (after 72 hours to 3 months) for vestibular assessment (Note: VOMS includes oculomotor components)
 
Supplemental: Sport-Related Concussion (SRC) Persistent/Chronic (3 months and greater post concussion)
 
Exploratory: Sport-Related Concussion (SRC) Acute (time of injury until 72 hours)
Short Description of Instrument
The Vestibular/Ocular Motor Screening (VOMS) Assessment is a brief clinical screening tool that is used to identify patients with vestibular and ocular motor impairment following concussion via patient-reported symptom provocation following each assessment. Specifically, the VOMS measures 5 areas of the vestbular and ocular systems (1) smooth pursuit, (2) horizontal and vertical saccades, (3) convergence, (4) horizontal vestibular ocular reflex (VOR), and (5) visual motion sensitivity (VMS).
Scoring
Patients verbally rate changes in headache, dizziness, nausea and fogginess symptoms compared to their immediate pre-assessment state on a scale of 0 (none) to 10 (severe) following each VOMS assessment to determine if any domain provokes symptoms. Convergence is assessed by both symptom report and objective measurement of the near point of convergence (NPC). NPC values are averaged across 3 trials, and normal NPC values are within 5cm.  
 
Advantages: The VOMS requires limited equipment: 14 pt font NPC hand held fixation stick, metronome, and 1 page paper scoring form, and only takes approximately 5 minutes to administer and score. Clinical cut-off scores are available (2+ symptom provocation on any item, and 5+ cm on average NPC distance). Initialy evidence suggests the tool is good in identifying concussion and tracking recovery of vestibular/ocular motor domains.
 
Limitations: With the exception of the NPC distance measure, the VOMS focuses mostly on subjective symptom reporting.  
 
Sub-population: Has been validated with ages 11 to adult
References
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;42(10):2479–2486.
 
Kontos AP, Sufrinko AS, Elbin RJ, Puskar A, Collins MW. Reliability and associated risk factors for the vestibular/ocular motor screen tool in healthy collegiate athletes. Am J Sports Med. 2016;44(6):1400–1406.
 
Sufrinko AM, Mucha A, Covassin T, Marchetti G, Elbin RJ, Collins MW, Kontos AP. Sex differences in vestibular/ocular and neurocognitive outcomes after sport-related concussion. Clin J Sport Med. 2017;27(2):133–138.
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