Documenting Ocular Motor Skills

So you have done a great ocular motor assessment. Checked extra ocular movements, saccades, tracking and convergence. (Not sure how to do that? Check here.) How do you efficiently communicate the results to team members of the team?

NSUCO Norms

The eye doctors use a specific process and scoring procedure that results in a series of numbers that describes the accuracy of the eye movements. Called the NSUCO Norms, it provides a process for assessing and scoring saccades and tracking. The interpretation of these scores outside of the optometric community can be confusing though it does provide norms for head movement and accuracy by age. The norms are useful in helping the therapist decide if results are age appropriate but generally speaking, only eye doctors know what the series of numbers describes.

Documenting for the Multidisciplinary team

As therapists, we need a way to document eye movements that makes sense to other team members and parents.

Documenting Saccades

Documenting saccades should mention accuracy, head and body movement observed during the assessment

“Patient showed accurate saccades with age appropriate head movement during saccade assessment”

For poor performance “Patient showed undershoots on 4 of 5 trials with excessive head movement for a person of this age.”

Documenting Tracking/Pursuits

Documenting tracking is similar to saccades.

“Patient showed smooth tracking without lose of fixation and minimal head and body movement during tracking assessment.

For poor performance “Patient showed jerky tracking, with 6 loses of fixation and excessive head movement during tracking assessment.

Documenting Convergence

Be aware that convergence in a binocular task. Failure of one eye or the other to fully converge is not an indication of a problem with that eye, but instead is a problem of coordination of both eyes. This is observable when performing a cover test at near, as the therapist will observe both eyes demonstrating an exophoria.

While some docs mat document the “break” and “recovery” point, the break is all that is necessary. Documenting convergence would be as simple as “Patient demonstrates a near point of convergence of 2 cm”. Recall that a normal near point of convergence is less than 6 cm.

Want to learn more?

The The Childhood Vision Toolkit contains more information on how you can assess treat ocular motor problems