Athlete eye-balance screens may move beyond concussion rehab

David Bartlett and four co-authors argued in a British Journal of Sports Medicine editorial published Oct. 9 that concussion eye-and-balance screening could be adapted for athlete performance work.

Evidence grade: Claim (no study cited). The proposal matters because the modified Vestibular Ocular Motor Screen, or mVOMS, is already part of Sport Concussion Office Assessment Tool 6, while its use beyond concussion assessment remains unproven.

From symptom screen to skill profile

The authors frame the shift as a way to move sports medicine beyond restoring athletes to their pre-injury level. They said coordination between vision, balance, proprioception, which is the body’s sense of position, and motor response is relevant to both performance and injury prevention.

Vestibular-ocular motor assessments are used in sport-related concussion management to find impairment, follow recovery and inform return-to-play decisions, according to the editorial. The authors link that clinical use to post-concussion problems including unstable gaze, visual motion intolerance and impaired eye-head coordination.

“The aim of this editorial is to discuss how assessments used in the management of concussion could also be used to optimise sports performance,” the authors wrote in the British Journal of Sports Medicine editorial.

The mVOMS includes symptom-provoking tasks for smooth pursuit eye movements, rapid eye shifts known as saccades, and the vestibulo-ocular reflex, the mechanism that helps keep vision stable during head movement, the authors said. It is used to provoke symptoms to support concussion diagnosis, not to decide return to play or measure sporting skill.

Bartlett and his co-authors argue that the same domains could be viewed as trainable capacities. They point to smooth pursuit, saccades, the vestibulo-ocular reflex and near point convergence as functions that may matter in sport-specific visual control.

The editorial also cites the “Quiet Eye” concept, described as a longer period of visual attention before a precise action, as an example of why gaze control may matter in tasks such as golf putting or basketball free throws. The source text does not provide study size, duration, effect size, confidence intervals, funders or conflicts for that evidence.

Where the evidence stops

The authors said elite athletes perform above population norms in dynamic visual acuity and gaze-stabilisation tasks, and that sport-specific vestibulo-ocular reflex adaptations have been documented. Those statements are presented in the editorial as supporting background, not as proof that adding mVOMS-style drills raises performance.

The proposal applies to athletes across levels and ages, according to the authors, including amateur and professional competitors. It does not directly apply to non-athletes, and the editorial does not test a training programme in injured or healthy participants.

The editorial cannot show that vestibular-ocular drills improve match results, reduce injuries or shorten rehabilitation. It is not a randomized controlled trial, prospective cohort study or systematic review, and it gives no absolute performance gains, risk reductions or confidence intervals.

The authors also connect eye movement with neck function. They said concussion can involve both oculomotor and cervical dysfunction, and that rehabilitation often combines neck range and stability work with gaze-stability tasks.

One example is the smooth pursuit neck torsion test, which the editorial says can help identify cervical sensorimotor contributions to oculomotor function. In plain terms, the test is meant to examine whether neck position affects eye-movement control.

The authors argue that future performance work should not isolate gaze stability from the demands of a sport. They cite cricket as an example, saying elite cricketers show faster visual reaction times linked to gaze control and anti-saccades, which are eye movements that suppress a reflexive look toward a distraction.

For readers, the practical meaning is limited. The article supports a research and clinical question: whether tools used after concussion can be measured objectively, tailored to a sport and tested as part of training or late-stage rehabilitation.

The next step described by the authors is not a dated trial or guideline vote, but a call for clinicians to profile vestibular-oculomotor function and build individualized drills that include smooth pursuits, saccades, gaze stability, sport-specific context, decision-making and fatigue. No dated catalyst was supplied.

Source: editorial, British Journal of Sports Medicine, Oct. 9, 2026.

Atlas360 reports health research and does not provide medical advice.