Anna Wan, MSN, RN, FNP-C

All Publications

• Long-term test and retest reliability of clinical vergence testing. Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) Scheiman, M., Raghuram, A., Master, C., Robich, M. L., Toole, A., Shelton, E. R., Srinivasan, G., Marusic, S., Meiyeppen, S., Jordan, L. A., Roberts, T. L., EPICC Study Group, Roberts, T. L., Jordan, L. A., Dalton, K. N., Grant, G. A., Liao, Y. J., Porter, J., Purcell, L. K., Scheiman, M., Swanson, M. A., Viswanathan, S., Jordan, L. A., Sinnott, L. T., Robich, M. L., Shaw, K. J., Myers, J. A., Choi, S. S., Porter, J., Patel, N., Koutures, C., Platt, J., Raghuram, A., O'Brien, M., Vyas, N., Wiecek, E., Marusic, S., Ghosh, D., Wu, C., Master, C., Calandra, L., Easby, K., Mozel, A., Podolak, O., Rownd, K., Godfrey, M., McGinnis, I., Ford, C., Stenger, K., Pollock, K., Housel, K., Chen, A., Han, S., Huang, K., Parker, S. M., Youngerman, J., Bansal, S., Breau, N., Wu, J., Burgher, A., Law, C. L., Posey, A., Sayani, A., Issac, L., Bennett, R., Green, K., Riaz, A., Scheiman, M., Meiyeppen, S., Roberts, T., Grant, G., Kraus, E., Beres, S., Moss, H., Wan, A., Slinger, K., Leonen, J., Hu, A., Srinivasan, G., Baah, C., Grieb, E. M., Lew, C., Vandiver, T., Clewes, K., Bansal, S., Lumba-Brown, A., Balaji, A., Viswanathan, S., Modica, P. A., Pothiadia-Irungovel, A. B., Vaughn, M., McDaniel, C., Morrison, A., Widmer, D., Buckland, M., Shelton, E., Toole, A. J., Stevens, N., Swanson, M. W., Gould, S., Montejo, J., Ferrill, L., Swanson-Kimani, E., Weise, K. K., Cardona, Z., Dalton, K. N., Purcell, L. K., Labreche, T., Shalhoub, J., Abuleil, D. 2025

  Abstract

  PURPOSE: To establish long-term reliability measures for vergence testing in a control population of adolescents.METHODS: Healthy participants between 12 and 17.5years with normal binocular vision were recruited from 10 clinical sites. Cover test, near point of convergence (NPC), positive and negative fusional vergences, vergence facility (12∆ base-out/3∆ base-in) and vergence jumps (using the Oculomotor Assessment Tool) were performed at the initial visit and repeated at 90days. The mean and standard deviation were calculated for the overall group for NPC, vergence facility and vergence jumps and by prism dioptre step value for PFV and NFV (1Delta or 2Delta if below 20∆ or 5Delta above 20∆). Agreement was assessed using Bland-Altman plots and 95% limits of agreement (LOA).RESULTS: Ninety-three participants (mean age 14.3±1.7years, 52% female) were enrolled and 91 (98%) completed the initial and 90-day outcome evaluation. The mean differences were significantly greater than zero for vergence facility (p<0.05) and the first and second 30s of vergence jumps (p<0.01). The 95% LOA were narrow for NPC (±2.5) and negative fusional vergence (±5.9), suggesting good repeatability. LOA were larger for positive fusional vergence (±17.8), vergence facility (±9.8) and vergence jumps (±16.2). Analysis of the positive fusional vergence data indicates that the different step sizes (1∆ or 2∆ vs. 5∆) in the horizontal prism bar contribute to considerably larger variability in these measures.CONCLUSIONS: In participants with normal binocular vision and no concussion history, good reliability yielded comparable results 90days apart for all vergence measures. The results provide values that can be used to interpret the effect of intervention for vergence disorders in clinical practice and research studies. An important outcome of this study is the understanding that 5∆ steps on the typical horizontal prism bar contribute to high variability in positive fusional vergence measures when findings are ≥20∆.

  View details for DOI 10.1111/opo.70022

  View details for PubMedID 41048201

• Return to learn: An ethnographic study of adolescent young adults returning to school post-concussion. Journal of clinical nursing Wan, A. n., Nasr, A. S. 2020

  Abstract

  The Centers for Disease Control and Prevention estimates that 3.8 million concussions occur in the United States each year. Concussion symptoms can negatively impact the academic performance of adolescents after they return to school. The purpose of this study was to better understand the perceptions of parent-adolescent dyads as male and female adolescents returned to learn after sustaining a concussion.A qualitative ethnographic study of 10, English-speaking, parent-adolescent dyads was conducted, following the adolescents return to school after a recent concussion. Dyads were recruited from a Concussion Clinic in Menlo Park, California between October 2018- October 2019. Adolescents were aged 14-16 years old. Each dyad participated in a semistructured interview. Interviews were subsequently transcribed and analyzed using thematic analysis. This qualitative study design utilized COREQ. (Supplemental File 1) . This study was approved by the Institutional Review Board and ethics committee.Three categories were identified: adolescents feeling misunderstood by school staff about their injuries, adolescents feeling overwhelmed by their injuries, and academic accommodations lacking clarity and implementation. The overarching theme that emerged was clear: Parents and adolescents lacked consistent guidelines for the adolescents' return to learn after a concussion.Post-concussion syndrome as a result of head injury is a complex condition that requires a multidisciplinary approach to treatment. This treatment should be individualized and appropriately adjusted to provide the adolescent with the most optimal environment for recovery. This study provides data to suggest that more guidance from the medical provider or treatment team is needed for teachers and school administrators in order to create an ideal return to learn environment for the adolescent who is recovering from a head injury.

  View details for DOI 10.1111/jocn.15617

  View details for PubMedID 33351994