Vision disorders in mild traumatic brain injury

Eric Singman, Patrick Quaid Optometrist

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Conservatively, it is estimated that at least 40% of the primate brain is primarily visual machinery. It is, therefore, prudent to explore visual function carefully in mild traumatic brain injury (mTBI) beyond the ostensible reassurance offered when a patient sees with 20/20 acuity bilaterally. After mTBI, deficits in visual processing as reflected in abnormal eye teaming rather than those from direct injury to the afferent visual pathways or oculomotor nerves are far more common. Visual symptoms commonly reported after mTBI include fluctuations in visual acuity at near, headaches with visual-intensive tasks, insecure balance, a sense of being visually overwhelmed, and photophobia. These can often be related to accommodative dysfunction, loss of vergence facility, saccadic dysfunction, deficiency of smooth pursuits, and impaired visual information processing. Patients will often have difficulty verbalizing their complaints, not only because of cognitive difficulties seen after mTBI such as impaired word-finding, memory, and complex attention, but also because there are only vague terms available to the layperson for the subtle visual problems. The examiner must, therefore, ask validated questions reflecting visual processing dysfunction and perform tests that reliably identify it. Assuming normality solely based upon a healthy globe and normal visual acuity and visual field might not only be incorrect, but also can result in limited gains in other rehabilitative areas. Therapy should be integrative with providers working as a team. This chapter will not only focus on identifying, measuring and explaining visual processing concerns after mTBI but also provide guidance for the generalist encountering patients.

Original languageEnglish (US)
Title of host publicationNeurosensory Disorders in Mild Traumatic Brain Injury
PublisherElsevier
Pages223-244
Number of pages22
ISBN (Electronic)9780128123447
ISBN (Print)9780128125489
DOIs
StatePublished - Jan 1 2019

Keywords

  • Accommodation
  • Fusion
  • Saccades
  • Smooth pursuits
  • Stereopsis
  • Vergence facility
  • Visual information processing
  • mTBI

ASJC Scopus subject areas

  • Medicine(all)

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