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Visual problems following traumatic brain injury

Many veterans of the United States armed forces who have traumatic brain injury (TBI) or post-traumatic stress disorder also have undiagnosed, chronic vision problems, according to two studies presented today at the 116th Annual Meeting of the American Academy of Ophthalmology, jointly conducted this year with the Asia-Pacific Academy of Ophthalmology. The studies are reported in the November 11, 2012 edition of Psychology & Psychiatry.

In a study conducted at the Veterans Affairs Medical Center, in Washington, D.C., researchers found that vision problems in veterans with mild TBI are much more common and persistent than previously recognized, with 67 percent of the 31 patients studied reporting chronic vision disorders. Though none of the affected veterans had suffered direct eye wounds, their vision continued to be impaired more than a year after they endured the injuries that caused their TBI.

The vision problems most frequently reported by the veterans in the study were convergence, which is the ability to focus both eyes simultaneously in order to read or see other nearby objects, and sensitivity to light. Veterans' ability to readjust their focus when moving their gaze between far and near objects, known as accommodation, was also reduced. Other complaints included double vision and "floaters," which are spots or spidery shapes that seem to move across the visual field. Full recovery of visual function took five years or more in many of the veterans, which is much longer than is typically seen in sports concussions and other non-blast-related TBI.

"Physicians who care for veterans with TBI need to know that many of them have vision problems," said M. Teresa Magone, M.D., staff ophthalmologist with the Washington, D.C. Veterans Affairs Medical Center, who led the study. "It is critical that these patients receive vision assessment and when appropriate, be referred to ophthalmologists to make sure they get the eye care they need, for as long as they need it."

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