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Volume 3
Optometry: Open Access
ISSN: 2476-2075
Optometry 2018
October 08-09, 2018
October 08-09, 2018 | Edinburgh, Scotland
3
rd
International Conference and Expo on
Optometry & Vision Science
Neuro-optometric rehabilitation of Mild Traumatic Brain Injury (mTBI)
Joseph Hallak
1
and
Jeffrey Becker
2
1
State University of New York, USA
2
Pennsylvania State University, USA
M
TBI is by definition a complex pathophysiological process affecting the brain, induced by biomechanical forces. It is an
injury to the brain resulting in three categories of symptoms: physical/somatic, e.g. headache, vision, GI disturbance;
cognitive, e.g. attention, memory and; psychiatric, e.g. mood swing, personality changes. Most of these symptoms should get
better within 2–3 weeks of total rest (sometimes more) barring any second impact syndrome. A concussion lasting less than
30 minutes with a Glasgow coma scale (GCS 13–15) is considered mTBI. It can result in temporary or permanent neurological
symptoms. Neuro-imaging tests such as CT scan or MRI may or may not show evidence of any damage. High school football
accounts for 47% of all reported sports concussions, followed by ice hockey and soccer. An mTBI accounted 82% of the 340,000
cases of blast injuries in the US military between 2000 and 2015. Highlights of clinical vision and perception examination
and rehabilitation of the mTBI patients include the following: thorough history, correction of small errors, out of instrument
subjective examination, contrast sensitivity and glare assessment, monocular, bi-ocular and binocular accommodative facility,
vergenses, saccades and fusional ranges. Treating patients with equipment that offers visual, vestibular and proprioceptive
abilities will provide the best outcome. Devices and methods tapping multisensory system and featuring feedback with
proprioceptive and balance capability are essential for office and home. That is because the main goals of rehabilitation
are endurance, integration and internalization of learned skills for lasting long term benefits and avoiding regression after
therapy. Keep in mind the three phases of neuro-optometric rehabilitation: visual stabilization: postural/peripheral awareness,
monocular skills; binocular vision integration: oculomotor/accommodative, convergence, stereopsis, localization–static and
dynamic; visual automaticity: multisensory integration.
Recent Publications:
1. Capó-Aponte J E, Jorgensen-Wagers K L, Sosa J A, et al. (2017) Visual dysfunctions at different stages after blast and
non-blast mild traumatic brain injury. Optom Vis Sci. 94:7–15.
2. Armstrong R A, McKee A C and Cairns N J (2017) Pathology of the superior colliculus in chronic traumatic
encephalopathy. Optom Vis Sci. 94:32–42.
3. Poltavski D, Lederer P and Cox L K (2017) Visually evoked potential markers of concussion history in patients with
convergence insufficiency. Optom and Vision Science 94(7):742–750.
4. Eisenberg MA, Meehan WP and Mannix R (2014) Duration and course of post-concussive symptoms. Pediatrics 133
(6):999–1006.
5. PR and Berkovic SF (2011) Concussion: The history of clinical and pathophysiological concepts and misconceptions.
Neurology 57(12):2283–2289.
Biography
Joseph Hallak is an Optometrist. He was a Founder and Chairman of a continuing education study group and Director of the Contact Lens and Low Vision Clinics.
Hallak is an adjunct Assistant Clinical Professor, the State University of New York, College of Optometry and Adjunct Clinical supervisory faculty, the New England
College of Optometry and Salus University. He is a contributing editor to Primary Care Optometry News. He is a member of certain Optometry societies.
Jeffrey Becker is a graduate of the Pennsylvania State University and graduated from The Illinois College of Optometry. He has been a practicing Optometrist in
Northeastern Pennsylvania for over 34 years, with a specialty practice in Rehabilitative Optometry. Becker is an adjunct faculty member at Misericordia University,
Dallas. He examined and treated over 3000 head injury, stroke, and neurologically impaired patients ranging in ages from birth to senior citizens. Becker recently
accepted an appointment by Governor Wolfe to be a board member on the State board of Optometry in 2017.
Joseph Hallak et al., Optom open access 2018, Volume 3
DOI: 10.4172/2476-2075-C1-008