Author(s): Brahm KD, Wilgenburg HM, Kirby J, Ingalla S, Chang CY,
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Abstract PURPOSE: The purpose of this study was to determine the frequencies of visual impairment and dysfunction among combat-injured Polytrauma Rehabilitation Center (PRC) inpatient and Polytrauma Network Site (PNS) outpatient military personnel with traumatic brain injury (TBI). METHODS: A retrospective analysis of data from vision screenings of 68 PRC-inpatients with moderate to severe levels of TBI and 124 PNS-outpatients with mild TBI at the VA Palo Alto Health Care System was conducted. RESULTS: Eighty-four percent of PRC-inpatients and 90\% of PNS-outpatients had TBIs associated with a blast event. The majority of patients in both the PRC and PNS populations had visual acuities of 20/60 or better (77.8\% PRC, 98.4\% PNS). Visual dysfunctions (e.g., convergence, accommodative, and oculomotor dysfunction) were common in both PRC and PNS populations. In the PRC-inpatient population, acuity loss of 20/100 to no light perception (13\%) and visual field defects (32.3\%) were found. In the PNS-outpatient population, acuity loss of 20/100 to no light perception (1.6\%) and visual field defects (3.2\%) were infrequently found. In both the PRC and PNS populations, visual field defects were more often associated with blast than non-blast events. CONCLUSIONS: Blast events were the most frequent mechanism of injury associated with TBI in combat-injured servicemembers. The vision findings suggest that combat troops exposed to blast with a resulting mild TBI are at risk for visual dysfunction, and combat troops with polytrauma injuries are at risk for visual dysfunction and/or visual impairment. The visual consequences of such injuries necessitate further study and support the need for appropriate evaluation and treatment in all severities of TBI.
This article was published in Optom Vis Sci
and referenced in Optometry: Open Access