A MULTI-DISCIPLINARY APPROACH TO MANAGEMENT OF VISUAL SEQUELAE IN TRAUMATIC BRAIN INJURY

Jonas Auditorium

Introduction. Traumatic brain injury (TBI) is defined as any “direct or indirect impulse to the head or body with 10 accompanying neurological symptoms”(1). Symptoms of visual dysfunctions are commonly observed following TBI, including eyestrain, blurry vision, intermittent double vision, poor tracking skills, and headache (2,3). These symptoms affect quality of life (4,5) and can be experienced for years after TBI (2,3). Case presentation. We present two cases of TBI with visual sequelae. The first patient, a 17-year-old Caucasian female, presented with visual symptoms following a horseback riding fall 1.5 months prior, while the second patient, a 28-year-old Caucasian male, presented with visual symptoms after multiple sports concussions 5-15 years prior. Treatment with vision therapy has resolved symptoms in both cases. Deviation From the Expected. Visual dysfunctions after TBI may go unnoticed as they commonly occur in context of normal visual acuity at distance and near (2). Education among health care providers about the visual effects of TBI can help improve quality of life for individuals with these symptoms. Discussion. Approximately 8 million people suffer TBI annually (2), of which 40-90% experience visual dysfunction (1). Office-based vision therapy with home reinforcement has proven to be an effective means to reduce visual symptoms (6). Conclusion. Many believe decreased vision is the primary indication for a comprehensive eye examination. However, most individuals with TBI experience non-specific symptoms that affect accommodation, vergence, and ocular motility systems without affecting visual acuity. These visual dysfunctions can be recognized by a comprehensive eye examination and treated effectively through in- office vision therapy. Grants. No grant or funding was used or required.