Static and dynamic aspects of accommodation in mild traumatic brain injury: a review

Accommodation refers to the process of obtaining and maintaining a focused foveal retinal image of an object of interest. It involves optical, sensory, motor, perceptual, cognitive, pharmacologic, and biomechanical aspects, and hence represents a complex, multilevel neurologic control process. In patients with mild traumatic brain injury (mTBI), this process frequently is disrupted and compromised neurologically because of the pervasiveness of the coup-contrecoup, swelling, and shearing aspects of the brain injury. In this report, we review the earlier literature on accommodation in mTBI and then present several new findings from our clinical research unit, along with their clinical implications.