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Concurrent vision dysfunctions in convergence insufficiency with traumatic brain injury
Tara L Alvarez1, Eun H Kim, Vincent R Vicci
1Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey 07102, USA. tara.l.alvarez@njit.edu
Summary
Approximately 9% of traumatic brain injury (TBI) patients had convergence insufficiency (CI) without other visual or vestibular issues. A comprehensive visual and vestibular exam is recommended for all TBI patients.
Area of Science:
- Ophthalmology
- Neurology
- Optometry
Background:
- Convergence insufficiency (CI) is frequently reported in patients with traumatic brain injury (TBI).
- The prevalence of concurrent visual dysfunctions alongside CI in TBI patients remains largely uncharacterized.
- This study aims to elucidate the co-occurrence of CI and other visual impairments in a TBI population.
Purpose of the Study:
- To determine the prevalence of convergence insufficiency (CI) in traumatic brain injury (TBI) patients.
- To assess the frequency of simultaneous visual dysfunctions in TBI patients diagnosed with CI.
- To investigate the relationship between CI and other neurological and visual deficits post-TBI.
Main Methods:
- Retrospective analysis of 557 TBI civilian patient medical records.
- Comprehensive optometric evaluations including visual acuity, oculomotor function, binocular vision, accommodation, visual fields, ocular health, and vestibular function.
- Statistical comparisons using chi-squared and Z tests between CI and non-CI groups, and inpatient/outpatient subgroups.
Main Results:
- CI without other simultaneous visual or vestibular dysfunctions was found in approximately 9% of the TBI sample.
- Photophobia (16.3%) and vestibular dysfunction (18.5%) were noted in the CI subgroup.
- High prevalence rates for CI (23.3%) and cranial nerve palsies (26.9%) were observed in the TBI population.
- Accommodative dysfunction affected 24.4% of nonpresbyopic TBI patients.
- Visual field deficits or inattention were significantly more common in inpatients (29.6%) than outpatients (p < 0.001).
Conclusions:
- Convergence insufficiency, independent of other visual or vestibular issues, affects about 9% of visually symptomatic TBI patients.
- A significant proportion of TBI patients experience CI alongside other visual or vestibular dysfunctions.
- Thorough visual and vestibular examinations are crucial for all TBI patients to identify and manage these deficits.
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