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Visual Dysfunctions at Different Stages after Blast and Non-blast Mild Traumatic Brain Injury
José E Capó-Aponte1, Kendra L Jorgensen-Wagers, Josue A Sosa
1*OD, PhD, FAAO †PhD ‡BS §PhD, FAAO ∥MS Visual Sciences Branch, Sensory Research Division, U.S. Army Aeromedical Research Laboratory, Fort Rucker, Alabama (JEC-A, JAS, DVW, LAT, DWR); Department of Optometry, Womack Army Medical Center, Fort Bragg, North Carolina (JEC-A); Traumatic Brain Injury Clinic, Landstuhl Regional Medical Center, APO, Germany (KLJ-W); and Psychology Service & Western Blind Rehabilitation Center, Veteran Affairs Palo Alto Health Care System, Menlo Park, California (GLG).
Purpose:
To assess the prevalence of visual dysfunctions and associated symptoms in war fighters at different stages after non-blast- or blast-induced mild traumatic brain injury (mTBI).
Methods:
A comprehensive retrospective review of the electronic health records of 500 U.S. military personnel with a diagnosis of deployment-related mTBI who received eye care at the Landstuhl Regional Medical Center. For analysis, the data were grouped by mechanism of injury, and each group was further divided in three subgroups based on the number of days between injury and initial eye examination.
Results:
The data showed a high frequency of visual symptoms and visual dysfunctions. However, the prevalence of visual symptoms and visual dysfunctions did not differ significantly between mechanism of injury and postinjury stage, except for eye pain and diplopia. Among visual symptoms, binocular dysfunctions were more common, including higher near vertical phoria, reduced negative fusional vergence break at near, receded near point of convergence, decreased stereoacuity, and reduced positive relative accommodation.
Conclusions:
The lack of difference in terms of visual sequelae between subgroups (blast vs. nonblast) suggests that research addressing the assessment and management of mTBI visual sequelae resulting from civilian nonblast events is relevant to military personnel where combat injury results primarily from a blast event.
