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Restoration of Vision After Brain Injury Using Magnet Glasses.

Kevin E Houston¹, Eleftherios I Paschalis, Danielle C Angueira

¹From the Spaulding Rehabilitation Hospital, Boston, Massachusetts (KEH, DCA, MAI); Departments of Ophthalmology (KEH, EIP, PMB) and Physical Medicine and Rehabilitation (MAI), Harvard Medical School, Boston, Massachusetts; Keratoprosthesis Laboratory, Massachusetts Eye and Ear, Boston, Massachusetts (EIP); and Kessler Foundation, West Orange, New Jersey (AMB).

American Journal of Physical Medicine & Rehabilitation

|August 24, 2016

Summary

Visual impairments after traumatic brain injury (TBI) can be managed. A magnetic eyelid device improved vision by expanding the visual field through an eye turn, aiding mobility.

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Area of Science:

Ophthalmology
Neuroscience
Rehabilitation Medicine

Background:

Visual impairments are a frequent complication of traumatic brain injury (TBI), significantly impacting patients' quality of life.
Homonymous hemianopia and cranial nerve palsies are among the visual deficits that can occur post-TBI.

Observation:

A severe TBI patient presented with complete right homonymous hemianopia and right cranial nerve III palsy, including exotropia and ptosis.
Treatment of the right ptosis with a magnetic levator prosthesis restored eyelid opening.

Findings:

The 30-degree right exotropia, previously a source of visual impairment, advantageously generated 30 degrees of right visual field expansion upon eyelid opening.
This visually expanded field facilitated by the exotropia and ptosis correction improved the patient's wheelchair mobility and reaching abilities during inpatient therapy.

Implications:

This case is the first to report visual field expansion achieved through strabismus, facilitated by ptosis correction.
Strabismus should be considered as a strategy for visual field expansion in patients with homonymous visual deficits, potentially before patching.
A multidisciplinary vision rehabilitation team is crucial for evaluating and implementing such unique treatment approaches.