The Relationship Between Severe Visual Acuity Loss, Traumatic Brain Injuries, and Ocular Injuries in American Service...

Area of Science:

• Ophthalmology
• Neurology
• Military Medicine

Background:

• Traumatic brain injury (TBI) is known to cause visual impairments, but the link between TBI severity and severe visual acuity loss (SVAL) is not well-established.
• Military service members are at risk for both TBI and ocular injuries due to combat environments.

Purpose of the Study:

• To investigate the relationship between the severity of TBI and the incidence of SVAL in U.S. service members.
• To identify risk factors for SVAL, including ocular injuries and head trauma.

Main Methods:

• Retrospective analysis of data from the Defense and Veterans Eye Injury and Vision Registry (DVEIVR) and the Defense and Veterans Brain Injury Center (DVBIC) from 2001-2015.
• Logistic regression model used to analyze the association between TBI, ocular injuries (open globe injury, anterior/posterior segment disorders), and SVAL, adjusting for covariates.
• TBI cases were classified using International Statistical Classification of Diseases criteria.

Main Results:

• Of 25,193 unique patients, 7,217 had TBI and 1,367 had low vision; 638 had both.
• Neither unclassified TBI nor differentiated TBI were significant risk factors for SVAL.
• Ocular injuries (open globe injury, anterior/posterior segment disorders) and other open head wounds (OOHW) were significant risk factors for SVAL.

Conclusions:

• While direct eye or head injuries increase SVAL risk, TBI itself was not a significant independent risk factor for SVAL in this cohort after adjusting for ocular factors.
• Further research is warranted to explore potential associations between TBI and moderate vision acuity loss.