Visual profile of acquired brain injury in Indian cohort: a retrospective study

With the increasing global prevalence of acquired brain injury (ABI), the burden of visual problems as a sequelae to ABI is on the rise. This study reports the visual profile of patients with ABI seen in Neuro-Optometry Clinic (NOC) at a tertiary eye-care center in Southern India.

A retrospective study was carried out between January 2014 and December 2015. Medical records of patients diagnosed with ABI referred by Neuro-Ophthalmologists to the NOC were reviewed. The detailed history, clinical findings of neuro assessment and management details were recorded.

Of the 241 patients with ABI, 208 had Traumatic Brain Injury (TBI) and 33 had Cerebro-Vascular Accident (CVA). The mean (SD) age of patients with TBI was 35 ± 14 years and CVA was 52 ± 16 years. Binocular diplopia (61%) was seen predominantly in TBI due to vertical deviation (31%). Cranial nerve palsy was most common in TBI (55%) than CVA (36%) and visual field defects were most frequently seen in CVA (27%).

Cranial nerve paresis and restrictive strabismus with diplopia were the most common presentations in TBI and visual field defects in CVA. A neuro-optometric evaluation is recommended to identify visual dysfunctions and provide appropriate management options.

ABI: Acquired Brain Injury; TBI: Traumatic Brain Injury; CVA: Cerebrovascular Accident; NOC: Neuro-Optometry Clinic; NSBVA: Non-Strabismic binocular vision anomalies; OMD: Oculomotor dysfunction; VFD: Visual field defect; GON: Glaucomatous optic neuropathy.