How to assess visual function in acquired brain injury-Asking is not enough

Area of Science:

• Neuroscience
• Ophthalmology
• Rehabilitation Medicine

Background:

• Acquired brain injury (ABI) can cause diverse dysfunctions, including vision problems that hinder rehabilitation and daily activities.
• Visual impairments after ABI are frequently overlooked, with no standardized assessment protocols.
• Oculomotor dysfunctions are a significant, yet often underestimated, consequence of ABI.

Purpose of the Study:

• To determine the frequency of objectively measured oculomotor dysfunctions in ABI patients.
• To investigate the relationship between patient-reported symptoms and objective visual findings.
• To evaluate the utility of the Vision Interview (VI) and Convergence Insufficiency Symptom Survey (CISS) in detecting visual impairment post-ABI.

Main Methods:

• A cross-sectional study involving 73 outpatients with ABI.
• Comprehensive optometric examinations were conducted alongside standard evaluations.
• Vision Interview (VI) and Convergence Insufficiency Symptom Survey (CISS) were administered to assess symptoms.

Main Results:

• A high prevalence of vision-related symptoms and objectively measured dysfunctions was observed.
• Fusion vergence deficits were the most common finding, present in 83% of patients.
• Moderate associations were found between specific Vision Interview items and visual deficits; CISS demonstrated moderate sensitivity and specificity.

Conclusions:

• Patients with ABI exhibit a high incidence of visual symptoms and functional deficits.
• A combined approach of symptom assessment (e.g., VI, CISS) and objective vision examination is essential for comprehensive evaluation.
• Integrated assessment strategies are necessary to effectively address the complex visual challenges faced by individuals with ABI.