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Consensus Statement on Visual Rehabilitation in Mild Traumatic Brain Injury
Prem S Subramanian1, Jason J S Barton1, Paul Ranalli1
1Departments of Ophthalmology, Neurology, and Neurosurgery (PSS), University of Colorado School of Medicine, Aurora, CO; Sue Anschutz-Rodgers University of Colorado Eye Center (PSS), Aurora, CO; Department of Surgery (Division of Ophthalmology) (PSS), Uniformed Services University of the Health Sciences, Bethesda, MD; Departments of Medicine (Neurology) (JJSB), Ophthalmology and Visual Sciences, Psychology University of British Columbia, Vancouver, Canada; Departments of Medicine (Neurology) (PR), Otolaryngology, Ophthalmology and Visual Sciences, University of Toronto, Ontario, Canada; Department of Medicine (CS), University of Washington School of Medicine, Seattle; Departments of Ophthalmology and Neurological Surgery (CEF), University of Washington School of Medicine, Seattle; Department of Neuroscience (BF), University of California San Diego School of Medicine, San Diego; and The Neurology Center (BF), Carlsbad, CA.
Optometric visual rehabilitation therapies for conditions like posttrauma visual syndrome lack strong scientific evidence. Current studies are limited, necessitating guidance for physicians on treatment efficacy.
Area of Science:
- Neuro-optometry and Behavioral Optometry
- Ophthalmology and Neurology
Background:
- Optometric visual rehabilitation therapy is utilized for various visual disorders.
- Diagnoses such as posttrauma visual syndrome, visual midline shift syndrome, and vertical heterophoria syndrome are common in patients with neurological conditions or symptoms like dizziness and headache.
- These diagnoses are frequently made by neuro-optometrists and behavioral optometrists.
Purpose of the Study:
- To provide guidance to physicians regarding the rationale, evidence, and efficacy of optometric visual rehabilitation therapies.
- To address frequent patient inquiries about the utility of these treatment strategies.
- To inform neuro-ophthalmologists, ophthalmologists, and neurologists involved in the care of patients undergoing these therapies.
Main Methods:
- Review of existing scientific literature and clinical studies.
- Analysis of the evidence base for optometric visual rehabilitation therapies.
- Assessment of the scientific underpinnings of diagnoses like posttrauma visual syndrome.
Main Results:
- The scientific basis for these optometric diagnoses and treatments is currently weak.
- Published clinical studies are predominantly case reports and case series, lacking control populations.
- There is a need for higher-quality evidence to support the efficacy of these therapies.
Conclusions:
- The efficacy of optometric visual rehabilitation therapies for conditions like posttrauma visual syndrome is not well-established.
- Physicians require clear guidance on the evidence supporting these treatments.
- Further rigorous clinical studies are needed to validate these therapeutic approaches.
