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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.
Abstract:
Optometric visual rehabilitation therapy has been used for a variety of visual disorders. Descriptively named entities such as posttrauma visual syndrome, visual midline shift syndrome, and vertical heterophoria syndrome are frequently diagnosed by neuro-optometrists and/or behavioral optometrists in patients after stroke or head injury or in the setting of dizziness and/or headache. The scientific underpinnings of these diagnoses and treatments are weak, and published clinical studies comprise case reports and case series without comparison to control populations. Neuro-ophthalmologists are frequently questioned by patients about the utility of such treatment strategies. Many ophthalmologists and neurologists also are involved in the care of patients who carry these diagnoses and undergo these visual therapies. Involved physicians may benefit from guidance about the rationale, evidence, and level of evidence for the efficacy of these therapeutic approaches.
