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Traumatic Brain Injury l: Introduction

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...

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Vision Training Methods for Sports Concussion Mitigation and Management

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Retrospective Analysis of Vision Rehabilitation for Veterans With Traumatic Brain Injury-Related Vision Dysfunction.

Sandra L Winkler¹, Dezon Finch¹, Imelda Llanos¹

¹Research Service, James A. Haley Veterans' Hospital, Tampa, FL 33612, USA.

Military Medicine

|May 15, 2023

Summary

Veterans with traumatic brain injury (TBI) often experience vision problems. This study found that vision rehabilitation services at VA centers varied based on patient needs and clinic availability, highlighting a need for specialized training.

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Area of Science:

Ophthalmology
Neurology
Rehabilitation Medicine

Background:

Traumatic brain injury (TBI) frequently causes vision impairments, including oculomotor and accommodative abnormalities, and visual-vestibular dysfunction.
The rising incidence of TBI among combat veterans necessitates effective diagnosis and management of associated visual deficits.
Understanding the delivery of vision rehabilitation services is crucial for optimizing care for veterans with TBI-related visual dysfunction.

Purpose of the Study:

To investigate the vision rehabilitation assessments and interventions provided to veterans with TBI-related visual dysfunction.
To identify the types of assistive devices prescribed to veterans following TBI.
To determine how demographic and clinical variables influence the delivery of vision rehabilitation services.

Main Methods:

A retrospective analysis of data from 350 veterans with TBI at five VA Polytrauma Rehabilitation Centers (2008-2017).
Utilized natural language processing of clinician notes and logistic regression of structured data.
Examined vision assessments, interventions, assistive technology, and specialty clinics involved in care.

Main Results:

Veterans were most commonly assessed for saccades, accommodation, visual field, and convergence.
Interventions focused on eye-hand coordination, saccades, accommodation, vergence, and binocular dysfunction.
Services and available technologies, including eyeglasses and aids for the blind, were associated with patient comorbidities and clinic resources.

Conclusions:

Vision rehabilitation services should align with veteran needs, not solely with service availability.
Existing low vision and blind rehabilitation programs require adaptation and cross-training in neurologic recovery for TBI comorbidities.
Standardizing specialized TBI vision care across VA facilities and into community settings is essential for improved veteran outcomes.