Visual Impairment and Dysfunction in Combat-injured Servicemembers With Traumatic Brain Injury

被引:166
作者
Brahm, Karen D. [1 ]
Wilgenburg, Heidi M. [1 ]
Kirby, Jennine [1 ]
Ingalla, Shanida [1 ]
Chang, Chea-Yo [1 ]
Goodrich, Gregory L. [1 ]
机构
[1] VA Palo Alto Hlth Care Syst, Western Blind Rehabil Ctr, Palo Alto, CA 94086 USA
关键词
traumatic brain injury; binocular vision; vision disorders; blast injuries; vision screening; IRAQ; WAR; AFGHANISTAN; MILITARY;
D O I
10.1097/OPX.0b013e3181adff2d
中图分类号
R77 [眼科学];
学科分类号
100212 [眼科学];
摘要
Purpose. The purpose of this study was to determine the frequencies of visual impairment and dysfunction among combat-injured Polytrauma Rehabilitation Center (PRC) inpatient and Polytrauma Network Site (PNS) outpatient military personnel with traumatic brain injury (TBI). Methods. A retrospective analysis of data from vision screenings of 68 PRC-inpatients with moderate to severe levels of TBI and 124 PNS-outpatients with mild TBI at the VA Palo Alto Health Care System was conducted. Results. Eighty-four percent of PRC-inpatients and 90% of PNS-outpatients had TBIs associated with a blast event. The majority of patients in both the PRC and PNS populations had visual acuities of 20/60 or better (77.8% PRC, 98.4% PNS). Visual dysfunctions (e.g., convergence, accommodative, and oculomotor dysfunction) were common in both PRC and PNS populations. In the PRC-inpatient population, acuity loss of 20/100 to no light perception (13%) and visual field defects (32.3%) were found. In the PNS-outpatient population, acuity loss of 20/100 to no light perception (1.6%) and visual field defects (3.2%) were infrequently found. In both the PRC and PNS populations, visual field defects were more often associated with blast than non-blast events. Conclusions. Blast events were the most frequent mechanism of injury associated with TBI in combat-injured service-members. The vision findings suggest that combat troops exposed to blast with a resulting mild TBI are at risk for visual dysfunction, and combat troops with polytrauma injuries are at risk for visual dysfunction and/or visual impairment. The visual consequences of such injuries necessitate further study and support the need for appropriate evaluation and treatment in all severities of TBI. (Optom Vis Sci 2009;86:817-825)
引用
收藏
页码:817 / 825
页数:9
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