Identification of Binocular Vision Dysfunction (Vertical Heterophoria) in Traumatic Brain Injury Patients and Effects of Individualized Prismatic Spectacle Lenses in the Treatment of Postconcussive Symptoms: A Retrospective Analysis

Doble, Jennifer E.; Feinberg, Debby; Rosner, Mark; Rosner, Arthur J.

doi:10.1016/j.pmrj.2010.01.011

Cited by 41 publications

(27 citation statements)

References 11 publications

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“…NVP is one of the most common oculomotor signs seen in servicemembers with blast-induced mTBI [7]. However, damage to the vestibular system could also account for the increased vertical deviation in the experimental (Cadre) group found in the present study [31][32]. A previous study by St. Onge et al found some vestibular problems under similar training conditions, even after only The use of FDT perimetry detected a general decrease in VF sensitivity, based on MD values, that was higher for both eyes but only significant for OS in the Cadre group.…”

Section: Discussionmentioning

confidence: 50%

Effects of repetitive low-level blast exposure on visual system and ocular structures

et al. 2015

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Abstract-The purpose of this study was to determine whether repetitive exposure to low-level blasts during military breacher training produces acute and cumulative damage to the ocular tissues or visual system. The effects of low-level blast exposure on high-contrast visual acuity, contrast sensitivity, oculomotor function, color vision, visual field (VF), pupillary light reflex, corneal endothelial cell density (ECD), macular thickness, retinal nerve fiber layer thickness, and cup-to-disc ratio were assessed using a battery of standard clinical ophthalmic tests administered 10 times over a 2-year period. Data from nine male breacher instructors (Cadre) were compared with data from four male breacher engineers (Control). The Cadre group showed higher vertical deviation at near than the Control group over time. The VF mean deviation on the left eye tended to be worse in the Cadre group throughout the study, suggesting a decrease in VF sensitivity (Cadre: -0.20 +/-0.15 dB; Control: 1.05 +/-0.15 dB; p = 0.03). , p = 0.03). These results suggest that even low-level primary blast has the potential to produce occult eye injury.

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Section: Discussionmentioning

confidence: 50%

Effects of repetitive low-level blast exposure on visual system and ocular structures

et al. 2015

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“…In 2010, a retrospective study showed that of 83 brain injury patients with post concussive symptoms remaining after standard treatment, 77 of them had vertical heterophoria. When treated, there was a 71% decrease in their symptoms [63].…”

Section: • Vertical Heterophoriamentioning

confidence: 97%

Auditory/Visual Integration Assessment and Treatment in Brain Injury Rehabilitation

Zelinsky¹

2014

Traumatic Brain Injury

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“…[26][27][28][29][30][31] Visual symptoms are included in 1 of the 3 categories often used to describe proposed subtypes of concussion, though visual symptoms may be placed in the cognitive or somatic category. [26][27][28][29][30][31] Patients with closed-head injuries were less tolerant of luminance (brightness) than control participants at 1366 lux (a measure of lumens per square meter; 1 foot candle ¼ 11 lux) versus 1783 lux. 26 In a study using resting-state functional magnetic resonance imaging in patients with closed-head injuries and matched controls, a cluster of increased functional connectivity in the right frontoparietal network was noted in the injured group.…”

Section: Visual Symptoms In Concussionmentioning

confidence: 99%

“…30 Vertical heterophoria has been documented in some postconcussion patients. 31 This is a misalignment in which the line of sight of 1 eye is higher than the other when at physiologic rest, causing diplopia. 31 Patients with vertical heterophoria excessively use the levator and depressor extraocular muscles to realign the line of sight and maintain a fused image, avoiding diplopia.…”

Section: Visual Symptoms In Concussionmentioning

confidence: 99%

“…31 Patients with vertical heterophoria excessively use the levator and depressor extraocular muscles to realign the line of sight and maintain a fused image, avoiding diplopia. 31 The muscle fatigue that occurs contributes to symptoms. The utricle and brainstem are likely areas of involvement for the faulty alignment signal.…”

Section: Visual Symptoms In Concussionmentioning

confidence: 99%

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The Gaming of Concussions: A Unique Intervention in Postconcussion Syndrome

Lynch

Anderson

Benton³

et al. 2015

Journal of Athletic Training

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Objective: To present the case of 2 adolescent high school student-athletes who developed postconcussion syndrome with protracted and limiting visual complaints that markedly affected academic, social, and athletic activity for a year after the onset of symptoms. Both had significant improvement soon after a unique intervention was administered.Background: A 14-year-old female soccer and softball player sustained 2 concussions in the same week. She had persistent symptoms for a year that affected her grades and precluded athletic participation. A 15-year-old male football player sustained a concussion during an altercation with 2 other male adolescents. He continued to have symptoms 1 year later, with a marked decrease in academic performance and restriction from athletics. Both adolescents reported blurry vision, photophobia, and associated headache as significant components of the postconcussion syndrome.Differential Diagnosis: Concussion, postconcussion syndrome, skull fracture, subdural hematoma, epidural hematoma, second-impact syndrome, and visually sensitive migraine.Treatment: Both patients were advised to obtain computer gaming glasses to use throughout the day. The female patient was diligent in her use of the glasses, with marked lessening of symptoms. The male patient was less accepting of the glasses but did report lessening of symptoms when using the glasses.Uniqueness: We hypothesized that postconcussion syndrome with marked visual complaints would respond to and improve with decreased stimulation of the visual system. This was attempted with the addition of computer gaming glasses. Both adolescent athletes responded well to the filtering of visual stimuli by off-the-shelf computer gaming glasses.Conclusions: Postconcussion syndrome is a persistent condition with a myriad of symptoms. Two young athletes developed postconcussion syndrome with prominent visual symptoms that lasted a year. The addition of computer gaming glasses markedly lessened symptoms in both patients.

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Identification of Binocular Vision Dysfunction (Vertical Heterophoria) in Traumatic Brain Injury Patients and Effects of Individualized Prismatic Spectacle Lenses in the Treatment of Postconcussive Symptoms: A Retrospective Analysis

Cited by 41 publications

References 11 publications

Effects of repetitive low-level blast exposure on visual system and ocular structures

Effects of repetitive low-level blast exposure on visual system and ocular structures

Auditory/Visual Integration Assessment and Treatment in Brain Injury Rehabilitation

The Gaming of Concussions: A Unique Intervention in Postconcussion Syndrome

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