Interventions for eye movement disorders due to acquired brain injury

Abstract

The primary objective is to assess the effects of any intervention and determine the effect of timing of any intervention in the treatment of strabismus, gaze deficits and nystagmus due to acquired brain injury in order to align visual axes in primary and/or secondary gaze positions.

Vision Therapy: Ocular Motor Training in Mild Traumatic Brain Injury

“…100,101 There are similar issues still regarding the treatment of ocular motor aspects of mTBI, not only for vision therapy but also for pharmacologic interventions. 83 Further work incorporating the features discussed above is required to determine the role of vision therapy in mTBI management.…”

“…These studies are important to the field but have several weaknesses, which led a recent Cochrane review to classify their evidence as having "very low certainty." 83 First is the lack of diagnostic criteria for mTBI. Second is the small cohort size, made smaller because 3 subjects who did the training first dropped out before doing the placebo arm.…”

“…Seventh, the crossover design is problematic. 83 Although this has the advantage of each subject acting as their own control, it is more appropriate for interventions whose effects decay after cessation, with washout periods that can reset the baseline between the first and second interventions and allow assessment for carryover effects (see Hoggan and colleagues 85 ). If the durability of training effects is unknown, then it is difficult to designate an appropriate baseline for the placebo arm in those who train first.…”

Core outcome set for three ophthalmic conditions: a healthcare professional and patient consensus on core outcome sets for amblyopia, ocular motility and strabismus (COSAMS Study)

“…3 There are several approaches to the management of these conditions including occlusion, penalisation, spectacles, prisms, drugs, surgery, botulinum toxin, exercises, watchful waiting or a combination of two or more of the above. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Interventional systematic reviews in this field of research have identified that there is considerable variation in the outcomes being measured and reported in primary research studies, which impacts on the ability to compare and synthesise outcome results across studies. Moreover, it was noted that there is a paucity of outcome data available on important patient outcomes such as Strengths and limitations of this study ► This study followed robust methodology as guided by the Core Outcome Measures in Effectiveness Trials Initiative.…”

“…Open access quality of life, long-term outcome and the cost of treatment. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] To mitigate these issues and to increase the relevance of research, a core outcome set (COS) can be developed, which represents an agreed standardised set of outcomes that should be measured and reported in all studies for a specific area of health or healthcare. A search of the Core Outcome Measures in Effectiveness Trials (COMET) database revealed that there are several studies that have investigated important outcomes for the eyes and vision disease; examples include cataract, 21 22 glaucoma 23 and age-related macular degeneration, 24 but none have specifically looked at amblyopia, strabismus or ocular motility disorders.…”