Eye and visual function in traumatic brain injury

Abstract

Abstract-Combat blast is an important cause of traumatic brain injury (TBI) in the Department of Veterans Affairs polytrauma population, whereas common causes of TBI in the civilian sector include motor vehicle accidents and falls. Known visual consequences of civilian TBI include compromised visual acuity, visual fields, and oculomotor function. The visual consequences of TBI related to blast remain largely unknown. Blast injury may include open globe (eye) injury, which is usually detected and managed early in the rehabilitation journey. The incidence, locations, and types of ocular damage in eyes without open globe injury after exposure to powerful blast have not been systematically studied. Initial reports and preliminary data suggest that binocular function, visual fields, and other aspects of visual function may be impaired after blast-related TBI, despite relatively normal visual acuity. Damage to the ocular tissues may occur from blunt trauma without rupture or penetration (closed globe injury). Possible areas for research are development of common taxonomy and assessment tools across services, surgical management, and outcomes for blast-related eye injury; the incidence, locations, and natural history of closed globe injury; binocular and visual function impairment; quality of life in affected servicemembers; pharmacological and visual therapies; and practice patterns for screening, management, and rehabilitation.

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

“…The acute and chronic visual problems experienced by servicemembers and Veterans following blast exposure are frequent and often complex [6][7][8]10,[29][30]. While exposure to low-level blast was not expected to induce an mTBI, we hypothesized that the cumulative effects of repetitive low-level blasts could produce damage to ocular structures and parts of the brain responsible for ocular motility and visual processing, which could induce mTBI-like symptoms.…”

Compound 49b Reduces Inflammatory Markers and Apoptosis after Ocular Blast Injury

“…Ocular trauma is a leading cause of vision loss for soldiers, as well as the general public [8,15] . Unfortunately, little is known of the effects of exposure of blast pressure to the 16 retina.…”

Automating the assessment of visual dysfunction after traumatic brain injury

“…In addition, the author will mention whether the testing for the visual dysfunctions has reached the point where automation has been or could be considered. It should be noted that detailed statistics documenting the frequency with which the following deficits occur after mTBI are not available for most of the problems described [4].…”