Neuro-Ophthalmic Manifestations of Head Trauma

Stavern, Gregory P. Van; Biousse, Val rie; Lynn, Michael; Simon, Deborah J.; Newman, Nancy J.

doi:10.1097/00041327-200106000-00012

Cited by 55 publications

(50 citation statements)

References 18 publications

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“…10 The eyes are often involved in head injury (directly and indirectly) with neuroophthalmic deficits. 2,[4][5][6][7][8]11,12 Most ophthalmologists when faced with injured patients tend to focus on obvious ocular manifestations such as contusions and laceration. Subtle manifestations may be equally important and may go unrecognized.…”

Section: Discussionmentioning

confidence: 99%

“…13 As was found in our study, high velocity impact due to RTA is the commonest cause of head injury reported, 4 with young men most frequently involved. 2 Trauma patients often have multiple injuries including ocular involvement. Several retrospective studies have reported neuro-ophthalmic findings a few months after head trauma.…”

Section: Discussionmentioning

confidence: 99%

“…Several retrospective studies have reported neuro-ophthalmic findings a few months after head trauma. [2][3][4][5][6][7][8] This study has looked at the ocular findings in the acute stage of head injury. These included physical ocular trauma, orbital fractures and neuro-ophthalmic findings.…”

Section: Discussionmentioning

confidence: 99%

“…1 Head injuries are frequently associated with ophthalmic manifestations and consequent morbidity. 2 Many of the ophthalmic findings are often ignored and present much later to specialist neuro-ophthalmic clinics. Clinical correlation of the ophthalmic findings is important in early localization of the site of injury, ongoing assessment, management and prognosis of the patient with head injury.…”

Section: Introductionmentioning

confidence: 99%

“…[2][3][4][5][6][7][8] This study aims to record the various ocular findings in closed head injury and to attempt a correlation between the neurological signs, ocular signs, GCS, and outcome, thus getting closer to pinning down prognosticators of adverse outcome. To our knowledge, this is the only prospective study recording ocular findings in the first few hours following closed head injury.…”

Section: Introductionmentioning

confidence: 99%

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Ocular manifestations of head injury: a clinical study

Kulkarni

Aggarwal

Kulkarni

et al. 2004

Eye

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Aim This prospective study aimed to clinically correlate the various ocular findings with the neurological status in cases of closed head injury. Methods A total of 200 consecutive cases of closed head injury admitted to a major teaching hospital underwent a thorough ophthalmic assessment. The Glasgow coma scale (GCS) and the Revised trauma score (RTS) were applied to grade the severity of injury and assess the prognosis. Kendall's tau-b and Fisher's exact test were used in the analysis. Results The main causes of head injury were road traffic accidents 52.5% followed by assaults in 34%. Ocular involvement was found in 167(83.5%) cases. These included corneal and scleral tears in 2%, subconjunctival haemorrhage or ecchymosis in 46%, orbital fractures 12%, pupillary involvement 6.5%, papilloedema 5.5%, intraocular trauma 5.5%, proptosis 3%, lateral rectus palsy 2%, lacrimal gland prolapse 1%, and optic nerve trauma 0.5%. All 21 patients (10.5%) who died had eye involvement. In all, 150 cases (75%) with a RTS of 12 had a good prognosis. Of these 124 (82.6%) had ocular involvement of no neurological significance. Conclusions Although sophisticated imaging techniques are available to localize lesions, early ophthalmic assessment in correlation with the GCS aids in prognosticating outcomes. Pupillary involvement, papilloedema, and ocular motor paresis pointed to a more severe head injury. To our knowledge, this is the only prospective study recording ocular findings in the first few hours and attempting a correlation with the final outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ocular manifestations of head injury: a clinical study

Kulkarni

Aggarwal

Kulkarni

et al. 2004

Eye

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Vision Therapy: Ocular Motor Training in Mild Traumatic Brain Injury

Barton

Ranalli

2020

Annals of Neurology

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Vision therapy in the form of ocular motor training is increasingly used to treat visual complaints, particularly in the setting of persistent symptoms after mild traumatic brain injury (mTBI). In this review, we discuss the rationale behind this intervention and the evidence for its utility. Although the efficacy of exercises for primary convergence insufficiency is plausible and supported by data, there is not yet strong evidence of benefit for the post‐traumatic variant. It is not established that abnormalities in fixation, pursuit, and saccades in mTBI are the cause of post‐concussive symptoms, or that these abnormalities arise from ocular motor damage rather than being secondary effects of cognitive problems with attention or executive control. The few studies to date have significant methodological weaknesses. More substantial evidence is required before vision therapy can be accepted as a useful tool in the rehabilitation of patients with brain trauma. ANN NEUROL 2020;88:453–461

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Traumatic Optic Neuropathy

Tow

Subramanian

2019

Neuro-Ophthalmology

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Neuro-Ophthalmic Manifestations of Head Trauma

Cited by 55 publications

References 18 publications

Ocular manifestations of head injury: a clinical study

Ocular manifestations of head injury: a clinical study

Vision Therapy: Ocular Motor Training in Mild Traumatic Brain Injury

Traumatic Optic Neuropathy

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