title: Eye and visual function in traumatic brain injury.
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 service members; pharmacological and visual therapies; and practice patterns for screening, management, and rehabilitation.
authors.affiliation: Ophthalmology Section 112-B1, Department of Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304, USA. glenn.cockerham@va.gov
authors.forename: Glenn C
authors.initials: GC
authors.lastname: Cockerham
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Goodrich
authors.forename: Eric D
authors.initials: ED
authors.lastname: Weichel
authors.forename: James C
authors.initials: JC
authors.lastname: Orcutt
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Rizzo
authors.forename: Kraig S
authors.initials: KS
authors.lastname: Bower
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Schuchard
mesh_terms: D001753:Blast Injuries / Q000150:complications*; D001930:Brain Injuries / Q000150:complications*; D003266:Continuity of Patient Care; D004172:Diplopia; D005131:Eye Injuries / Q000150:complications* / Q000209:etiology / Q000534:rehabilitation; D006297:Health Services Accessibility; D006801:Humans; D054542:Iraq War, 2003-2011; D008889:Military Personnel; D011788:Quality of Life; D014481:United States; D014493:United States Department of Veterans Affairs; D014786:Vision Disorders / Q000209:etiology* / Q000534:rehabilitation*