title: Post-traumatic stress disorder and vision.
abstract: Post-traumatic stress disorder (PTSD) can be defined as a memory linked with an unpleasant emotion that results in a spectrum of psychological and physical signs and symptoms. With the expectation of at least 300,000 postdeployment veterans from Iraq and Afghanistan having PTSD, optometrists will be faced with these patients' vision problems. Complicating the diagnosis of PTSD is some overlap with patients with traumatic brain injury (TBI). The estimated range of patients with TBI having PTSD varies from 17% to 40%, which has recently led the Federal government to fund research to better ascertain their relationship and differences. As a result of the sensory vision system's interconnections with the structures of the limbic system, blurry vision is a common symptom in PTSD patients. A detailed explanation is presented tracing the sensory vision pathways from the retina to the lateral geniculate body, visual cortex, fusiform gyrus, and the hypothalamus. The pathways from the superior colliculus and the limbic system to the eye are also described. Combining the understanding of the afferent and efferent fibers reveal both feedforward and feedback mechanisms mediated by nerve pathways and the neuropolypeptides. The role of the peptides in blurry vision is elaborated to provide an explanation as to the signs and symptoms of patients with PTSD. Although optometrists are not on the front line of mental health professionals to treat PTSD, they can provide the PTSD patients with an effective treatment for their vision disorders.
authors.affiliation: Elite Performance and Learning Center, PS, Seattle, Washington, USA. tracht@accommotrac.com
authors.forename: Joseph N
authors.initials: JN
authors.lastname: Trachtman
mesh_terms: D001930:Brain Injuries / Q000150:complications; D006801:Humans; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000628:therapy; D014786:Vision Disorders / Q000209:etiology*; D014795:Visual Pathways