title: Development of a mild traumatic brain injury-specific vision screening protocol: a Delphi study.
abstract: Although traumatic brain injury (TBI) can happen to anyone at any time, the wars in Iraq and Afghanistan have brought it renewed attention. Fortunately, most cases of TBI from the recent conflicts are mild TBI (mTBI). Still, many physical, psychological, and social problems are associated with mTBI. Among the difficulties encountered are oculomotor and vision problems, many of which can impede daily activities such as reading. Therefore, correct diagnosis and treatment of these mTBI-related vision problems is an important part of patient recovery. Numerous eye care providers in the Department of Veterans Affairs, in military settings, and in civilian practices specialize and are proficient in examining patients who have a history of TBI. However, many do not have this level of experience working with and treating patients with mTBI. Recognizing this, we used a modified Delphi method to derive expert opinions from a panel of 16 optometrists concerning visual examination of the patient with mTBI. This process resulted in a clinical tool containing 17 history questions and 7 examination procedures. This tool provides a set of clinical guidelines that can be used as desired by any eye care provider either as a screening tool or adjunct to a full eye examination when seeing a patient with a history of mTBI. The goal of this process was to provide optimal and uniform vision care for the patient with mTBI.
authors.affiliation: VA Palo Alto Health Care System, 795 Willow Rd, Bldg T-365, Menlo Park, CA 94025. Gregory.Goodrich@va.gov.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Goodrich
authors.forename: Gary L
authors.initials: GL
authors.lastname: Martinsen
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Flyg
authors.forename: Jennine
authors.initials: J
authors.lastname: Kirby
authors.forename: Steven M
authors.initials: SM
authors.lastname: Asch
authors.forename: Karen D
authors.initials: KD
authors.lastname: Brahm
authors.forename: John M
authors.initials: JM
authors.lastname: Brand
authors.forename: Diana
authors.initials: D
authors.lastname: Cajamarca
authors.forename: Jenette L
authors.initials: JL
authors.lastname: Cantrell
authors.forename: Theresa
authors.initials: T
authors.lastname: Chong
authors.forename: John A
authors.initials: JA
authors.lastname: Dziadul
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Hetrick
authors.forename: Michael A
authors.initials: MA
authors.lastname: Huang
authors.forename: Carolyn
authors.initials: C
authors.lastname: Ihrig
authors.forename: Shanida P
authors.initials: SP
authors.lastname: Ingalla
authors.forename: Bradley R
authors.initials: BR
authors.lastname: Meltzer
authors.forename: Chrystyna M
authors.initials: CM
authors.lastname: Rakoczy
authors.forename: Ashley
authors.initials: A
authors.lastname: Rone
authors.forename: Elliot
authors.initials: E
authors.lastname: Schwartz
authors.forename: Jane E
authors.initials: JE
authors.lastname: Shea
mesh_terms: D001930:Brain Injuries / Q000150:complications*; D003697:Delphi Technique; D006801:Humans; D008487:Medical History Taking; D014786:Vision Disorders / Q000175:diagnosis* / Q000209:etiology*; D014787:Vision Tests