title: Chronic visual dysfunction after blast-induced mild traumatic brain injury.
abstract: The purpose of this study was to investigate the long-term visual dysfunction in patients after blast-induced mild traumatic brain injury (mbTBI) using a retrospective case series of 31 patients with mbTBI (>12 mo prior) without eye injuries. Time since mbTBI was 50.5 +/- 19.8 mo. Age at the time of injury was 30.0 +/- 8.3 yr. Mean corrected visual acuity was 20/20. Of the patients, 71% (n = 22) experienced loss of consciousness; 68% (n = 15) of patients in this subgroup were dismounted during the blast injury. Overall, 68% (n = 21) of patients had visual complaints. The most common complaints were photophobia (55%) and difficulty with reading (32%). Of all patients, 25% were diagnosed with convergence insufficiency and 23% had accommodative insufficiency. Patients with more than one mbTBI had a higher rate of visual complaints (87.5%). Asymptomatic patients had a significantly longer time (62.5 +/- 6.2 mo) since the mbTBI than symptomatic patients (42.0 +/- 16.4 mo, p < 0.004). Long-term visual dysfunction after mbTBI is common even years after injury despite excellent distance visual acuity and is more frequent if more than one incidence of mbTBI occurred. We recommend obtaining a careful medical history, evaluation of symptoms, and binocular vision assessment during routine eye examinations in this prepresbyopic patient population.
authors.affiliation: Department of Surgery/Eye Clinic, Department of Veterans Affairs Medical Center, 50 Irving St NW, Washington, DC 20422. maria.magone@va.gov.
authors.forename: M Teresa
authors.initials: MT
authors.lastname: Magone
authors.forename: Ellen
authors.initials: E
authors.lastname: Kwon
authors.forename: Soo Y
authors.initials: SY
authors.lastname: Shin
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000453:epidemiology*; D001930:Brain Injuries / Q000453:epidemiology*; D015984:Causality; D002908:Chronic Disease; D015897:Comorbidity; D005107:Explosions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D015835:Ocular Motility Disorders / Q000453:epidemiology; D020795:Photophobia / Q000453:epidemiology*; D012189:Retrospective Studies; D014474:Unconsciousness / Q000453:epidemiology; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data*; D014786:Vision Disorders / Q000453:epidemiology*
keywords: accommodative insufficiency; blast-induced traumatic brain injury; combat-related traumatic brain injury; convergence insufficiency; dismounted injury; eyes; loss of 
  consciousness; mild traumatic brain injury; near vision deficit; photophobia; traumatic brain injury; visual dysfunction