Vision problems resulting from head and brain injuries - what we can learn from the way the US Army uses vision therapy

Recently an interview appeared between Dr. Kathy Freeman and Dr. Randall Beatty, an assistant professor in ophthalmology at the University of Pittsburgh School of Medicine in Pittsburgh, Pennsylvania, about his experience treating combat eye injuries.

Dr. Beatty served as a colonel in the US Air Force Reserve Medical Service in Irag and Afghanistan, where he treated American service members and Iraqi and Afghan military and police personnel, as well as civilians, who experienced traumatic eye injuries during the course of the wars.

Below is the portion of the interview where the doctors talk about vision problems that arise from brain injuries. Dr. Freeman specifically mentions vision training (vision therapy) as a treatment. There is tons of evidence on the effectiveness of vision therapy in treating vision problems that result form brain injuries.  We have had considerable success in our Vancouver eye clinic treating vision problems that result form brain injuries sustained in car accidents, sports and falls.

Dr. Freeman: What are your thoughts on the traumatic brain injury that might be associated with these injuries?

Dr. Beatty: Well, traumatic brain injury was one of the things that kept us busy. A recent review of the VA literature reports that over 250,000 US service people have been diagnosed with some form of traumatic brain injury.2 The symptoms of those patients who have suffered traumatic brain injury are very similar to those associated with migraine headache—visual distortion, headaches, and extreme photosensitivity, not only to sunlight but even to lights inside. Some patients are very sensitive to the flickering of fluorescent lights. These are some visual disturbances that you won’t pick up just by having someone read an eye chart. The symptoms may be episodic, depending on how the patient is recovering from the post-concussive events, which can take quite a while; some may not really ever recover.

Dr. Freeman: How do you think eye care practitioners can best serve these veterans?

Dr. Beatty: I think that, overall, anyone who has been in a combat zone, and especially anybody who has had a concussion or suffered a concussive force by a nearby IED, will need to have very complete eye examinations on an ongoing basis. Dr. Glen Cockerham, at the VA Hospital in Palo Alto, California, did a study of returning veterans3 and, although the number was small, he found that a very high percentage of those veterans had some sort of ocular abnormality that could be attributable to their time in the combat zone. And that’s where we think that there may be problems with late-onset glaucoma as the years go by and as these veterans get older. In summary, very careful and complete eye examinations are necessary, and the emphasis cannot only be on detecting ocular pathology. It is essential to talk with these patients to determine what bothers them about their visual system—for example, do they experience photophobia or double vision? And, then, institute not only medical treatment but nonmedical as well—such as different types of eyewear that have tints, prism; low-vision devices that address the visual impairment; non-optical aids that can help with the distortion. In addition, there may be some need for different types of visual training. There should be attention to visual field analysis, detecting areas where there may be scotomas or blind spots.
And all of these things may be complicated by the fact that these patients also have cognition problems, deficits of short-term and long-term memory, which impacts their ability to handle low vision devices. Some of them have lost limbs or have other limitations that make it difficult to hold things and that complicate their visual rehabilitation. We’re now saving people on the battlefield with brain injuries and other types of trauma who, in the past, did not make it back to the trauma centers, and they are surviving and undergoing rehabilitation. This will result in more challenging long-term rehabilitative care, which is going to involve extensive physical and occupational therapy. And, in addition to those therapies, there should be visual rehabilitation.

The US army uses doctors of optometry to provide vision therapy to soldiers who have sustained brain injuries.  Here is a video:

RELATED ARTICLES

Traumatic brain injury often results in convergence insufficiency
Dec 11, 2012

Brain injuries and vision problems 
Nov 04, 2012

Vision problems after car accident are caused by brain injury
Nov 07, 2012

Motion sickness and vision therapy - see sickness syndrome
Apr 18, 2012

Image courtesy of koratmember / FreeDigitalPhotos.net

map | directions | FREE parking | book an appointment 

The US Army uses vision therapy to treat traumatic brain injuries

The United States Army uses vision therapy to treat traumatic brain injuries and has developmental optometrists on staff to provide the therapy.  It's no surprise since vision therapy is the most effective way to treat the vision problems that are the result of traumatic brain injury.  Vision therapy can be though of as neuro-ocular rehabilitation or rehab for the eyes and the brain.

At our Vancouver optometry clinic, we have the largest vision therapy practice in the city and we treat many patients who have vision problems as a result of traumatic brain injuries.  Most of the injuries resulted from car accidents or concussions sustained in sporting activities.  If you are reading this because you have vision problems arising form a brain injury, you can find a developmental optometrist near you at the website of the College of Optometrists in Vision Development.

For a list of scientific studies on vision therapy treatment of vision problems caused by brain injury, click here.   Here is a video on how the US army uses vision therapy to treat brain injuries (I bet you've never seen a doctor of optometry in camouflage before!):

http://www.pentagonchannel.mil/

Related Articles

Traumatic brain injury often results in convergence ... - See for Life
Dec 11, 2012
Brain injuries often result in vision problems like convergence insufficiency and other vision problems according to a December 2012 study.

Brain injuries and vision problems - See for Life
Nov 04, 2012
Brain injuries cause vision problems and disorders that are treated by Vision Source Vancouver optometrist, Dr. Mini Randhawa.

Eye movement dysfunctions, their treatment and reading related
Dec 28, 2012
Eye movement dysfunctions, their treatment and reading related problems in patients with mild traumatic brain injury (mTBI)

Vision problems after car accident are caused by brain ... - See for Life
Nov 07, 2012
Vision problems caused by brain injury in a car accident are treated with vision therapy even a decade after the accident.