CT scans are tools used for differential diagnosis and may help rule out structural problems. However, as this study clearly highlights, even if the results are negative, patients should be followed up on the functional deficits that are often invisible on imaging because symptomology-wise, they are detrimental to the patients.
Vision may also be involved. In this study specifically, patients were assessed with the Rivermead Post Concussion Questionnaire (RPQ) and the Brief Symptom Inventory-18 at 3 months. These tools measure severity of several physical symptoms associated with post-concussion syndrome but do not include queries about the visual system.
Previous studies showed that 90% of TBI patients suffer from visual dysfunctions, such as, but not limited to, blurred vision, sensitivity to light, reading difficulty, headaches with visual tasks, reduction or loss of visual field, and difficulties with eye movements. As optometrists, we are well aware that, left untreated, visual system disorders can have serious consequences, such as the ability to organize and make sense of visual information, poor depth perception, and difficulties concerning balance and posture.
This study also found that that less than half of patients with mTBI self-reported receiving TBI educational material at discharge or seeing a medical practitioner within 3 months of the injury. Patients with persistent symptoms often are not aware of what to expect in their road to recovery and assume their symptoms will pass over time.
Members of the Neuro-Optometric Rehabilitation Association (NORA) provide patients with brain injury-related disabilities with a complete ocular health evaluation and visual rehabilitation program. We are a group of professionals with specific training and clinical experience in this area. Because no brain injury is like the other, we use an interdisciplinary, integrated team approach to tailor our rehabilitation programs to the patient’s individual needs.
NORA is also in the process of updating its website and working on the development of educational resources to help patients, caregivers and health care professionals. We welcome the opportunity to partner with other professional organizations within and outside of eye care who play a vital role in the rehabilitation of patients with concussions, stroke or other neurological deficits.
Shirley Ha, HBSc, OD, FCOVD, LBM
Dr. Patricia Fink Optometry, Burlington, Ontario
Chair, NORA Membership Committee
Disclosures: Ha reports no relevant financial disclosures