Tbi military 1

Diagnosis and Management of TBI-Related Vision Problems Mitchell Scheiman, OD

Objectives ,[object Object],[object Object],[object Object]

Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Overview of Traumatic Brain Injury

Traumatic Brain Injury (TBI) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Epidemiology of TBI ,[object Object],[object Object],[object Object],[object Object],[object Object]

TBI: Iraq and Afghanistan Wars ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Classification of TBI ,[object Object],[object Object],[object Object]

Judging Severity of TBI ,[object Object],[object Object],[object Object],[object Object]

Post Traumatic Amnesia (PTA) Scale PTA Score Severity of Injury < 10 minutes Very mild 10 to 60 minutes Mild 1 to 24 hours Moderate 1 to 7 days Severe > 7 days Very severe

TBI: Prevalence of Vision Problems in Civilian Population ,[object Object],[object Object],Ciuffreda KJ, Kapoor N, Rutner D, et al. Occurrence of oculomotor dysfunctions in acquired brain injury: a retrospective analysis. Optometry 2007;78:155-61

Results ,[object Object],[object Object],[object Object],[object Object],[object Object]

Recent Prevalence Studies in Military/VA Populations

Goodrich, G et al.- 2007 ,[object Object],[object Object],[object Object],[object Object],Goodrich, G et al. Visual function in patients of a polytrauma rehabilitation center: A descriptive study. Journal of Rehabilitation Research & Development 2007; 44: 929–936

Results Problem All Subjects (n=46) Blast (n=21) NonBlast (n=25) Convergence Insufficiency 30% 24% 36% Accommodative Dysfunction 22% 24% 20% Pursuit/Saccade Dysfunction 20% 5% 32% Visual Field Defects 21% (100 Eyes)

Brahm, et al. - 2009 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Brahm KD, et al. Visual impairment and dysfunction in combat-injured servicemembers with TBI. Optom Vis Sci 2009;86:817-825

Brahm et al. ,[object Object],[object Object],[object Object],[object Object],[object Object]

Stelmack - 2009 ,[object Object],Joan A. Stelmack, O.D., M.P.H. Visual function in patients followed at a Veterans Affairs Polytrauma Network Site: An electronic medical record review. Optometry 2009;80:419-424

Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Prevalence of CI in the TBI Population ,[object Object],[object Object]

Common Vision Problems after TBI? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Optometric Role TBI-Related Vision Disorders

Significance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Optometric Role ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Military Optometric Role ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Vision Rehabilitation Models ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Vision Rehabilitation Team ,[object Object],[object Object],[object Object],[object Object],[object Object]

Occupational Therapist (OTs) ,[object Object],[object Object],[object Object],[object Object],[object Object]

TBI Protocol ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Optometrist ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Optometrist ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Occupational Therapist ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Three Component Model of Vision Visual Integrity Visual Efficiency Visual Information Processing

Visual Information Processing Disorders

Summary ,[object Object],[object Object]

Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

For Model to Work ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tbi military 1

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