Vision Problems Associated with Traumatic Brain Injury, TBI

Full Article at: Federal Agencies Share Latest Research on Polytrauma and Reintegration at Conference

A further highlight of the conference was a presentation by Gregory Goodrich, Ph.D., of the VA Palo Alto Healthcare System, on vision problems relating to TBI. At least 6,000 Veterans are affected by visual problems related to TBI, said Goodrich. He described efforts to develop new tests and therapies to detect and treat many serious conditions.

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In fact, the American Society of Cataract and Refractive Surgery says 85 percent of soldiers with traumatic brain injury have some type of vision problem.

Full Article at: Iraq, Afghanistan Soldiers Suffer Unseen Eye Injuries
While soldiers wear protective armor, the gear doesn’t protect against all injuries. Of particular devastation are roadside bombs, high energy explosive devices that may be packed with shrapnel, nails or other sharp objects to cause death or maximize injury. Often the face is unprotected, leading to serious facial trauma (including damage to the eyes and potential loss of sight).

The American Society of Cataract and Refractive Surgery reports at least 16 percent of soldiers injured in Iraq or Afghanistan have some type of eye damage (compared to six percent of World War II veterans and nine percent of Vietnam veterans).

Researchers are finding that even if the soldier wears protective eyewear, vision can still be affected. Glenn Cockerham, M.D., Ophthalmologist with the V.A. Palo Alto Healthcare System in Palo Alto, CA, says the blast can induce indirect damage through traumatic brain injury. When a soldier is propelled into the air from the force of a bomb, the brain bounces back and forth inside the skull, bruising the delicate nerve fibers. In addition, the heat and pressure changes associated with the velocity of the blast wave can also injure the brain, even when there are no outward signs of injury.

Vision problems without any obvious physical damage to the eye are called closed globe injuries. Cockerham says soldiers can have significant problems, like retinal detachment, optic nerve damage or a tear of the iris (leading to eye drainage problems and glaucoma). More importantly, many of the vision problems (like the ability to use both eyes together) can’t easily be detected because soldiers still have 20/20 vision, and thus pass standard eye screening tests.

Cockerham says closed globe injuries are most commonly associated with traumatic brain injury. In fact, the American Society of Cataract and Refractive Surgery says 85 percent of soldiers with traumatic brain injury have some type of vision problem. So, Cockerham uses an “ocular trauma exam” to thoroughly examine the eyes and vision of soldiers with brain injuries.