@article{ref1,
title="Visual Impairment and Dysfunction in Combat-Injured Service Members With Traumatic Brain Injury",
journal="Optometry and vision science",
year="2009",
author="Brahm, Karen D. and Wilgenburg, Heidi M. and Kirby, J. and Ingalla, Shanida and Chang, Chung-Yi and Goodrich, Gregory L.",
volume="86",
number="7",
pages="817-825",
abstract="PURPOSE.: The purpose of this study was to determine the frequencies of visual impairment and dysfunction among combat-injured Polytrauma Rehabilitation Center (PRC) inpatient and Polytrauma Network Site (PNS) outpatient military personnel with traumatic brain injury (TBI). METHODS.: A retrospective analysis of data from vision screenings of 68 PRC-inpatients with moderate to severe levels of TBI and 124 PNS-outpatients with mild TBI at the VA Palo Alto Health Care System was conducted. RESULTS.: Eighty-four percent of PRC-inpatients and 90% of PNS-outpatients had TBIs associated with a blast event. The majority of patients in both the PRC and PNS populations had visual acuities of 20/60 or better (77.8% PRC, 98.4% PNS). Visual dysfunctions (e.g., convergence, accommodative, and oculomotor dysfunction) were common in both PRC and PNS populations. In the PRC-inpatient population, acuity loss of 20/100 to no light perception (13%) and visual field defects (32.3%) were found. In the PNS-outpatient population, acuity loss of 20/100 to no light perception (1.6%) and visual field defects (3.2%) were infrequently found. In both the PRC and PNS populations, visual field defects were more often associated with blast than non-blast events. CONCLUSIONS.: Blast events were the most frequent mechanism of injury associated with TBI in combat-injured servicemembers. The vision findings suggest that combat troops exposed to blast with a resulting mild TBI are at risk for visual dysfunction, and combat troops with polytrauma injuries are at risk for visual dysfunction and/or visual impairment. The visual consequences of such injuries necessitate further study and support the need for appropriate evaluation and treatment in all severities of TBI.<p /> <p>Language: en</p>",
language="en",
issn="1040-5488",
doi="10.1097/OPX.0b013e3181adff2d",
url="http://dx.doi.org/10.1097/OPX.0b013e3181adff2d"
}