Optometric Care of Acquired Brain Injuries

Vision problems and symptoms are among the most common difficulties associated with acquired brain injuries. The nerve systems that control the way the eyes work and focus together, and transmit the visual information to the back of the brain for understanding of our visual world, are the most complex systems of the brain. Vision enables us to be aware of our surroundings and to know where we are in our world, to steer our walking through our environment, to direct the hand and other actions to write and hold things, and to help us stay balanced.

Since vision systems are in many parts of the brain, it is possible for any insult to the brain to lead to significant effects on a person's ability to read, drive, walk and work. A vision problem can also restrict a person's ability to benefit as much as possible from rehabilitation services.

Brain injuries which may cause visual problems can result from: stroke; motor vehicle accident; falls; sporting head injuries and concussion; and domestic violence, including child abuse

By far the most common injury we deal with is stroke.

The symptoms of eye and vision problems associated with acquired brain injury include, but are not limited to, the following: Double vision; Blurred vision; Poor reading comprehension; Headaches; Dizziness and Sensitivity to light.

Optometric Assessment and Management

The person with vision problems following brain injury should be examined by an optometrist who has special training and experience in care of eye and vision problems related to brain injury. Frequently the optometrist will work together with the occupational therapist, neurologist, general medical practitioner, and other rehabilitative specialists to relate specific visual problems to the effects on the person's ability to function in activities of daily living, as well as the ability to benefit fully from other rehabilitative services.

Optometric management may include: Spectacles to provide clear and stable vision following the head injury; special lens to treat double vision, or provide more stable balance and movement; Special tints to reduce light sensitivity.

A big part of the therapy is counselling and education of patient, family, and caregivers about the patient's visual problems, functional implications, goals, prognosis and management options.

The optometrist's role is to provide essential vision services in diagnosing and treating eye and vision problems to maximise the patient's visual function and comfort, and subsequent quality of life.