Mild Traumatic Brain Injury (mTBI)

Often visual problems resulting from Concussions and other Traumatic Brain Injury are overlooked during initial treatment of the injury. Frequently these problems are hidden and neglected, lengthening and impairing rehabilitation. Because there is a close relationship between vision and the brain, Traumatic Brain Injury, including Concussions and Sports-related Head Injury can disrupt the visual process, interfering with the flow and processing of information.

Below are papers published by researchers investigating the visual symptoms that occur after mild traumatic brain injury (mTBI) as well as the effect of various treatments on these symptoms. 


Symptoms of mTBI

Chronic visual dysfunction after blast-induced mild traumatic brain injury

Written by M. Teresa Magone, MD;* Ellen Kwon, OD; Soo Y. Shin, MD

This study investigates visual dysfunction long term in patients with mild traumatic brain injury (mTBI) as a result of a blast injury who sustained no eye injuries. Long term visual dysfunction is common years after injury was induced despite strong visual acuity, or sharp vision, and is more frequent if multiple blast injuries occurred.

To read this paper in full, please click here.


Vision Concerns After Mild Traumatic Brain Injury

Written by Brad P. Barnett, MD, PhD Eric L. Singman, MD, PhD

This review covers the acute and chronic effects of mild traumatic brain injury (mTBI) and current and future techniques that are used to identify and treat visual symptoms.

To read this paper in full, please click here.


Deficits in Visual System Functional Connectivity after Blast-Related Mild TBI are Associated with Injury Severity and Executive Dysfunction

Written by Casey S. Gilmore, Jazmin Camchong, Nicholas D. Davenport, Nathaniel W. Nelson, Randy H. Kardon, Kelvin O. Lim & Scott R. Sponheim

Results of this study demonstrate the relationship between the severity of mild traumatic brain injury (mTBI), executive processes of the brain, and integration of visual sensory inputs.

To read this paper in full, please click here.


Improving Eye Motility after mTBI

Oculomotor Rehabilitation in Acquired Brain Injury: A Case Series

Written by Neera Kapoor, OD, MS, Kenneth J. Ciuffreda, OD, PhD, Ying Han, MD, PhD

In a case series study, investigators measured the effects of oculomotor rehabilitation on ocular motility, or eye movement, and reading eye movements using eye movement recordings and subjective measures of reading ability in an individual with a traumatic injury, and another who suffered a stroke. Both individuals showed improvements in objective measures of eye movement, and subjective measures of reading ability and therefore suggests a need for further clinical trials in this field.

To read this article in full, please click here.


Effect of chromatic filters on visual performance in individuals with mild traumatic brain injury (mTBI): A pilot study

Written by Vanessa Fimreite, Kevin T. Willeford, Kenneth J. Ciuffreda

Reading performance and visuo-cortical responsivity were tested in adults with mild traumatic brain injury (mTBI) wearing spectral filters, as objective measures of their effects have not been previously recorded. Results indicated that the use of spectral filters should be used in conjunction with other treatments in photosensitive patients or those suffering from mTBI.

To read this article in full, please click here.


Oculomotor neurorehabilitation for reading in mild traumatic brain injury (mTBI): An integrative approach

Written by Preethi Thiagarajan,∗, Kenneth J. Ciuffreda, Jose E. Capo-Aponte, Diana P. Ludlam and Neera Kapoor

Oculomotor-based vision rehabilitation (OBVR) had a positive effect on eye movement control, reading rate, and overall reading ability in individuals with mild traumatic brain injury (mTBI).

To read this article in full, please click here.


Effect of oculomotor rehabilitation on accommodative responsivity in mild traumatic brain injury

Written by Preethi Thiagarajan, BS Optom, MS, PhD;* Kenneth J. Ciuffreda, OD, PhD

Accomodation, or the ability to focus the eyes, was measured before and after oculomotor training (OMT) in individuals with mild traumatic brain injury (mTBI) and showed improvement, suggesting oculomotor learning and brain-visual plasticity in the adult brain.

To read this article in full, please click here.


Improving Vergence Symptoms after mTBI

Objective Assessment of Vergence after Treatment of Concussion-Related CI: A Pilot Study

Written by Mitchell Scheiman, OD, PhD, FAAO, Henry Talasan, MS, Gladys L Mitchell, MAS, FAAO, and Tara L. Alvarez, PhD

This study uses objective measures of disparity vergence as an outcome measure for convergence insufficiency related to a concussion injury, a condition wherein the eyes are unable to work together to look at a nearby object. The use of disparity vergence as an objective measure after therapy is important as it gives researchers physiological information that is not typically accessible with traditional clinical tests, and can be used in clinical trials in the future that investigate novel therapies.

To read this article in full, please click here.


Effect of oculomotor rehabilitation on vergence responsivity in mild traumatic brain injury

Written by Preethi Thiagarajan, BS Optom, MS, PhD;* Kenneth J. Ciuffreda, OD, PhD

A range of vergence responses were measured in individuals with mild traumatic brain injury (mTBI) before and after oculomotor training (OMT) and showed significant improvement affecting near-vision problems and visual attention.

To read this article in full, please click here.


Treating Multiple Symptoms of mTBI

Vision therapy for oculomotor dysfunctions in acquired brain injury: A retrospective analysis

Written by Kenneth J. Ciuffreda, O.D., Ph.D., Daniella Rutner, O.D., M.S., Neera Kapoor, O.D., M.S., Irwin B. Suchoff, O.D., D.O.S., Shoshana Craig, O.D., and M.E. Han, O.D.

This study investigated the effects of conventional optometric treatments for oculomotor disorders resulting from either mild traumatic brain injuries (mTBI) or cerebrovascular accidents (CVA) in adults. The results showed that 90% of the mTBI adults and 100% of the CVA adults had treatment success even at retesting which took place 2-3 months after completion of therapy.

To read this article in full, please click here.


A Novel Computer Oculomotor Rehabilitation (COR) Program for Mild Traumatic Brain Injury (mTBI)

Written by Kenneth J. Ciuffreda, Naveen K. Yadav, Preethi Thiagarajan, and Diana P. Ludlam

Researchers present a computer based oculomotor rehabilitation program which resulted in successful treatment for patients suffering from visual symptoms resulting from traumatic brain injury (TBI). 

To read this article in full, please click here.


Vision Therapy for Post-Concussion Vision Disorders

Written by Michael Gallaway, Mitchell Scheiman, and G. Lynn Mitchell

This case series investigated the most common visual symptoms of convergence insufficiency and accommodative insufficiency following concussions and concluded that completion of visual therapy improved the aforementioned visual symptoms in most cases.

To read this article in full, please click here.


Investigating Brain Responses after mTBI

Effect of oculomotor vision rehabilitation on the visual-evoked potential and visual attention in mild traumatic brain injury

Written by Naveen K. Yadav, Preethi Thiagarajan, & Kenneth J. Ciuffreda

Significant changes were recorded on visual evoked potentials (VEP) and visual attention in adults with mild traumatic brain injury (mTBI) following oculomotor vision rehabilitation (OVR) indicating this type of rehabilitation affects the visual system at early visuo-cortical levels among other visual pathways.

To read this article in full, please click here.


Framework for Patient Treatment

Conceptual Model of Optometric Vision Care in Mild Traumatic Brain Injury

Written by Kenneth J. Ciuffreda, O.D., Ph.D., Diana P. Ludlam, B.S.

This article proposes a four tier conceptual model for optometric care for patients with mild traumatic brain injury (mTBI) to make the process less overwhelming. The four tiers include: optometric exam, and analysis of oculomotor problems, non-oculomotor problems, and non-visioned based problems.

To read this article in full, please click here.

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