Joseph Hallak and Jeffrey Becker
State University Of New York, USA and Pennsylvania State University, USA
Title: Neuro-optometric rehabilitation of Mild Traumatic Brain Injury (mTBI)
Biography
Biography: Joseph Hallak and Jeffrey Becker
Abstract
MTBI is by definition a complex pathophysiological process affecting the brain, induced by biomechanical forces. It is an
injury to the brain resulting in three categories of symptoms: physical/somatic, e.g. headache, vision, GI disturbance;
cognitive, e.g. attention, memory and; psychiatric, e.g. mood swing, personality changes. Most of these symptoms should get
better within 2–3 weeks of total rest (sometimes more) barring any second impact syndrome. A concussion lasting less than
30 minutes with a Glasgow coma scale (GCS 13–15) is considered mTBI. It can result in temporary or permanent neurological
symptoms. Neuro-imaging tests such as CT scan or MRI may or may not show evidence of any damage. High school football
accounts for 47% of all reported sports concussions, followed by ice hockey and soccer. An mTBI accounted 82% of the 340,000
cases of blast injuries in the US military between 2000 and 2015. Highlights of clinical vision and perception examination
and rehabilitation of the mTBI patients include the following: thorough history, correction of small errors, out of instrument
subjective examination, contrast sensitivity and glare assessment, monocular, bi-ocular and binocular accommodative facility,
vergenses, saccades and fusional ranges. Treating patients with equipment that offers visual, vestibular and proprioceptive
abilities will provide the best outcome. Devices and methods tapping multisensory system and featuring feedback with
proprioceptive and balance capability are essential for office and home. That is because the main goals of rehabilitation
are endurance, integration and internalization of learned skills for lasting long term benefits and avoiding regression after
therapy. Keep in mind the three phases of neuro-optometric rehabilitation: visual stabilization: postural/peripheral awareness,
monocular skills; binocular vision integration: oculomotor/accommodative, convergence, stereopsis, localization–static and
dynamic; visual automaticity: multisensory integration.