Optometry & Vision Science

Much has been said in the past decade concerning traumatic brain injured patients. Although each injury is particularly

unique, certain general observations can be made of neurologically-driven behaviors that seem to be both reasonably

common and associated with this type of sudden, forced movement of the cranial bony structures and the resulting actions

within the cerebral soft tissues. The visual pathways and the globe itself are in a unique position to reveal certain aspects of the

neural damage. Visual field studies, oculocoherence tomography, and dilated fundus examination can be used to demonstrate

vitreous detachments, scotomas, and retinopathy, while other routine testing demonstrates paresis of accommodation,

convergence insufficiency, irregular eye movements, and numerous other degradation of binocular function. As an active

contributor to the general health care team, the eye care specialist should be aware of at least the most common signs, both focal

and global and the associated symptoms. Recent studies have been published that support the contentions of those providers

who work routinely with this particular population. While much research remains to be done, the authors of this paper have

proposals that seem to at least partially suggest possible physical explanations for several of the most commonly encountered

challenges experienced in a significant group of athletes, accident victims and soldiers. This presentation has been developed

based upon clinical experience of the traumatic brain injury (TBI) team in a Veterans Health Administration hospital, a team

of providers that assesses, diagnoses and provides rehabilitation on an outpatient level to patients who have sustained a wide

variety of brain injuries. Principally developed by those who provide this service on a daily basis, the observations are those

of rehabilitative neurological professionals and will provide comment on the mechanism of injury, some diffuse effects on the

structure and function and an attempt to incorporate approaches and applications of techniques used today in restoration of

neuromuscular function in those with traumatic cerebrospinal injury.