Optometry - Journal of the American Optometric Association
Clinical researchThe frequency of occurrence, types, and characteristics of visual field defects in acquired brain injury: A retrospective analysis
Section snippets
Previous studies of visual field defects in ABI
There have been several noteworthy investigations on the occurrence of visual field defects in individuals with ABI. The report by Zihl8 was based on a group of 392 patients who were examined between 1978 and 1986. His subjects were predominately individuals with CVA (79%). Zihl8 found that 370 (94%) of his subjects had unilateral defects, whereas the remaining 22 subjects had bilateral defects. Overall, hemianopias predominated, whereas quadrantanopias and paracentral scotomas were rare. He
Methods
A computer-based query was obtained for patients examined at the Raymond J. Greenwald Rehabilitation Center (RJGRC) between October 1, 2000, and October 7, 2003. This unit is a clinic at the State University of New York, State College of Optometry. The query used the 99203 (new patient evaluation) and 99213 (established patient evaluation) Current Procedural Terminology (CPT) codes. The majority of these patients were referred from rehabilitation professionals at the following institutions:
Frequency of occurrence of the targeted field defects in the total ABI sample and the TBI and CVA groups
Some type of visual field defect was specified in 102 records of the 220 in the sample of ABI patients (46.36%). The TBI group accounted for 62 of these defects, and the CVA group for 40. Table 3 presents these numbers and the percentages for the TBI and CVA groups and the total ABI sample (TBI+CVA).
The data for the types of the targeted visual field defects found in the total sample of 220 and the subgroups are presented in Table 4. It shows that, in the TBI group, the most frequent defect was
Comparison of the current findings with those of other studies
The findings for our overall ABI sample and the breakdown into the CVA and TBI groups allow for focused comparisons with other studies. Thus, in our combined pool of 160 TBI and 60 CVA subjects, 102 (46.36%) had some type of visual field defect according to the targeted categories. In the more numerous TBI group, 38.75% had 1 of these defects (see Table 3). This percentage is quite close to the findings of Sabates et al.10 of 35% in their sample of 188 TBI closed head patients. It is also close
General comments
An indication of the increasing involvement of optometrists in the ocular and visual care of ABI patients is the number of their contributions to the general rehabilitation literature pertaining to these patients.6, 7, 9, 23 Further, recent articles that studied the same sample as the present study's have indicated that these patients are at significant risk for various types of ocular disease24 and oculomotor dysfunctions.25 The potential negative effects of both conditions on one's quality of
Summary
- 1
The current study is unique in that the frequency of occurrence and the lateral and altitudinal characteristics of specific types of visual field defects are presented for a total group of ABI patients and additionally for the TBI and CVA subgroups.
- 2
In the total sample (ABI) of 220 subjects, 46.36% had a diagnosis of visual field defect (see Table 3).
- 3
In the TBI sample of 160 subjects, 38.75% had a diagnosis of visual field defect (see Table 3).
- 4
In the CVA sample of 60 subjects, 66.67% had a
References (29)
- et al.
Detection of visual field deficits and visual neglect with computerized light emitting diodes
Arch Physical Med Rehab
(1994) - et al.
Occurrence of oculomotor dysfunction in acquired brain injury: A retrospective analysis
J Am Optom Assoc
(2007) - et al.
The neuropsychological evaluation: A pathway to understanding the sequelae of brain injury
- et al.
An overview of acquired brain injury and optometric implications
- et al.
The occurrence of ocular and visual dysfunctions in an acquired brain-injured patient sample
J Am Optom Assoc
(1999) - et al.
Clinical management of binocular vision
Visual dysfunction following traumatic brain injury
Rehabilitation and management of visual dysfunction following traumatic brain injury
- et al.
Vision disturbances following traumatic brain injury
Curr Treat Options Neurol
(2002) Cerebral disturbances of elementary visual dysfunctions
Rehabilitative optometric interventions for the adult with acquired brain injury
Neuro-ophtlalmological findings in closed head injury
J Clin Neurol Ophthalmol
Early rehabilitation after stroke
Stroke re-visited: visual problems following stroke and their effect on rehabilitation
British Orthoptic Journal
Cited by (72)
Intrinsically photosensitive retinal ganglion cell-driven pupil responses in patients with traumatic brain injury
2021, Vision ResearchCitation Excerpt :Symptoms in TBI patients are often multifactorial, including both physical and cognitive impairments. Up to 60% of TBI patients report some form of visual impairment (Ciuffreda et al., 2007), including oculomotor and binocular deficits (Cockerham et al., 2009, Kapoor & Ciuffreda, 2002), photophobia (Capo-Aponte et al., 2012, Waddell & Gronwall, 1984), and visual field defects (Lemke et al., 2013, Suchoff et al., 2008). Similar to findings in other neurological conditions, such as Alzheimer’s (Kirbas et al., 2013, Parisi et al., 2001) and multiple sclerosis (Cheng et al., 2007, Narayanan et al., 2014), patients with TBI have been shown to demonstrate abnormal findings in the inner retina, specifically, of the retinal ganglion cells.
Disrupted resting-state EEG alpha-band interactions as a novel marker for the severity of visual field deficits after brain lesion
2021, Clinical NeurophysiologyCitation Excerpt :Homonymous visual field defects (HFVDs) are a common consequence of acquired brain injuries and greatly affect quality of life (Hepworth et al., 2016; Rowe et al., 2013; Suchoff et al., 2008).
Scan path during change-detection visual search
2021, Computers in Biology and MedicineRehabilitation Assessment and Management of Neurosensory Deficits After Traumatic Brain Injury in the Polytrauma Veteran
2019, Physical Medicine and Rehabilitation Clinics of North AmericaCitation Excerpt :Visual compensatory strategies include the following: Use rehabilitation that stresses peripheral awareness and teaches patients to continuously scan their environment.51,54 Scroll or tilt reading material away from the field of loss.51
Vision Rehabilitation After Traumatic Brain Injury
2019, Physical Medicine and Rehabilitation Clinics of North AmericaCitation Excerpt :Visual field deficits have been found in 35% of patients with TBI in a sample clinic population having a range of visual symptoms.27 Deficits of all types may be present, ranging from hemianopia to small, scattered regions of reduced sensitivity (Table 6).27 Fig. 2 is an algorithm that outlines the steps and clinical decision points in the eye care and rehabilitation process for patients with visual field loss associated with TBI/acquired brain injury.