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2018 AOA TBI Panel

BVVT 2018 03 17 079

Concussion/Traumatic Brain Injury Panel

Part 2: Vision Assessment after Brain Injury

AOA TBI Part2 Simonson LECTURE SLIDES

Visual problems resulting from Traumatic Brain Injury (TBI)

and

Clinical chair-side pearls when working with Post-Concussion Vision Syndrome

Additional Resources:

  1. OCULOMOTOR
    1. VOMS: Vestibular Oculo-motor ScreenSource: Mucha A, Collins MW, Elbin RJ, Furman JM, Troutman-Enseki C, DeWolf RM, Marchetti G, Kontos AP. A brief vestibular andocular motor screening(VOMS) assessment to evaluate preliminary concussion: Preliminary findings. Am J Sports Med; in press.
      Form Sources: https://www.bamc.org/media/1393/voms-exam.pdf
      https://www.physiotherapyalberta.ca/files/vomstool.pdf
      VOMS Instruction Set
       https://www.youtube.com/watch?v=PJLv5zdmEns
    2. The King-Devick Test: https://kingdevicktest.com/
    3. NSUCO Oculomotor Test
      NSUCO-Oculomotor-Test Instruction Set
      Norms for Oculomotor Skills: Pursuits and Saccades: https://www.oepf.org/sites/default/files/journals/jbo-volume-3-issue-6/3-6%20Maples.pdf
  2. PERIPHERAL VISION
    1. Tests for Neglect/Unilateral Spatial Inattention: https://www.strokengine.ca
    2. amsler-grid
  3. PERCEPTION: VISUAL/VESTIBULAR
    1. Visual Vertigo
    2. Balance Error Scoring System manual
    3. BIVSS Symptom Assessment: BIVSS_clinical
      Brain_Injury_Vision_Symptom_Survey__BIVSS_.98478_08.2016
    4. http://www.braininjuries.org/traumatic_brain_injury.html
  4. BINOCULAR (Sensory Fusion/Motor Alignment)
    1. Worth 4 Dot W4D results
    2. Bagolini Lens Bagolini Test Responses
  5. VISION REHABILITATION
    1. Neuro-optometric Rehabilitation Association: https://noravisionrehab.com/
    2. Vision Training can decrease concussions: http://healthnews.uc.edu/news/?%2F26057%2F

Courses for additional training:

Neuro-optometric Rehabilitation Association: https://noravisionrehab.com/clinical-skills/fellowship-program

The College of Optometrists in Vision Developoment: https://www.covd.org/page/braininjury?

The Optometric Extension Program Foundation: http://oepf.org/education

REFERENCES:

Research supporting vision rehabilitation following head injury:

1.Vision Therapy for Post-Concussion Vision Disorders. Gallaway, M, et al. Optometry & Vision Science: Jan 2017 – Vol 94 – Issue 1 – p. 68-73 .

2.A Review of the Current Practice in Diagnosis and Management of Visual Complaints Associated with Concussion and Postconcussion Syndrome. Heinmiller, L and Gunton, K. Curr Opin Ophthalmol 2016; 27(5): 407-412.

3.Current and Emerging Rehabilitation for Concussion: A Review of the Evidence. Broglio, S, et al. Clin Sports Med 2015 April; 34 (2): 213-231.

4.Concurrent Vision Dysfunctions in Convergence Insufficiency with Traumatic Brain Injury. Alvarez, T, et al. Optom Vis Sci. 2012 December: 89 (12)

5.Website (retrieved 2/7/2017) http://casemed.case.edu/clerkships/neurology/NeurLrngObjectives/Vision.htm

6.Review of Optometry, “Save a Life, Neuro-Optometry Primer: The Brain” by Mario Gutierrez, OD, FAAO. https://www.reviewofoptometry.com/CMSDocuments/2009/9/Neuro-Optom-Supp_RO-09.02.09.pdf

7.http://cpdailyliving.com/cortical-visual-impairment-cvi-cerebral-palsy-underdiagnosed-undertreated/

8.http://www.perkinselearning.org/videos/webcast/cortical-visual-impairment-and-evaluation-functional-vision

9.http://www.visiontherapysuccess.com/headtrauma.php

ADDITIONAL INFORMATION:

What did not fit into the alloted time?

Videonystagmography

  1. Ocular Mobility:  the eyes follow objects that jump from place to place, stand still, or move smoothly.
  2. Optokinetic Nystagmus: view a large, continuously moving visual image.
  3. Positional Nystagmus:  You will have your head and body moved into various positions to make sure that there are no inappropriate eye movements (nystagmus), when your head is in different positions. This test is looking at your inner ear system.
  4. Caloric Testing:  Your inner ears (one at a time) with be stimmulated with warm and then cold air. This test in the only test available that can decipher between a unilateral and bilateral loss.

*Please let Dr. Simonson know if there is information that we discussed not included on this page. Thank you for attending this course!