Märta Berthold-Lindstedt1, Jan Johansson2, Jan Ygge2, Kristian Borg1. 1. Division of Rehabilitation Medicine, Department of Clinical Science, Karolinska Institute, Danderyd University Hospital, Stockholm, Sweden. 2. Eye and Vision, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Abstract
BACKGROUND: Acquired brain injury affects many brain areas and causes a range of dysfunctions including vision-related issues. These issues can have negative impacts on rehabilitation progress and activities of daily life but may easily be overlooked. There is no common recommendation about how to assess visual impairments after ABI. The purpose of this study was to estimate the frequency of objectively measures oculomotor dysfunctions, and also how these findings are related to two inventories intended to support detection of visual impairment. METHODS: The study was cross-sectional and included 73 outpatients. In addition to the standard evaluation program, the patients went through a comprehensive optometric examination. The inventories used were the Vision Interview (VI) and the Convergence Insufficiency Symptom Survey (CISS). RESULTS: All three types of examinations showed a high proportion vision-related symptoms. Fusion vergence was the most common objectively measured finding, 83%. There were seven statistically significant associations between five VI items and five visual deficits. The strength of associations was moderate (Phi 0.261-0.487, p < .05). The sensitivity and specificity of the CISS were moderate. CONCLUSION: We found high percentages of the patients with visual symptoms and dysfunctions. Due to the complexity of visual symptoms and functional deficits in ABI, we find it necessary to combine both symptom assessment and vision examination in order to capture visual function issues.
BACKGROUND: Acquired brain injury affects many brain areas and causes a range of dysfunctions including vision-related issues. These issues can have negative impacts on rehabilitation progress and activities of daily life but may easily be overlooked. There is no common recommendation about how to assess visual impairments after ABI. The purpose of this study was to estimate the frequency of objectively measures oculomotor dysfunctions, and also how these findings are related to two inventories intended to support detection of visual impairment. METHODS: The study was cross-sectional and included 73 outpatients. In addition to the standard evaluation program, the patients went through a comprehensive optometric examination. The inventories used were the Vision Interview (VI) and the Convergence Insufficiency Symptom Survey (CISS). RESULTS: All three types of examinations showed a high proportion vision-related symptoms. Fusion vergence was the most common objectively measured finding, 83%. There were seven statistically significant associations between five VI items and five visual deficits. The strength of associations was moderate (Phi 0.261-0.487, p < .05). The sensitivity and specificity of the CISS were moderate. CONCLUSION: We found high percentages of the patients with visual symptoms and dysfunctions. Due to the complexity of visual symptoms and functional deficits in ABI, we find it necessary to combine both symptom assessment and vision examination in order to capture visual function issues.
Authors: Natalya Merezhinskaya; Rita K Mallia; DoHwan Park; Daniel W Bryden; Karan Mathur; Felix M Barker Journal: Optom Vis Sci Date: 2019-08 Impact factor: 1.973