0
0

Chapter 23. Vision Problems

Neera Kapoor, O.D., M.S.; Kenneth J. Ciuffreda, O.D., Ph.D.
DOI: 10.1176/appi.books.9781585624201.681269

Sections

Excerpt

Vision is one of the primary sensory modalities involved in tasks such as stance, gait, reading, and other basic activities of daily living. Furthermore, adequate vision is a requisite for evaluation and treatment performed during most types of rehabilitation, such as optometric, ophthalmological, neuropsychological, physical, vestibular, occupational, and speech and language therapies. Nonetheless, the diagnosis and management of functional vision deficits have been frequently overlooked in textbooks and teaching curricula used by many rehabilitation professionals (Wainapel 1995). The recent increasing interest in functional vision and its integrative effect on rehabilitation in patients with traumatic brain injury (TBI) (Ciuffreda et al. 2007; Kapoor and Ciuffreda 2002; Suter 2004, 2007; Tinette et al. 1995; Wainapel 1995) serve as the impetus for this chapter.

Your session has timed out. Please sign back in to continue.
Sign In Your Session has timed out. Please sign back in to continue.
Sign In to Access Full Content
 
Username
Password
Sign in via Athens (What is this?)
Athens is a service for single sign-on which enables access to all of an institution's subscriptions on- or off-site.
Not a subscriber?

Subscribe Now/Learn More

PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing PsychiatryOnline@psych.org or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Figure 23–1. Horizontal section of the human eye.AP=anterior pole; CONJ=conjunctiva; LAM CRIB=lamina cribrosa; MED=medial; N=nodal point; PP=posterior pole; VA=visual axis.Source. Reprinted from Last RJ: Wolff's Anatomy of the Eye and Orbit. Philadelphia, PA, WB Saunders, 1968, pp 39–181. Used with permission.

Figure 23–2. Schematic representation of primary neural visual pathways.F = fovea.Source. Reprinted from Trobe JD, Glaser JS: The Visual Fields Manual: A Practical Guide to the Testing and Interpretation. Gainesville, FL, Triad Publishing, 1983, pp 29–62. Used with permission of the publisher.

Figure 23–3. Typical scattered visual field defect pattern after traumatic brain injury.
Table Reference Number
Table 23–1. Percentage of visual and ocular conditions in an acquired brain-injured (ABI) sample with comparative values for a random adult population
Table Reference Number
Table 23–2. Oculomotor deficits following traumatic brain injury
Table Reference Number
Table 23–3. Structural impairments following traumatic brain injury
Table Reference Number
Table 23–4. Vision deficits following traumatic brain injury and their associated principal vision symptoms

References

Baker RS, Epstein AD: Ocular motor abnormalities from head trauma. Surv Ophthalmol 35:245–267, 1991
[PubMed]
 
Baloh RW, Honrubia V: Clinical Neurophysiology of the Vestibular System, 3rd Edition. New York, Oxford University Press, 2001
 
Bartlett JD, Jaanus SD: Clinical Ocular Pharmacology, 5th Edition. Boston, MA, Butterworth-Heinemann, 2008
 
Bengtzen R, Woodward M, Lynn MJ, et al: The "sunglasses sign" predicts nonorganic visual loss in neuro-ophthalmologic practice. Neurology 70:218–221, 2008
[PubMed]
 
Benjamin WJ: Borish's Clinical Refraction, 2nd Edition. St. Louis, MO, Butterworth-Heinemann, 2006
 
Bronstein AM: Vision and vertigo: some visual aspects of vestibular disorders. J Neurol 251:381–397, 2004
[PubMed]
 
Bucci MP, Kapoula Z, Yang Q, et al: Abnormality of vergence latency in children with vertigo. J Neurol 251:204–213, 2004
[PubMed]
 
Chang TT, Ciuffreda KJ, Kapoor N: Critical flicker frequency and related symptoms in mild traumatic brain injury. Brain Inj 21:1055–1062, 2007
[PubMed]
 
Ciuffreda KJ: The efficacy of and scientific basis for optometric vision therapy in non-strabismic accommodative and vergence disorders. Optometry 73:735–762, 2002
[PubMed]
 
Ciuffreda KJ, Tannen B: Eye Movement Basics for the Clinician. St. Louis, MO, Mosby, 1995 (see pp 1–9)
 
Ciuffreda KJ, Suchoff IB, Marrone MA, et al: Oculomotor rehabilitation in traumatic brain-injured patients. J Behav Optom 7:31–38, 1996
 
Ciuffreda KJ, Han Y, Kapoor N, et al: Oculomotor rehabilitation for reading in acquired brain injury. NeuroRehabilitation 21:9–21, 2006
[PubMed]
 
Ciuffreda KJ, Kapoor N, Rutner D, et al: Occurrence of oculomotor dysfunctions in acquired brain injury: a retrospective analysis. Optometry 78:155–161, 2007
[PubMed]
 
Ciuffreda KJ, Rutner D, Kapoor N, et al: Vision therapy for oculomotor dysfunctions in acquired brain injury: a retrospective analysis. Optometry 79:18–22, 2008
[PubMed]
 
Du T, Ciuffreda KJ, Kapoor N: Elevated dark adaptation thresholds in traumatic brain injury. Brain Inj 19:1125–1138, 2005
[PubMed]
 
Eskridge JB, Amos J, Bartlett JD (eds): Clinical Procedures in Optometry. Philadelphia, PA, Lippincott, 1991
 
Fox RS: The rehabilitation of vergence and accommodative dysfunctions in traumatic brain injury. Brain Injury Professional 2:12–15, 2005
 
Girkin CA, Miller NR: Central disorders of vision in humans. Surv Ophthalmol 45:379–405, 2001
[PubMed]
 
Griffin JR, Grisham JD: Binocular Anomalies: Diagnosis and Vision Therapy, 4th Edition. Boston, MA, Butterworth-Heinemann, 2002
 
Han ME, Craig SB, Rutner D, et al: Medications prescribed to brain injury patients: a retrospective analysis. Optometry 79:252–258, 2008
[PubMed]
 
Han Y, Ciuffreda KJ, Selenow A, et al: Dynamic interactions of eye and head movements during return-sweep saccades when reading with single vision and progressive lenses in a simulated computer-based environment. Invest Ophthalmol Vis Sci 44:1534–1545, 2003a
 
Han Y, Ciuffreda KJ, Selenow A, et al: Static aspects of eye and head movement during reading in a simulated computer-based environment with single vision and progressive lenses. Invest Ophthalmol Vis Sci 44:145–153, 2003b
 
Han Y, Ciuffreda KJ, Kapoor N: Reading-related oculomotor testing and training protocols for acquired brain injury. Brain Res Protocols 14:1–12, 2004
[PubMed]
 
Hellerstein LF: Visual problems associated with brain injury, in Understanding and Managing Vision Deficits: A Guide for Occupational Therapists. Edited by Scheiman M. Thorofare, NJ, Slack, 1997, pp 233–247
 
Hellerstein LF, Freed S, Maples WC: Vision profile of patients with mild brain injury. J Am Optom Assoc 66:634–639, 1995
[PubMed]
 
Jackowski MM: Altered visual adaptation in patients with traumatic brain injury: photophobia, abnormal dark adaptation, and reduced peripheral visual field sensitivity, in Visual and Vestibular Consequences of Acquired Brain Injury. Edited by Suchoff IB, Ciuffreda KJ, Kapoor N. Santa Ana, CA, Optometric Extension Program Foundation, 2001, pp 145–173
 
Kapoor N, Ciuffreda KJ: Vision disturbances following traumatic brain injury. Curr Treat Options Neurol 4:271–280, 2002
[PubMed]
 
Kapoor N, Ciuffreda KJ, Harris G, et al: A new portable clinical device for measuring egocentric localization. J Behav Optom 12:115–118, 2001
 
Last RJ: Wolff's Anatomy of the Eye and Orbit. Philadelphia, PA, WB Saunders, 1968 (see pp 39–181)
 
Leigh RJ, Zee DS: The Neurology of Eye Movements, 4th Edition. New York, Oxford University Press, 2006
 
Lepore FE: Disorders of ocular motility following head trauma. Arch Neurol 52:924–926, 1995
[PubMed]
 
Leslie S: Accommodation in acquired brain injury, in Visual and Vestibular Consequences of Acquired Brain Injury. Edited by Suchoff IB, Ciuffreda KJ, Kapoor N. Santa Ana, CA, Optometric Extension Program Foundation, 2001, pp 56–76
 
Malamut D: Vestibular therapy and ocular dysfunction in traumatic brain injury: a case study, in Visual and Vestibular Consequences of Acquired Brain Injury. Edited by Suchoff IB, Ciuffreda KJ, Kapoor N. Santa Ana, CA, Optometric Extension Program Foundation, 2001, pp 201–219
 
Miller NR, Newman NJ, Biousse V, et al (eds): Walsh and Hoyt's Clinical Neuro-ophthalmology, 6th Edition. Philadelphia, PA, Lippincott Williams & Wilkins, 2004
 
Milner AD, Goodale MA: The visual brain in action. Oxford, UK, Oxford University Press, 1995
 
Robertson IH, Halligan PW: Spatial Neglect: A Clinical Handbook for Diagnosis and Treatment. Hove, East Sussex, UK, Psychology Press, 1999
 
Rutner D, Kapoor N, Ciuffreda KJ, et al: Occurrence of ocular disease in traumatic brain injury in a selected sample: a retrospective analysis. Brain Inj 20:1079–1086, 2006
[PubMed]
 
Sabates NR, Gonce MA, Farris BK: Neuro-ophthalmological findings in closed head trauma. J Clin Neuroophthalmol 11:273–277, 1991
[PubMed]
 
Scheiman M, Gallaway M: Vision therapy to treat binocular vision disorders after acquired brain injury: factors affecting prognosis, in Visual and Vestibular Consequences of Acquired Brain Injury. Edited by Suchoff IB, Ciuffreda KJ, Kapoor N. Santa Ana, CA, Optometric Extension Program Foundation, 2001, pp 89–113
 
Scheiman M, Wick B: Clinical Management of Binocular Vision: Heterophoric, Accommodative, and Eye Movement Disorders, 2nd Edition. Philadelphia, PA, Lippincott, 2002
 
Schlageter K, Gray K, Shaw R, et al: Incidence and treatment of visual dysfunction in traumatic brain injury. Brain Inj 7:439–448, 1993
[PubMed]
 
Stedman's Medical Dictionary, 28th Edition. Baltimore, MD, Lippincott Williams & Wilkins, 2005
 
Stein JF: Representation of egocentric space in the posterior parietal cortex. J Exper Physiol 74:583–606, 1989
[PubMed]
 
Suchoff IB, Ciuffreda KJ: A primer for the optometric management of unilateral spatial inattention. Optometry 75:305–318, 2004
[PubMed]
 
Suchoff IB, Gianutsos R: Rehabilitative optometric interventions for the acquired brain injured adult, in Physical Medicine and Rehabilitation: The Complete Approach. Edited by Grabois M, Garrison SJ, Hart KA, et al. New York, Blackwell Scientific, 2000, pp 608–620
 
Suchoff IB, Kapoor N, Waxman R, et al: The occurrence of ocular and visual dysfunctions in an acquired brain-injured patient sample. J Am Optom Assoc 70:301–309, 1999
[PubMed]
 
Suchoff IB, Kapoor N, Ciuffreda KJ, et al: The frequency of occurrence, types, and characteristics of visual field defects in acquired brain injury. Optometry 79:259–265, 2008
[PubMed]
 
Suh M, Basu S, Kolster R, et al: Increased oculomotor deficits during target blanking as an indicator of mild traumatic brain injury. Neurosci Lett 410:203–207, 2006a
 
Suh M, Kolster R, Sarkar R, et al: Deficits in predictive smooth pursuit after mild traumatic brain injury. Neurosci Lett 401:108–113, 2006b
 
Suter PS: Rehabilitation and management of visual dysfunction following traumatic brain injury, in Traumatic Brain Injury Rehabilitation: Rehabilitative Treatment and Case Management, 2nd Edition. Edited by Ashley MJ. Boca Raton, FL, CRC Press, 2004, pp 209–249
 
Suter PS: Peripheral visual field loss and visual neglect: diagnosis and treatment. J Behav Optom 18:78–83, 2007
 
Tinette M, Inouye S, Gill T, et al: Shared risk factors for falls, incontinence, and functional dependence. JAMA 273:1348–1353, 1995
 
Trobe JD, Glaser JS: The Visual Fields Manual: A Practical Guide to Testing and Interpretation. Gainesville, FL, Triad Publishing, 1983, pp 29–62
 
Wainapel SF: Vision rehabilitation: an overlooked subject in physiatric training and practice. Am J Phys Med Rehabil 74:313–314, 1995
[PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Related Content
Articles
Books
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 2.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 4.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 5.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 7.  >
Textbook of Traumatic Brain Injury, 2nd Edition > Chapter 12.  >
Topic Collections
Psychiatric News
PubMed Articles
Electrical stimuli in the central nervous system microenvironment. Annu Rev Biomed Eng 2014;16():397-430.doi:10.1146/annurev-bioeng-121813-120655.
 
  • Print
  • PDF
  • E-mail
  • Chapter Alerts
  • Get Citation