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Visual function rehabilitation needed after TBI, stroke

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Most patients with a traumatic brain injury (TBI) or stroke experience visual field (VF) defects with unreliable VF test performance, according to a study

In this retrospective, cross-sectional study, best-corrected visual acuity (BCVA), intraocular pressure (IOP), ocular manifestations, and VF test results including VF defect pattern, reliability, and global indices, were compared between 118 patients (236 eyes) with TBI and stroke who underwent VF testing.

Ocular manifestations of TBI patients included:
-Strabismus (11.1%)
-Cataract (4.2%)
-Glaucoma suspect (2.8%)

Ocular manifestations of stroke patients included:
-Cataract (15.2%)
-Strabismus (8.5%)
-Diabetic retinopathy (4.9%)
-Extraocular movement (EOM) limitation (3.0%)
-Glaucoma suspect (3.0%)
-Nystagmus (2.4%)
-Drusen (1.2%)
-Vitreous hemorrhage (1.2%)

VF defect was noted in 85.5% of eyes of patients with TBI and 65.2% of eyes of stroke patients.

VF defect pattern in TBI patients included:
-Scattered (56.4%)
-Homonymous hemianopsia (14.5%)
-Homonymous quadrantanopia (10.9%)
-Total defect (3.6%)

VF defect pattern in stroke patients included:
-Homonymous hemianopsia (31.8%)
-Scattered (16.7%)
-Homonymous quadrantanopia (12.1%)
-Total defect (4.5%)

Only 27.3% of eyes in TBI patients and 24.2% of eyes in stroke patients showed reliable VF indices.

“Our findings suggest that accurate evaluation and rehabilitation of visual function should be a matter of greater concern and emphasis in the management of TBI and stroke patients, besides systemic diseases,” the authors concluded.

Lee YJ, Lee SC, Wy SY, et al. Ocular Manifestations, Visual Field Pattern, and Visual Field Test Performance in Traumatic Brain Injury and Stroke. J Ophthalmol. 2022;2022:1703806. doi: 10.1155/2022/1703806. PMID: 35036002; PMCID: PMC8759901.