New lab assesses concussions in real time

New lab assesses concussions in real time

A new diagnostic tool could assess the signs of acute traumatic brain injury (TBI) and the cumulative effects on the brain—helping physicians make better recommendations about a youth athlete's return to play after a concussion.

"Optometry can be both proactive and preventive to reduce second concussions"

The new Vestibular and Oculomotor Research Laboratory—or VORLab—is a joint effort between the University of Alabama's Birmingham School of Optometry and Department of Rehabilitation, and the Children's Hospital of Alabama.

Traumatic brain injuries occur when a blow to the head disrupts normal brain function. The most well known TBI—and the one most commonly associated with contact sports—is a concussion.

Researchers at the VORLab are working to create a diagnostic tool that would provide objective and real-time data on what's happening inside the brain in order to properly assess concussions and other TBIs. At the core of the lab is a chair system that performs horizontal, vertical and torsional movements and tracks binocular eye movements and stimulus feedback in real time.

Brenda Montecalvo, O.D., chair of the AOA's Vision Rehabilitation Section (VRS), is excited about the VORLab and believes it's an excellent example of how optometry can play a significant role in the detection, treatment and prevention of concussions.

"It is exciting to see that optometry is working alongside ophthalmology, physical therapy and neurosurgery to provide high-level assessments. Their efforts will help to protect individuals from second concussions that have in the past resulted in severe long-term brain damage," says Dr. Montecalvo.

Although Dr. Montecalvo is hopeful about this research, she realizes it is not all encompassing.

"This tool will measure only one aspect of visual conditions occurring secondary to concussion," she adds. "It is critical that each individual with even a mild concussion has a comprehensive eye and vision evaluation to rule out other vision-related concussion symptoms."

Optometry's role in concussion assessment
The Centers for Disease Control and Prevention reports that, in 2010, 2.5 million emergency department (ED) visits, hospitalizations or deaths in the United States were associated with TBIs.

Currently all 50 states and the District of Columbia have laws aimed at addressing youth sports-related concussions. Many of those laws require that a designated health care provider clear an athlete with a suspected concussion before returning to play.

Dr. Montecalvo, who specializes in treating patients with multiple concussions, says "It is quite obvious that their vision-related brain injuries may have been less severe had they not participated in activities causing a second concussion."

Patients who experience multiple concussions often deal with constant pain, headache, eyestrain, general poor health and long-term psychological difficulties, according to Dr. Montecalvo.

"If this tool should become commercially available and is provided in an optometric setting, it will allow an optometrist to be on the front line of being able to detect the severity of the concussion. Optometry can be both proactive and preventive to reduce second concussions," says Dr. Montecalvo.

Educating optometrists about brain injury is a goal of the AOA's VRS, which developed the Brain Injury Electronic Resource Manual, available to members online. A second volume, focusing on treatment and management of brain-injured patients over time, will be released later this year.

May 28, 2015

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