AOA brain injury manual addendum now available

An expanded AOA resource reinforces doctors' playbooks when it comes to patients with brain injuries, as the sport nearly synonymous with big hits and concussion risk takes the gridiron once again.

The next iteration of the AOA Vision Rehabilitation (VR) Brain Injury Electronic Resource Manual( BIERM), titled  Volume 1B: Traumatic Brain Injury: Optometric Management and Advanced Topics,   is now available as a comprehensive resource to aid doctors in evaluating such patients.

While BIERM Volume 1A: Traumatic Brain Injury Visual Dysfunction Diagnosis, addresses optometry's overall involvement in management and rehabilitation of patients with traumatic brain injury (TBI), Volume 1B provides an overview of high-yield optometric management protocols that are important to incorporate into the care of patients with visual sequelae of closed head trauma.

Volume 1B provides doctors with insight into subjects, including:

• Optometric management for visual sequelae of traumatic brain injury
• Practical general consideration for management of patients with visual sequelae of TBI
• Advanced topics, such as prescribing contact lenses for TBI patients, management of low vision in TBI patients and more
• Sample case studies
• Practice management considerations

Chrystyna Rakoczy, O.D., AOA Brain Injury Committee chair, says these topics present options doctors can easily put into practice without investment of costly resources.

"This Volume summarizes the foundations of optometric visual therapy/neuro-optometric rehabilitative therapy, thereby providing the primary eye care optometrist with the basics, emphasizing the importance of co-management with colleagues who provide optometric rehabilitative visual therapy services," Dr. Rakoczy says.

The BIERM—the culmination of six years of work—incorporates the latest advances in evaluation, management and rehabilitation, riding a groundswell of awareness in recent years about TBIs as highlighted by wounded combat veterans and America's sports culture.

Growing awareness for optometry's role in concussion assessment

By far, falls are the most common cause of TBI in the United States, yet it's under the stadium lights that TBI continues to generate headlines—and it's here that the role of optometry in injury assessment also is grabbing attention.

Football, the leading cause of organized sports-related TBI nationwide, returns September 3 with kickoff to the college season. Data from the NCAA Injury Surveillance Program shows concussions comprised 8% of college football injuries—of 24 programs tracked—with a 1-season concussion risk of 5% in 2015. And when it came to high school football, there was an even higher 10% 1-season concussion risk, according to a July 2015 study published in JAMA Pediatrics.

Nearly 50% of the brain is devoted to vision, meaning doctors of optometry are a crucial part of a multidisciplinary approach to care. Concussed patients often display signs of vision problems, including accommodative disorders, convergence insufficiency and saccadic dysfunction.

Sideline tests now track visual processing to determine concussion likelihood, and emergent technology also recognizes eye doctors' strengths in determining abnormal eye movements and feedback.

Read more about optometry's role in TBI management in the September 2014 edition of AOA Focus.