What you need to know about traumatic brain injury

Bomb blasts during wartime, motor vehicle accidents and big hits in competitive sports—all of these can cause traumatic brain injury (TBI).

"The document offers clinical pearls and advanced evaluation techniques."

Safety concerns in the NFL and wounded warriors returning home have put TBI in the spotlight. Because of the visual disorders associated with brain injury, optometrists have reasons to pay attention.

With increased awareness of TBI, the AOA's Vision Rehabilitation Section has developed the new Brain Injury Electronic Resource Manual (BIERM). The manual, developed over six years, is a comprehensive resource to aid optometrists in evaluating patients with brain injury.

"For the best patient outcomes, optometrists need to be involved with the rehabilitation team," said Maria Santullo Richman, O.D., member of the committee that developed the manual and chair of the AOA's Vision Rehabilitation Section. "In the past, few optometrists were on staff at hospitals or in rehabilitation centers. We wouldn't see these patients until much later in their care continuum. That's changing, and this manual reflects the optometrist's role in the rehabilitation model."

Clinical pearls for practicing ODs

"We took a hard look at research and clinical guidance on diagnosis of TBI," Dr. Richman said. "In turn, the document offers clinical pearls and advanced evaluation techniques for working with brain-injured patients."

The first section of the BIERM focuses on evaluation and assessment of common visual conditions associated with TBI, including binocular vision, accommodative, and eye movement disorders. To make it easier to use, it includes helpful elements such as a glossary, lists of commonly used equipment and an overview of the numerous tests involved in evaluation.

The work does not stop with the first volume.  A second volume in development will focus on treatment and management of brain-injured patients over time.

"Many ODs are already involved in caring for patients with brain injury, but there is still a lot of opportunity for others," Dr. Richman said. "Through this manual, we hope to make it easier for optometrists to help these patients—and give them a better quality of life."

January 29, 2014

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