Traumatic Brain Injury Rehabilitation

The statistics surrounding traumatic brain injuries (TBIs) are alarming, with approximately 2.8 million Americans experiencing some form of traumatic injury each year, equating to nearly 1 in 100 individuals. TBIs occur when the brain sustains damage due to a sudden injury, leading to symptoms such as headaches, confusion, poor concentration, and visual dysfunctions, among other issues. However, there is hope for rehabilitation through vision rehabilitation treatment as part of an integrated team approach.

What Is a Traumatic Brain Injury (TBI)?

A TBI refers to damage caused to the brain by a sudden injury. There are two types: closed head injury, where the skull remains intact but the brain may still be affected, and penetrating head injury, which involves a fracture in the skull.

Falls are the leading cause of TBIs, accounting for approximately 47% of cases, particularly among young children and individuals over 65 years old. Other causes include blunt force trauma (15%), car accidents (14%), and physical assaults (9%).

Common symptoms experienced after a TBI include headaches, confusion, dizziness, seizures, impaired concentration, memory issues, and changes in personality. Vision problems often arise due to the brain's extensive involvement in processing visual information.

To recover from a TBI, rehabilitation is crucial and takes various forms based on the individual's specific case and needs. It may involve physical, occupational, and speech therapy, as well as neurological and psychiatric care. Neuro-optometric rehabilitation stands out as one of the most effective approaches for addressing a range of visual problems resulting from traumatic brain injuries.

Rehabilitation for Traumatic Brain Injuries

During the acute stage, moderately to severely injured TBI patients typically receive treatment and care in the intensive care unit of a hospital. Rehabilitation programs will adjust as the patient's needs and abilities change. Rehabilitation can occur in different settings, including inpatient or outpatient rehab hospitals, home-based rehabilitation, day programs, and independent living centers.

What Does Rehabilitation Involve Following Brain Injury?

Since every individual's needs and functions vary following a brain injury, rehabilitation programs are tailored to match the patient's unique goals and requirements. These programs typically involve a case coordinator and a team of healthcare providers. The following treatments are offered based on the patient's abilities and functions, including visual skills, speech ability, mental and behavioral state, and language comprehension:

• Physical therapy
• Physical medicine
• Occupational therapy
• Neuro-optometric rehabilitation
• Psychiatric and psychological care
• Speech and language therapy

How Does TBI Impact Vision?

Studies indicate that approximately 90% of TBI patients experience some form of vision disruption, which occurs due to communication breakdown between the eyes and the brain. Common symptoms include blurred vision, eyestrain, increased sensitivity to light (photophobia), reading difficulties, visual field defects, color contrast issues, vestibular dysfunction, and decreased visual acuity. These visual abnormalities can significantly affect professional, educational, and other aspects of daily life.

Unfortunately, TBI-related vision problems may often go unrecognized during the initial treatment of the brain injury, as visual disruptions may not manifest until some time after the accident.

How Can an Optometrist Aid in TBI Recovery?

Optometrists, who typically work as part of an interdisciplinary team, play a crucial role in treating patients with TBIs. Neuro-optometric rehabilitation optometrists (neuro-optometrists) specialize in assessing and treating TBI-related visual disorders that impact patients' rehabilitation progress and quality of life.

At Child & Family Eye Care, we see a variety of TBI patients, including those who have experienced sports injuries, motor vehicle accidents, or falls. The complexity and severity of visual problems vary among individuals. By staying up-to-date with the latest research, we can create a personalized treatment plan tailored to the patient's unique needs, maximizing their chances of recovery and improvement in vision.

There are two types of eye doctors specializing in the detection and treatment of TBI-related vision problems: neuro-optometrists and neuro-ophthalmologists.

• Neuro-optometrists are Doctors of Optometry (OD) with extensive training in diagnosing and treating neurological conditions that affect the visual system. They provide neuro-optometric rehabilitation, a specialized form of vision rehabilitation for TBI patients.
• Neuro-ophthalmologists, on the other hand, are medically trained eye doctors (MD) who specialize in vision problems related to the nervous system, including TBI-related visual acuity loss.

Both neuro-optometrists and neuro-ophthalmologists can identify TBI-related vision problems and develop customized treatment plans to address them. Treatment may involve specialized glasses to aid visual processing or in-office and at-home neuro-rehabilitation procedures aimed at reducing symptoms and promoting visual recovery.

It's important to note that a single type of vision rehabilitation treatment may not be sufficient to address all the patient's needs. That's why an interdisciplinary, integrated team approach, involving various healthcare professionals, is essential for the rehabilitation of TBI patients.

Neuro-Optometric Rehabilitation for Brain Injuries

Neuro-optometric rehabilitation is a personalized treatment regimen for individuals with visual deficits resulting from traumatic brain injuries, physical disabilities, or other neurological issues. The vision complications that arise following a TBI are not related to visual acuity (20/20 vision) but rather to eye teaming, focusing, and tracking. These issues can lead to difficulties in reading and participating in sports.

The primary goal of neuro-optometric rehabilitation is to retrain the visual system and alleviate the visual symptoms caused by a traumatic brain injury. Through specific eye-training exercises, the brain can be rewired to improve eye function. Like other forms of rehabilitation, starting eye exercises early after a TBI enhances the chances of recovery and visual improvement.

During neuro-optometric rehabilitation, various tools and exercises are used to train different aspects of the visual system, such as eye tracking, focusing, eye teaming, visual discrimination (ability to discern letters like b's and d's), handwriting, and spatial awareness. Patients are assigned a series of home exercises with specialized equipment, and regular follow-up appointments with the optometrist are scheduled to assess progress.

Should Everyone with a Brain Injury See an Eye Doctor?

If you experience a traumatic brain injury, it is important to consult a neuro-optometrist or another eye doctor with specialized training in TBI-related visual abnormalities. This is especially crucial if you notice any changes in your vision following head trauma.

Children with Traumatic Brain Injury

Although the symptoms of TBI in children resemble those in adults, the functional impact can be quite different. Since a child's brain is still developing, a brain injury can lead to cognitive impairments that may not be immediately apparent but may manifest as the child grows older. Physical therapy, occupational therapy, speech therapy, optometric testing, and neuropsychological testing are recommended for children following a brain injury. Rehabilitation helps them compensate for impaired or lost functions and provides strategies to optimize their abilities as they recover.

At Child & Family Eye Care, our caring and knowledgeable staff are dedicated to providing the best vision care and treatment possible for patients of all ages.

We proudly serve patients from The Woodlands, Magnolia, Shenandoah, Tomball, and surrounding communities in Texas.