3
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      How to assess visual function in acquired brain injury—Asking is not enough

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Acquired brain injury affects many brain areas and causes a range of dysfunctions including vision‐related issues. These issues can have negative impacts on rehabilitation progress and activities of daily life but may easily be overlooked. There is no common recommendation about how to assess visual impairments after ABI. The purpose of this study was to estimate the frequency of objectively measures oculomotor dysfunctions, and also how these findings are related to two inventories intended to support detection of visual impairment.

          Methods

          The study was cross‐sectional and included 73 outpatients. In addition to the standard evaluation program, the patients went through a comprehensive optometric examination. The inventories used were the Vision Interview (VI) and the Convergence Insufficiency Symptom Survey (CISS).

          Results

          All three types of examinations showed a high proportion vision‐related symptoms. Fusion vergence was the most common objectively measured finding, 83%. There were seven statistically significant associations between five VI items and five visual deficits. The strength of associations was moderate (Phi 0.261–0.487, p < .05). The sensitivity and specificity of the CISS were moderate.

          Conclusion

          We found high percentages of the patients with visual symptoms and dysfunctions. Due to the complexity of visual symptoms and functional deficits in ABI, we find it necessary to combine both symptom assessment and vision examination in order to capture visual function issues.

          Abstract

          The study explores visual dysfunctions after acquired brain injury in a neurorehabilitation setting and studies the association with visual symptoms. We conclude that both symptom assessment and objective measurements are required to capture these issues.

          Related collections

          Most cited references31

          • Record: found
          • Abstract: found
          • Article: not found

          Occurrence of oculomotor dysfunctions in acquired brain injury: a retrospective analysis.

          The purpose of this retrospective study was to determine the frequency of occurrence of oculomotor dysfunctions in a sample of ambulatory outpatients who have acquired brain injury (ABI), either traumatic brain injury (TBI) or cerebrovascular accident (CVA), with associated vision symptoms. Medical records of 220 individuals with either TBI (n = 160) or CVA (n = 60) were reviewed retrospectively. This was determined by a computer-based query spanning the years 2000 through 2003, for the frequency of occurrence of oculomotor dysfunctions including accommodation, version, vergence, strabismus, and cranial nerve (CN) palsy. The majority of individuals with either TBI (90%) or CVA (86.7%) manifested an oculomotor dysfunction. Accommodative and vergence deficits were most common in the TBI subgroup, whereas strabismus and CN palsy were most common in the CVA subgroup. The frequency of occurrence of versional deficits was similar in each diagnostic subgroup. These new findings should alert the clinician to the higher frequency of occurrence of oculomotor dysfunctions in these populations and the associated therapeutic, rehabilitative, and quality-of-life implications.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Analyzing outcome of treatment of severe head injury: a review and update on advancing the use of the Glasgow Outcome Scale.

            The Glasgow Outcome Scale (GOS), two decades after its description, remains the most widely used method of analyzing outcome in series of severely head-injured patients. This review considers limitations recognized in the use of the GOS and discusses a new approach to assessment, using a structured questionnaire-based interview. Assignments can be made to an extended eight-point scale (GOSE) as well as the original five-point approach-in each case, with a high degree of interobserver consistency. The assignments are coherent with the principles of the World Health Organization classification of impairments, disabilities, and handicaps, and their validity is supported by strong associations with the results of neuropsychological testing and assessment of general health status. The need to allow for disability existing before injury, issues concerning the time of assessment after injury, and subdivisions of the scale into "favorable" and "unfavorable" categories are discussed. It is concluded that, in its improved structured format, the Glasgow Outcome Scale should remain the primary method of assessing outcome in trials of the management of severe head injury.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Visual impairment following stroke: do stroke patients require vision assessment?

              the types of visual impairment followings stroke are wide ranging and encompass low vision, eye movement and visual field abnormalities, and visual perceptual difficulties. the purpose of this paper is to present a 1-year data set and identify the types of visual impairment occurring following stroke and their prevalence. a multi-centre prospective observation study was undertaken in 14 acute trust hospitals. Stroke survivors with a suspected visual difficulty were recruited. Standardised screening/referral and investigation forms were employed to document data on visual impairment specifically assessment of visual acuity, ocular pathology, eye alignment and movement, visual perception (including inattention) and visual field defects. three hundred and twenty-three patients were recruited with a mean age of 69 years [standard deviation (SD) 15]. Sixty-eight per cent had eye alignment/movement impairment, 49% had visual field impairment, 26.5% had low vision and 20.5% had perceptual difficulties. of patients referred with a suspected visual difficulty, only 8% had normal vision status confirmed on examination. Ninety-two per cent had visual impairment of some form confirmed which is considerably higher than previous publications and probably relates to the prospective, standardised investigation offered by specialist orthoptists. However, under-ascertainment of visual problems cannot be ruled out.
                Bookmark

                Author and article information

                Contributors
                marta.berthold-lindstedt@ki.se
                Journal
                Brain Behav
                Brain Behav
                10.1002/(ISSN)2157-9032
                BRB3
                Brain and Behavior
                John Wiley and Sons Inc. (Hoboken )
                2162-3279
                23 November 2020
                February 2021
                : 11
                : 2 ( doiID: 10.1002/brb3.v11.2 )
                : e01958
                Affiliations
                [ 1 ] Division of Rehabilitation Medicine Department of Clinical Science Karolinska Institute Danderyd University Hospital Stockholm Sweden
                [ 2 ] Eye and Vision Department of Clinical Neuroscience Karolinska Institute Stockholm Sweden
                Author notes
                [*] [* ] Correspondence

                Märta Berthold‐Lindstedt, Division of Rehabilitation Medicine, Department of Clinical Science, Karolinska Institute, Danderyd University Hospital, SE 182 57 Danderyd, Sweden.

                Email: marta.berthold-lindstedt@ 123456ki.se

                Author information
                https://orcid.org/0000-0002-9717-1820
                Article
                BRB31958
                10.1002/brb3.1958
                7882154
                33230981
                2f77d10b-52c6-4530-96fb-81f0ede3c46e
                © 2020 The Authors. Brain and Behavior published by Wiley Periodicals LLC

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 February 2020
                : 21 October 2020
                : 28 October 2020
                Page count
                Figures: 1, Tables: 7, Pages: 0, Words: 5713
                Funding
                Funded by: The County Council of Stockholm
                Funded by: The Swedish Stroke Association
                Categories
                Original Research
                Original Research
                Custom metadata
                2.0
                February 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.9.7 mode:remove_FC converted:14.02.2021

                Neurosciences
                brain injuries,ocular motility disorders,stroke,traumatic brain injury,vision disorders

                Comments

                Comment on this article