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CLINICAL RESEARCH C

Better. By Design.
Role of Primary Care Optometrists in the Assessment

and Management of Patients with Traumatic Brain Injuries

in Canada

Bruder Moist Heat Compress Zoe Lacroix, O.D. Introduction
now available exclusively through Clinical Resident,
Paediatrics and Traumatic brain injury (TBI) results from a strong blow or jolt to the head
Labtician Ophthalmics Inc. Vision Therapy that disrupts the normal function of the brain. The severity of a TBI can
1
School of Optometry range from mild to severe, depending on the patient’s mental status, con-
and Vision Science, sciousness level and amnesia following the injury. The annual incidence
University of Waterloo of TBI in North America and Europe is conservatively estimated to be ap-
proximately 600/100,000. This translates to at least 200,000 TBI cases
2,3
Eyelid warming is an important Susan J. Leat, in Canada every year. According to the Centers for Disease Control and
step in the treatment of PhD, FCOptom, F.A.A.O. Prevention, and the Canadian Institute for Health Information, the leading
cause of TBIs that result in hospital admission is falls (35%-45%), followed
Professor,
chronic dry eye, MGD School of Optometry by motor vehicle accidents (17%-36%), collision-related events (struck by
4,5
and Blepharitis. and Vision Science, or against) (10-17%) and assaults (9-10%). Head injuries are more common
in the 0- to 19-year age group, followed by those who are aged 60+. Males
University of Waterloo
are more highly represented in every age group than females. However, it
• Patented technology Lisa W. Christian, O.D., should be noted that the demographics of patients who present in an op-
• When microwaved, the F.C.O.V.D., F.A.A.O. tometrist’s office may differ from those based on hospital admissions.
Clinical Associate Professor
clean, natural moist provides School of Optometry TBIs are classified by the duration of loss of consciousness and post-trau-
soothing relief and Vision Science, matic amnesia, along with the results of brain imaging (Table 1). Not all
6,7
of these signs need to be present. Menon et al. stated that TBI can be di-
• Fast acting, simply and naturally University of Waterloo agnosed when there is alteration in brain function defined by any one of
Waterloo
• Washable and reusable the following signs: a period of loss or decreased consciousness, any loss of
memory for events immediately before or after the injury, neurologic defi-
• Anti-bacterial cits (weakness, loss of balance, change in vision, dyspraxia paresis/paraly-
sis, sensory loss, aphasia, etc.), and any alteration in mental state at the time
• Non-Allergenic of the injury (confusion, disorientation, slowed thinking, etc.). 8

Common phenomena following a TBI include decreased attention, con-
centration and processing speed, memory problems, confusion, irritabil-
ity, depression and anxiety. Physical consequences can include headaches,
fatigue, dizziness and nausea, balance difficulties, visual disturbance and
sleep disruption. In cases of moderate to severe TBI, patients may also ex-
1
perience decreased executive function, increased confusion, depression,
anxiety, lack of impulse control, chronic pain and severe physical conse-
quences. Visual symptoms are observed in 75% of TBI cases. These symp-
6
9
toms can be caused by decreased visual function, disorders of the binocular
vision system, changes in ocular health and higher-order processing dis-
orders, which are discussed further below. Due to the broad spectrum of
visual symptoms that may occur following TBIs, it is important for the pri-
mary care optometrist to be familiar with the testing and management of
patients with a history of traumatic brain injury.
For more information or to order speak with your Labtician Thea Sales Representative or call
1-855-651-4934 or 905-901-5304, www.Labtician.com

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37529_CJO_SP18 February 20, 2018 10:55 AM APPROVAL: ___________________ DATE: ___________________