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K.J. Ciuffreda, N. Kapoor, D. Rutner, I.B. Suchoff, M.E. Han, S. Craig; Occurrence of Ocular Motor Dysfunction in Acquired Brain Injury: A Retrospective Analysis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2662.
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Individuals with acquired brain injury report symptoms of blur, double vision, and skipping lines when reading. This study was designed to determine retrospectively the occurrence of ocular motor (eye movements and accommodation) dysfunction in a large sample (n=220) of symptomatic individuals with either traumatic brain injury (TBI, n=160) or cerebrovascular accident (CVA, n=60).
A computer–based query yielding 486 records was conducted spanning the years 2001–2003 of intake evaluations of adult patients (ages: 18–75 years) with acquired brain injury (ABI) performed at our clinic. Three hundred of these 486 records were randomly selected, and only those with either TBI (n=160) or CVA (n=60) were reviewed. Ocular motor disorders included dysfunctions of: accommodation, version, vergence, strabismus, and cranial nerves III, IV, and/or VI. These conditions were diagnosed by testing ocular alignment, fusional vergence ranges, near point of convergence, amplitude of accommodation, lag of accommodation, relative accommodation, and versional ocular motor testing (pursuit, saccades, and fixation).
The results are summarized in Table 1 as a percentage of individuals in each subgroup with a given ocular motor dysfunction. TBI presented with a higher percentage of individuals manifesting accommodative and vergence dysfunctions. CVA presented with a higher percentage of individuals manifesting strabismic (including paralytic strabismus) and versional ocular motor deficits.
Since most types of rehabilitation use vision as the primary sensory modality, the presence of ocular motor dysfunction may significantly retard or impede the progress of the rehabilitation regimen, as well as negatively impact one’s quality of life and ability perform an avocation or vocation. The present findings should alert clinicians to the increased (up to 10–fold) occurrence of these specific ocular motor dysfunctions in the ABI population and its subgroups when compared with a matched, non–ABI cohort.
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