Abstract
Abstract: :
Purpose: Acquired brain injury (ABI) refers to brain insult occurring secondary to head trauma and stroke, as well as cranial post–surgical complications and vestibular insult. However, little is known about the occurrence of ocular disease in this population. Only one study has been conducted, but it had a small sample size (n=62) and combined all ABI subgroups. The purpose of this retrospective analysis was to determine the occurrence of ocular disease in patients manifesting either traumatic brain injury (TBI) or cerebrovascular accident (CVA) in a large, university–based rehabilitation population. Methods: A computer–based query was obtained spanning the years 2001–2003 of intake evaluations of patients with ABI performed at the SUNY, State College of Optometry Raymond J. Greenwald Rehabilitation Center. The query yielded 486 patients; 300 patients were then randomly selected. Among the 300 charts, only those with either TBI (n=160) or CVA (n=60) were reviewed with regard to the occurrence of ocular disease. Major categories of abnormalities included: external and internal anterior segment, pupil, lens, and posterior segment. Analysis included frequency of occurrence (%) and relative risk (RR) which compared the presence of an ocular disease condition in the ABI population to that of a random non–ABI population. Results: In the TBI population, the following ocular conditions exhibited increased occurrence as compared with the non–ABI cohort: blepharitis 18.8% vs. 11.2% (RR 1.68); dry eye 15.6% vs. 13% (RR 1.20), and vitreal–retinal disease 11.3% vs. 9.7% (RR 1.16). In the CVA population, the following ocular conditions exhibited increased occurrence as compared with the non–ABI cohort: vitreal–retinal disease 13.3% vs. 9.7% (RR 1.37) and ptosis 6.7% vs. 2.1% (RR 3.19). Conclusions: The present study extended an earlier investigation reporting increased occurrence of specific ocular diseases in the ABI population as compared with its non–ABI cohorts. This knowledge should alert clinicians to the increased occurrence of these conditions in the general ABI population, as well as its subpopulations. Failure to diagnose or treat these conditions can negatively impact the rehabilitative programs these patients undergo, as well as their quality of life.
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • neuro-ophthalmology: cortical function/rehabilitation • visual impairment: neuro-ophthalmological disease