Visual Rehabilitation in Post Mild Traumatic Brain Injury. Case-Based Review

Abstract

Background: Traumatic brain injury (TBI) can cause visual dysfunction affecting binocularity, spatial orientation, posture, and balance. Currently, there are several options for treating manifested visual disturbances; vision therapy is one of the possible treatment options. Methods: A 14-year-old female fainted and sustained trauma to the upper-temporal part of her right eyebrow. The patient presented with eye pain, a decreased visual field, and blurred vision and she exhibited great difficulties when reading. Both neurological tests and exploration of the anterior and posterior ocular segments showed results within normal limits. The patient was diagnosed with fusional vergence dysfunction, associated with accommodative infacility and oculomotor dysfunction. To eliminate her symptoms, a visual rehabilitation program was implemented; it consisted of accommodative, anti-suppressive, vergential, motility, hand–eye coordination, and peripheral vision exercises. Results: The symptoms manifested by the patient gradually dissipated throughout the course of therapy. However, not all optometric parameters reached normal values after visual therapy, which could indicate a traumatic injury that limited the achievement of normal optometric ranges. Conclusions: After a mild traumatic brain injury (mTBI), it is necessary to carry out a complete examination of the patient’s visual function. This visual examination must include an analysis of vergences, ocular motility, and the accommodative system to obtain an accurate diagnosis. The outcomes of the present clinical case imply that visual therapy should be considered as a treatment in cases of mTBIs.