Optometry And Brain Injury

Question 1

As an optometrist what do I stand to gain by knowing more about brain injury?

Answer 1

will be able to change a life in a way no other provider can

Question 2

What are TBIs?

Answer 2

concussion: sports, motor vehicle accident, falls, assault

Question 3

What non-traumatic acquired brain injuries?

Answer 3

stroke, anoxia (overdose), infection (herpetic encephalitis), arteriovenous malformation (AVM), metabolic

Question 4

How can you inquire about brain injuries?

Answer 4

Have you every had a motor vehicle accident, sports head injury, fall, workplace injury?

Question 5

What is the brain injury vision symptom survery?

Answer 5

2016, validated by comparing mTBI and nonTBI population, good test-test reliability; >31 predictive of mild to moderate TBI

Question 6

What is the scale of the brain injury symptom survey?

Answer 6

0-112, >31 is predictive of mild to moderate TBI

Question 7

What is a good question that may uncover a brain injury?

Answer 7

Do you have any problems when you go to the grocery store or deal with large crowds of people?

Question 8

What is visual extinction?

Answer 8

with simultaneous presentation of similar stimuli in each visual field, the phenomenon that the person is incapable of attending to one of the stimuli

Question 9

What are two other names for visual extinction?

Answer 9

hemispatial neglect and unilateral spatial inattention

Question 10

What side strokes predominately cause visual extinction?

Answer 10

right sided strokes to the posterior parietal area (in charge of visuo-spatial maps)

Question 11

Right sided damage –>

Answer 11

left sided inattention

Question 12

T/F neglect is a more severe form

Answer 12

true; patient unaware of left side of self and world, patient unable to interact with left space, can mimic homonymous hemianopsia

Question 13

What is prism adaptation?

Answer 13

purposefully creating a visuo-motor mismatch, so that the patient must activate areas of the brain responsible for recalibrating spatial maps

Question 14

What is an indirect result of prism adaptation?

Answer 14

the patient will now be aware of areas of space they previously ignored

Question 15

How is yoked prism generally prescribed in traumatic concussion patients?

Answer 15

small amounts (<5) in any direction, worn more often and long term

Question 16

What is concussion yoked prism used for?

Answer 16

space compression or expansion (abnormal egocentric localization)

Question 17

What is non-traumatic yoked prism used for?

Answer 17

image shifting (visual neglect/inattention)

Question 18

How is yoked prism generally prescribed in non-traumatic stroke patients?

Answer 18

larger amounts (10-30), opposite the field defect (typically BL>BR), work intermittently/in office

Question 19

What is the normal relationship between VOR and COR?

Answer 19

VOR > COR

Question 20

If there is damage to VOR what is the relationship between VOR and COR?

Answer 20

COR>VOR

Question 21

What is COR?

Answer 21

cervico-ocular reflex

Question 22

What is VOR?

Answer 22

vestibulo-ocular reflex

Question 23

How does space compression work?

Answer 23

at the apex of the prism space is compressed and at the base it is expanded

Question 24

T/F concussion patients are hypersensitive to space compression/expansion

Answer 24

true

Question 25

What are post trauma vision syndrome signs?

Answer 25

oculomotor dysfunction, ocular misalignment, accommodative dysfunction, CI, visual motion hypersensitivity, anomalous egocentric localization, photosensitivity, low blink rate/dry eye

Question 26

What are post trauma vision syndrome symptoms?

Answer 26

diplopia, blurred vision, objects appear to move, poor concentration and attention, staring behavior, asthenopia, dizziness or nausea, spatial disorientation

Question 27

What are accommodative therapies?

Answer 27

N/F Hart chart, monocular accommodative rock, monocular fixation/binocular field

Question 28

What are binocular VT therapies?

Answer 28

eye control, coin circles, brock string

Question 29

What are oculomotor therapies?

Answer 29

wall saccades, SVI saccades, reflexion/binovi

Question 30

What are visual spatial therapies?

Answer 30

greenwald eye movements, SVI rotator, CP saccades

Question 31

What are multisensory integration therapies?

Answer 31

flashlight pointing, balance board + column jumping + metronome, myers flying rings + bozu ball

Question 32

What basic technique could dramatically improve your patient’s success?

Answer 32

look hard look soft

Question 33

Is how we interact with our world more dependent on central vision or peripheral?

Answer 33

peripheral