Research Reports - The effect of spectacle treatment in patients with mild traumatic brain injury

Clin Exp Optom. 2016 Sep 14. doi: 10.1111/cxo.12458. [Epub ahead of print]

Johansson J(1), Nygren de Boussard C(2), Öqvist Seimyr G(2), Pansell T(2).

BACKGROUND: Visual symptoms and dysfunctions may be a part of the long-term
issues following mild traumatic brain injury. These issues may have an impact on
near work and reading, and thus affect activities of daily life and the ability
to return to work. The purpose of the study was to assess the effect of spectacle
treatment on near work-related visual symptoms, visual function and reading
performance in patients with persisting symptoms after mild traumatic brain
injury.
METHODS: Eight patients with persisting symptoms after mild traumatic brain
injury and anomalies of binocular function were included. Binocular function,
visual symptoms and reading performance were assessed before and after spectacle
treatment. Reading eye movements were recorded with eye tracking.
RESULTS: Four patients showed a considerable symptom reduction along with minor
improvement in clinical visual measures. Reading performance improved in four
patients; however, the relationship to symptom reduction was inconsistent. The
improvement was correlated to reduced average number of fixations per word
(r = -0.89, p = 0.02), reduced proportion of regressive saccades (r = -0.93,
p = 0.01) and a significant increase of mean progressive saccade length
(p = 0.03).
CONCLUSION: This pilot study found that spectacle treatment, specifically
directed at optimising near task visual function, significantly reduced symptoms
in 50 per cent of patients and improved reading performance in 50 per cent. While
promising, lack of placebo control and lack of correlation between reading
performance and symptom improvements means we cannot decipher mechanisms without
further study. 

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