Research Reports - The neuro-ophthalmology of head trauma

Lancet Neurol. 2014 Oct;13(10):1006-16

Ventura RE(1), Balcer LJ(1), Galetta SL(2)

Traumatic brain injury (TBI) is a major cause of morbidity and
mortality. Concussion, a form of mild TBI, might be associated with long-term
neurological symptoms. The effects of TBI and concussion are not restricted to
cognition and balance. TBI can also affect multiple aspects of vision; mild TBI
frequently leads to disruptions in visual functioning, while moderate or severe
TBI often causes structural lesions. In patients with mild TBI, there might be
abnormalities in saccades, pursuit, convergence, accommodation, and
vestibulo-ocular reflex. Moderate and severe TBI might additionally lead to
ocular motor palsies, optic neuropathies, and orbital pathologies. Vision-based
testing is vital in the management of all forms of TBI and provides a sensitive
approach for sideline or post-injury concussion screening. One sideline test, the
King-Devick test, uses rapid number naming and has been tested in multiple
athlete cohorts.

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