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Occurrence of oculomotor dysfunctions in acquired brain injury: A retrospective analysis

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Abstract

Background

The purpose of this retrospective study was to determine the frequency of occurrence of oculomotor dysfunctions in a sample of ambulatory outpatients who have acquired brain injury (ABI), either traumatic brain injury (TBI) or cerebrovascular accident (CVA), with associated vision symptoms.

Methods

Medical records of 220 individuals with either TBI (n = 160) or CVA (n = 60) were reviewed retrospectively. This was determined by a computer-based query spanning the years 2000 through 2003, for the frequency of occurrence of oculomotor dysfunctions including accommodation, version, vergence, strabismus, and cranial nerve (CN) palsy.

Results

The majority of individuals with either TBI (90%) or CVA (86.7%) manifested an oculomotor dysfunction. Accommodative and vergence deficits were most common in the TBI subgroup, whereas strabismus and CN palsy were most common in the CVA subgroup. The frequency of occurrence of versional deficits was similar in each diagnostic subgroup.

Conclusion

These new findings should alert the clinician to the higher frequency of occurrence of oculomotor dysfunctions in these populations and the associated therapeutic, rehabilitative, and quality-of-life implications.

Section snippets

Methods

A computer-based query was obtained for ABI patients examined between October 1, 2000, and October 7, 2003, using either the 99203 (new patient evaluation) or 99213 (established patient evaluation) procedure codes. All patients were ambulatory outpatients with vision-based symptoms. Optometrists from the Raymond J. Greenwald Rehabilitation Center (RJGRC) at the State University of New York (SUNY) State College of Optometry performed the vision examinations. The majority of patients were

Results

The percentage of individuals in the 2 subgroups manifesting the 5 basic categories of oculomotor dysfunctions are presented in Table 3. The majority of individuals with either TBI or CVA exhibited some type of oculomotor dysfunction. This ranged from 6.9% to 56.3% in the TBI subgroup and from 10.0 to 56.7% in the CVA subgroup. Deficits in accommodation (41.1%) and vergence (56.3%) were more prominent in the TBI subgroup, whereas those of strabismus (36.7%) and CN palsy (10%) were more

Discussion

The current retrospective analysis conducted in a large sample of ambulatory outpatients with either TBI or CVA and related vision symptoms supports previous reports of the markedly increased frequency of occurrence of oculomotor dysfunctions in these populations versus the non-ABI population.7, 9, 28 Furthermore, it extends these studies to include CVA, because CVA had not been investigated previously as its own subgroup.

The frequency of occurrence of oculomotor dysfunctions in the TBI and CVA

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