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Vision disturbances following traumatic brain injury (TBI) include anomalies of accommodation, version, vergence (nonstrabismic,
as well as strabismic), photosensitivity, visual field integrity, and ocular health.
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Traumatic brain injury patients with complex diplopia patterns, noncomitant strabismic anomalies, and advanced ocular health
anomalies are either monitored by or referred to neuro-ophthalmologists and ophthalmologists for evaluation and possible surgical
or medical intervention, as needed.
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Anomalies of accommodation, vergence, version, photosensitivity, and field of vision are amenable to noninvasive, rehabilitative
interventions, such as vision therapy, which is rendered by optometrists and is described in this article. Further, vision
therapy may be performed in isolation or in conjunction with the application of the following: Fusional prism spectacles (for
diplopia) Tinted spectacles (for photosensitivity) Yoked prism spectacles (for visual-spatial hemispheric inattention, with
or without a manifest visual field defect), as appropriate
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Dependent on the severity of vision impairment post-TBI, other types of rehabilitation, such as vestibular, physical, cognitive,
and occupational rehabilitation, are deferred pending the stabilization of vision function to an appropriate level.
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Rehabilitative optometric intervention is appropriate and beneficial for many TBI patients. Therefore, it should be offered
as a possible evaluation and treatment option to investigate the patient’s symptoms and determine the prognosis for treatment,
as would be done with any other therapeutic modality.
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