JBO - Volume 22 - Issue 6 - Clinical Management of Traumatic Brain Injury Induced Intermittent Exotropia in a Primary Care Practice

Appears in issue JBO - Volume 22 - Issue 6

Author
Johnson, Travis M., OD
PDF
Abstract

Background: Traumatic brain injuries are unfortunately common occurrences. In a healthy individual with a normally functioning nervous system, a sudden disruption will change their life in an instant. It is often difficult for patients that have experienced a traumatic brain injury to rehabilitate. The severity of the brain injury is significantly related to the level of sensory and motor deficit.

Case Report: This case report is an example of a patient who experienced a motor vehicle accident that immediately changed his binocular vision status. The patient’s chief complaint was described as “difficulty keeping his eye lined up.” Other complaints included glare, tracking images, and trouble concentrating. His job as an Information Technology (IT) professional was hindered by this sudden-onset vision disturbance. The patient suffered a choroidal rupture in the left eye secondary to the accident. Through a plan of home vision support activities in free-space and with computers, the patient was able to return to work free from the symptoms that had been plaguing him.

Conclusions: Correcting refractive error, prescribing prism, occlusion therapy, ocular calisthenics, and sensory/
motor training are necessary in the management of acquired noncomitant deviations. Whether or not your practice provides in-office vision therapy should not be a limiting factor in your treatment of patients that have suffered a traumatic brain injury. This case report serves as a prime example of how it can be accomplished.