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Administrative Closure
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The objective of this study is to test functional vision outcome measures that reflect the loss in everyday life tasks that require vision and that are sensitive to changes after a course of vision rehabilitation in Veterans/participants with TBI.
Traumatic brain injury (TBI) can cause vision loss because of diffuse or focal neuronal injury. Vision can be compromised because of local injury to one or both optic nerves, diffuse brain injury, and/or limitation in eye movements because of dysfunction of cranial nerves. These typical injuries may compromise any of the neural pathways that subserve afferent or efferent visual function. Self-reports of vision loss include diplopia, visual field loss, light sensitivity, reading problems and contrast sensitivity (color and luminance) loss. This project will pursue the following aims: 1) Identify the relationship between functional vision loss in everyday vision tasks (reading, visual search, way finding) and the characteristics of potential visual impairment (visual acuity, contrast sensitivity, visual fields, stereoacuity, eye movement disorders) associated with TBI; and 2) Determine the ability of the vision rehabilitation interventions (both monotherapy and combination therapy) to improve functional vision outcome measures that reflect everyday visual tasks. The vision rehabilitation interventions incorporated into this study will be Vision Restoration Therapy, NVT Eye Scanning Therapy, and standard Eccentric Viewing Training. These therapies are rehabilitative interventions prescribed for Veterans in Polytrauma Rehabilitation Centers, Blind Rehabilitation Centers, and advocated for VA Medical Center TBI clinics.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm 1 | Active Comparator | Group 1 - Combination Treatment |
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| Arm 2 | Active Comparator | Group 2 - Combination Treatment |
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| Arm 3 | Active Comparator | Group 3 - Combination Treatment |
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| Arm 4 | Active Comparator | Group 4 - Combination Treatment |
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| Arm 5 | Active Comparator | Group 5 - Monotherapy Treatment |
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| Arm 6 | Active Comparator | Group 6 - Monotherapy Treatment |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vision Restoration Therapy | Other | Therapy that enhances the neuronal plasticity of the visual system |
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| Measure | Description | Time Frame |
|---|---|---|
| Dynamic Visual Field | Baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Dynamic Visual Field | After First Therapy / Before Second Therapy (Average time is 4.5 months) | |
| Dynamic Visual Field | After Second Therapy (Average Time is 9 months) | |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ron Schuchard, PhD | VA Palo Alto Health Care System | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| VA Palo Alto Health Care System | Palo Alto | California | 94304-1290 | United States |
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| ID | Term |
|---|---|
| D001930 | Brain Injuries |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D006259 | Craniocerebral Trauma |
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| ID | Term |
|---|---|
| C005703 | salicylhydroxamic acid |
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| Arm 7 | Active Comparator | Group 7 - Monotherapy Treatment |
|
| NVT Eye Scanning Therapy | Behavioral | Therapy that trains eye and head scanning into the blind hemianoptic visual field |
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| Eccentric Viewing Training | Behavioral | Therapy that trains the person to compensate for visual field loss by learning to move the visual field loss to the position that is least likely to impact the current visual task |
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| Sham | Behavioral | Therapy that encourages subjects to do daily visual tasks at home while having no training or intended intervention benefit |
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| Reading Rate and Accuracy |
| Baseline |
| Reading Rate | After First Therapy / Before Second Therapy (average time is 4.5 months) |
| Reading Rate and Accuracy | After Second Therapy (average time is 9 months) |
| Visual Search Accuracy and Timing | Baseline |
| Visual Search Accuracy and Timing | After First Therapy / Before Second Therapy (average time is 4.5 months) |
| Visual Search Accuracy and Timing | After Second Therapy (average time is 9 months) |
| D020196 | Trauma, Nervous System |
| D014947 | Wounds and Injuries |