Screening Instruments for Measuring Visual Symptoms in Victims of Concussion

Screening Instruments for Measuring Visual Symptoms in Victims of Concussion

Visual dysfunction after mild traumatic brain injury (mTBI) is common but often remain undiscovered during longer periods of time. No valid, reliable and easy-to-use screening instrument for uncovering visual dysfunction exists. Furthermore, it is unknown whether optometric measurements currently used in assessing vision problems are consistent with patients' subjective complaints experienced in everyday life. A better understanding of patients' visual challenges combined with objective measurements, will contribute to a better and more efficient diagnostic investigation and treatment.

The aim of this study is to get a better understanding of patients who are suffering from visual dysfunction after mTBI. This understanding will be gained by:

1. developing and validating a questionnaire for uncovering subjective visual complaints in subjects with mTBI.
2. developing eye tracking based screening tools applicable both in- and outside of optometry clinics
3. examining relationships between self-reported data, eye tracking measurements and optometric measurements.

The study will consist of N = 200 subjects. N = 100 of the subjects are suffering from mTBI (commotio group). The second group N = 100 is the non-injured group that preferably will consist of relatives to the subjects in the commotio group. The subjects in both groups have to answer the questionnaires regarding subjective visual complains, undergo optometric tests and undergo eye tracking measurements.

Inclusion Criteria:

Individuals may be included if they:

• are adults between the ages 18 and 67
• have been diagnosed with mTBI by a doctor (emergency room or general practice) either exclusively or with another diagnosis e.g. fracture, neck trauma (doesn't apply to control group)
• can read and understand Danish
• continuously have symptoms related to trauma ≥ 2 months and ≤ 24 months after trauma origin (doesn't apply to control group)
• have best corrected visus at 0.8 or better in both eyes at distance and at near
• have given informed consent and willingness to participate in the study

Exclusion Criteria:

The following will be excluded if individuals:

• are diagnosed with one of the following neurological disorders: severe head trauma, brain tumor, Parkinson's disease, multiple sclerosis, dementia
• are diagnosed with a current active psychiatric disorder
• are diagnosed with one of the following somatic disorders which are unregulated: diabetes mellitus, metabolic disorders
• have a verified alcohol or drug abuse
• have amblyopia (that is, two lines difference or more in best corrected visus between the two eyes)
• have other visual problems such as constant strabismus, a history of strabismus surgery, congenital nystagmus and recognized eye illnesses such as glaucoma, age- related macular degeneration (AMD)
• have received vision therapy by an optometrist in relation to resent mTBI