Vision as a piece of the head trauma puzzle

• Published in: Eye (London) Vol. 37; no. 12; pp. 2385 - 2390
• Main Authors: Bell, Carter A, Grossman, Scott N, Balcer, Laura J, Galetta, Steven L
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.08.2023; Nature Publishing Group UK
• Subjects: Alzheimer's disease; Brain Concussion - diagnosis; Cognitive ability; Concussion; Craniocerebral Trauma; Encephalopathy; Eye Movements; Humans; Multiple sclerosis; Neurodegenerative diseases; Photosensitivity; Review; Saccades; Saccadic eye movements; Traumatic brain injury; Vergence eye movements; Vision; Vision Disorders - diagnosis; Vision Disorders - etiology; Visual pathways; Visual perception
• ISSN: 0950-222X; 1476-5454; 1476-5454
• DOI: 10.1038/s41433-023-02437-8

Approximately half of the brain's circuits are involved in vision and control of eye movements. Therefore, visual dysfunction is a common symptom of concussion, the mildest form of traumatic brain injury (TBI). Photosensitivity, vergence dysfunction, saccadic abnormalities, and distortions in visual perception have been reported as vision-related symptoms following concussion. Impaired visual function has also been reported in populations with a lifetime history of TBI. Consequently, vision-based tools have been developed to detect and diagnose concussion in the acute setting, and characterize visual and cognitive function in those with a lifetime history of TBI. Rapid automatized naming (RAN) tasks have provided widely accessible and quantitative measures of visual-cognitive function. Laboratory-based eye tracking approaches demonstrate promise in measuring visual function and validating results from RAN tasks in patients with concussion. Optical coherence tomography (OCT) has detected neurodegeneration in patients with Alzheimer's disease and multiple sclerosis and may provide critical insight into chronic conditions related to TBI, such as traumatic encephalopathy syndrome. Here, we review the literature and discuss the future directions of vision-based assessments of concussion and conditions related to TBI.