Veterans with Traumatic Brain Injury-related Ocular Injury and Vision Dysfunction: Recommendations for Rehabilitation.
Veterans with Traumatic Brain Injury-related Ocular Injury and Vision Dysfunction: Recommendations for Rehabilitation.
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患有创伤性脑损伤相关眼损伤和视力障碍的退伍军人：康复建议。
DOI：
10.1097/opx.0000000000001828
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发表时间：
2022
期刊：
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作者：
Winkler,SandraL;Finch,Dezon;Wang,Xinping;Toyinbo,Peter;Marszalek,Jacob;Rakoczy,ChrystynaM;Rice,CandiceE;Pollard,Kendra;Rhodes,MatthewA;Eldred,Kia;Llanos,Imelda;Peterson,Michael;Williams,Michael;Zuniga,Esteban;White,Helen;
目的本文报告了验光师和眼科医生提出的康复、眼镜/隐形眼镜以及影像/摄影/视频建议，作为退伍军人事务部规定的创伤性脑损伤特定眼部健康和视觉功能检查的一部分，在退伍军人事务部多发伤专业设施中对患有 TBI 的退伍军人进行。方法使用回顾性设计、自然语言处理以及描述性和回归统计，对数据进行分析2458 名持久自由行动/伊拉克自由行动退伍军人在 2008 年至 2017 年间接受了强制检查。 结果 在 2458 名退伍军人中，建议 24% 的人进行视力康复，57% 的人建议佩戴眼镜/隐形眼镜，58% 的人建议进一步进行成像/摄影/视频测试。使用转诊中的关键词，我们确定 37% 的退伍军人被转诊至盲人康复中心，16% 被转诊至职业治疗，3% 被转至低视力诊所。超过 50% 的转诊患者可以通过盲人康复、职业治疗或低视力诊所进行治疗。康复转诊与年龄较小、飞蚊症、光过敏、复视、视野和平衡缺陷、头晕和阅读困难显着相关。相比之下，佩戴眼镜和隐形眼镜的处方与年龄较大、光敏性、视力模糊、视野和夜视能力下降、阅读困难和干眼有关。影像/摄影/视频测试与飞蚊症、光敏性和头痛有关。结论研究结果描述了可用于患有 TBI 相关视力障碍的退伍军人的服务提供模式。这些数据解决的挑战是缺乏从 TBI 诊断到识别视力功能障碍，再到专门的视力康复，最后到社区重新融入和基于社区的视力康复的明确路径。
PURPOSEThis article reports rehabilitation, glasses/contacts, and imaging/photography/video recommendations made by optometrists and ophthalmologists as part of the Department of Veterans Affairs–mandated Performance of Traumatic Brain Injury Specific Ocular Health and Visual Functioning Examination administered to veterans with TBI at Department of Veterans Affairs polytrauma specialty facilities.METHODSUsing a retrospective design, natural language processing, and descriptive and regression statistics, data were analyzed for 2458 Operation Enduring Freedom/Operation Iraqi Freedom veterans who were administered the mandated examination between 2008 and 2017.RESULTSOf the 2458 veterans, vision rehabilitation was recommended for 24%, glasses/contacts were recommended for 57%, and further imaging/photography/video testing was recommended for 58%. Using key words in the referral, we determined that 37% of veterans were referred to blind rehabilitation, 16% to occupational therapy, and 3% to low-vision clinics. More than 50% of the referrals could have been treated by blind rehabilitation, occupational therapy, or low-vision clinics. Rehabilitation referrals were significantly associated with younger age, floaters, photosensitivity, double vision, visual field and balance deficits, dizziness, and difficulty reading. In comparison, prescriptions for glasses and contacts were associated with older age, photosensitivity, blurred vision, decreased visual field and night vision, difficulty reading, and dry eye. Imaging/photography/video testing was associated with floaters, photosensitivity, and headache.CONCLUSIONSFindings delineate service delivery models available to veterans with TBI-related vision impairment. The challenge these data address is the lack of clear paths from diagnosis of TBI to identification of vision dysfunction deficits to specialized vision rehabilitation, and finally to community reintegration and community based-vision rehabilitation.