Efficacy of vision therapy for blast related visual dysfunction in student veterans

Date

2014-05

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Abstract

Exposure to combat blast forces may have devastating effects on the student veteran’s future academic experience. There were over 2.1 million people deployed to Iraq and Afghanistan since 2001. The DOD estimates that as many as 287,911 may have sustained traumatic brain injuries (TBI), mostly from exposure to blasts from improvised explosive devices. Previous research indicates that 82% report reading problems after TBI yet often do not associate it with a vision problem. While other research indicates that as many as 80% of those with TBI will have some residual vision dysfunction which is not identified by standard eye exams. The DOD/VA estimate that a least 50,000 have been discharged without diagnosis of these visual injuries. These visual injuries jeopardize student veteran’s academic success. This transdisciplinary study explored an intervention to identify those likely to have visual disturbances related to blast exposure, relate those to academic difficulty. Initially, a survey was distributed to student veterans, which revealed 66% were combat veterans and 80% of those were exposed to blast forces during their combat tour. A Reading behavior inventory revealed that the students exposed to combat blasts read fewer types of material, read for less time, and enjoyed less reading satisfaction when compared with student veterans who had not been deployed, or veteran students who had deployed but not been exposed to blast forces. A sample of these were tested for the visual sequelae associated with blast exposure and found that 80% had related vision dysfunctions including binocular dysfunction, limited stereopsis, compromised acuity and dysfunctional ocular movements. An itinerant intervention of 6 weekly vision therapy sessions was used to improve visual function. When the veterans were reexamined, improvement was seen in optometric measures in every participant. Additionally, every participant reported subjective improvement in reading difficulty. Additionally, participants showed significant improvement in reading speed and comprehension, improving from 59% to 77% from baseline. Student combat veterans who have been exposed to blast forces are likely to have visual dysfunctions that negatively impact their reading speed and comprehension. Visual screening and itinerant vision therapy intervention in the academic environment has the potential to make huge impacts on the academic success of this population as well as provide similar benefit to millions who suffer civilian head injuries every year.

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Keywords

Student veteran, Traumatic brain injury (TBI), Neurological visual impairment, Vision therapy, Oef, Oif, Blast injury, Neurotrauma, Binocular visual dysfunction, Reading, Visual impairment

Citation