CLOSEDOCULAR TRAUMA AND VISION

EFFECTS

BY

SHEMINA

NADUPADUVILABDULAAZIZ

»CLOSED OCULAR TRAUMA

»SYMPTOMS»VISION&ASSESSMENT »STEPS TOCOPE

POINTSTO DISCUSS

CLOSED-OCULARTRAUMA IN TERMS OF VISION&

OPTOMETRY•

• Screening for Vision Loss TRAUMA

• Symptoms of Ocular Trauma 

• Phantom Vision With Ocular Trauma

• Ocular Traumatic Vision Loss in

with post traumtic Brain Injury

•  

•

CLOSED OCULAR TRAUMA Blunt force can hurt the eye without

piercing it. These ''closed-eye injuries'' are difficult to diagnose because there's no obvious injury to the outside of the eye. But inside, blunt force can damage the cornea, retina, lens, and optic nerves. Sometimes, vision problems from ocular trauma don't show up for one to three years after it happens, May not know that they have eye damage until they have an eye exam or start having vision problems .

VISION&CLOSEDTRAUMAA Simple eye chart test cannot always

diagnose ocular trauma. Persons able to see well, although they have other visual symptoms. More thorough vision screenings are needed for victims with traumatic brain injury. Patient with closed traumaat Walter Reed Army Medical Center who have had traumatic brain injury within two years now have screenings for vision loss. The Center's staff found that 64% of these patients have vision problems

Mines/quriees conducting blast, here fujarahmore significant we have more in the mountain /rural area they are more likely to be severely shaken by a blast from

these explosive device to workers

For veterans returning from war in Iraq and Afghanistan, vision problems caused by traumatic brain injury are a growing concern

Symptoms of Ocular TraumaBlast-related ocular trauma may start as

color blindness and become more severe. Other symptoms visionproblems:

• Light sensitivity

• Eye strain&Headaches

• Double visionDizziness

• Problems with depth perception&Poor balance

Phantom Vision With Ocular Trauma

• Phantom Vision With Ocular Trauma

• 20% of people with ocular trauma also have Charles Bonnet syndrome or "phantom vision" in which they see hallucinations. People may be afraid to mention that they see visions, so doctors and family members should ask about them.

Phantom Vision With Ocular Trauma { Continuation}

• Sometimes it can be difficult to separate hallucinations from physical reality.

• Strangers or familiar people sitting at homeAnimals in the closet

• Realistic objects that are out of place, such as a double-decker bus

• Blurry colors&Strange shapes

• These are not ghost or superstitious things

Ocular Trauma: Vision Loss in Vets with Traumatic Brain

Injury

• A simple eye chart test cannot always diagnose ocular trauma. Veterans may still be able to see well, although they have other visual symptoms. More thorough vision screenings are needed for veterans with traumatic brain injury. All soldiers at Walter Reed Army Medical Center who have had traumatic brain injury within two years now have screenings for vision loss. The Center's staff found that 64% of these soldiers have vision problems

Steps to copeThe care specialists at intermediate low

vision clinics help victims touse the vision they have. Therapy may include positioning devices and special lighting. The aim is to them in reading, writing, finding signs, cooking, and managing medicines. Advanced low vision clinics help patient to move around and find their way independently. Specialists also help them to use their hearing and other senses more effectively, which can be very helpful when traveling.

Process Flow

• Reciving the patient

• History taking

• Charting vision

• refraction

• ANTERIOR CHAMBER

• POSTERIOR• LENS• RETINA

PHYSCIANOPTOMETRIST

NURSE

Low vision exam

• The Low Vision Examination begins with an extensive history. Special emphasis is placed on the functional problems of the patient including such items as vision to read, functioning in the kitchen, glare problems, travel vision, the workplace, television viewing, school requirements, etc. It will also include a careful review of your ocular and medical history

Vision in chronic closedtraumapatient

Careful measurements be made of the visual acuity using low vision test charts followed by low vision refraction. Charts include a larger range of letters to more accurately determine a starting point for measurement of low vision.

It determines the measurement of the patient's prescription by special techniques changing the lighting levels, testing through filters and using larger changes which may be easier for view

VISION TEST continuation

• Additional understanding of the patient’s Functional vision can be obtained through the use of the Amsler grid, contrast sensitivity, the laser-scanning ophthalmoscope, visual evoked potential and electroretinogram. Contrast sensitivity tests the eye’s ability to discriminate subtle changes in vision rather than the absolute black-on-white contrast of a visual acuity chart.

VISION TEST. Contrast sensitivity is a better predictor of

real world functioning.[v] The use of a laser-scanning ophthalmoscope allows one to plot the precise area used by the patient with central retinal damage. [vi] The visual evoked potential or VEP, a form of electroencephalogram, shows an increasing role in the assessment of patients with a brain injury.[vii] Electroretinograms are helpful in the differential diagnosis of many retinal diseases and traumatic effects. [viii]

•

VISION EFFECTS

• While visual field testing is used to diagnose ocular and neurological effects, it can also predict how the low vision patient may function in day-to-day activities and how well the patient may respond to various rehabilitative approaches.

• Visual fields may be tested by confrontations, manual perimeters or by computerized perimetry as per physician request

Assessment Of Low vision

• Refraction in low vision determines the measurement of the patient's prescription by special techniques which may include changing the lighting levels, testing through filters and using larger changes which may be easier for you to view.

VISION EFFECT COPING TRAUMA

• Visions tend to lessen after a year or 18 months. In the meantime, antiseizure drugs may ease phantom visions for some patients. If the visions are particularly upsetting, anti-anxiety medicines may help. Veterans who also have depression may find relief through mental health counseling and medications such as antidepressants

AREA OFVISION AID NEED

• Various reading aids including strong

• As reading eyewear, magnifiers, electronic magnifiers and even electronic reading machines may be tested.

STEPS TO COPE re

• Othervictims learn eye exercises and other activities to help them ignore the visions. Visions often occur when it is quiet, so staying active, keeping rooms bright, and playing music may help limit visions.

STEPS TO COPE

• The aim is to aid victims in reading, writing, finding signs, cooking, and managing medicines. Advanced low vision clinics help them move around and find their way independently. Specialists also help these veterans use their hearing and other senses more effectively, which can be very helpful when traveling.

PITFALLS TO AVOID

• Donot trust on subjective exams

• Another very important part of the low vision exam is the dilated internal examination

• intraocular pressures and external eye health evaluation.

• These ensure that there are no ocular diseases or complications that may require treatment or referral to another specialist.

Optometrist &Opthalmologist role

The low vision examination in severecases is quite different from the basic eye health and refractive examination routinely performed by primary care optometrists and ophthalmologists. The goals of the low vision exam include assessing the functional needs, capabilities and limitations of theclosed trauma patient’s visual system, Assessing ocular and systemic diseases and their impact on functional vision, evaluating and prescribing low vision systems and therapies.

•

conclusion• Victims who have closed ocular trauma

• By brain injury impairment that eyeglasses, contact lenses, surgery, or medicine can't fix.) Tests revealed that these victims had mild to severe vision problems. And 2% of them were legally blind.

Getting Help for Vision Loss and Ocular Trauma

• We need inpatient programs for serious and complex cases at polytrauma rehabilitation centers.

• Outpatient rehabilitation at poly trauma network sites may help if your case is less severe. Know that you are not alone, and help is available

• Unfortunately middle east not focused more in this topic even we have one in RASHID HOSPITAL