3. 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
•
•
4. 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 .
5. VISION&CLOSEDTRAUMA
A 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
6. 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
7. Symptoms of Ocular Trauma
Blast-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
8. 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.
9. 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
10. 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
11. Steps to cope
The 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.
12. Process Flow
• Reciving the
patient
• History taking
• Charting
vision
• refraction
• ANTERIOR
CHAMBER
• POSTERIOR
• LENS
• RETINA
PHYSCIAN
OPTOMET
RIST
NURSE
13. 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
14. 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
15. 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.
16. 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]
17. 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
18. 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.
19. 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
20. AREA OFVISION AID NEED
• Various reading aids including strong
• As reading eyewear, magnifiers,
electronic magnifiers and even electronic
reading machines may be tested.
21.
22. STEPS TO COPEre
• 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.
23. 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.
24. 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.
25. 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.
•
26. 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.
27. 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
