Today’s guest blogger is Dr. Derek Tong. Dr. Tong graduated with Honors from the Southern California College of Optometry at Marshall B. Ketchum University, where he also completed residency training in Pediatric Optometry and Vision Therapy. He is the Clinic Director and Residency Coordinator of the Center for Vision Development Optometry in Pasadena CA. The center focuses on working with children and adults with traumatic brain injury, strabismus, amblyopia, learning problems, and other unique vision needs. He is an Adjunct Clinical Assistant Professor of both the Southern California College of Optometry at Marshall B. Ketchum University and the Western University College of Optometry. Professionally, he is a Trustee and past President of the San Gabriel Valley Optometric Society. He had also served as a school board member at the Christian school near his home. In his spare time, he enjoys travelling with his family and teaching children’s Bible lessons at his local Bible Study Fellowship.
The US Center for Disease Control (CDC) reported that there are over 2.5 million new cases of Traumatic Brain Injury (TBI) each year. Motor vehicle accidents (MVA) account for 14% of all TBI cases. According to the United States National Highway Traffic Safety Administration (NHTSA), there were 5.8 million motor vehicle accidents in 2008 with a total of 1.6 million individuals injured. Data from the US Department of Defense indicated there were over 300,000 TBI cases in the US military since 2000.
Research conducted at the State College of New York (SUNY) State College of Optometry showed that 90% of TBI patients were found to have vision dysfunctions such as binocular vision dysfunctions, oculomotor anomalies, accommodative dysfunctions, strabismus, and cranial nerve palsies. The most common symptoms reported by the patients included loss of balance, dizziness, eyestrain with near tasks, light sensitivity, headaches, near vision blur, vertigo, and motion sickness. These symptoms often make driving very challenging since operating a motor vehicle is a complex multi-sensory process involving integration of visual, perceptual, auditory, motor and cognitive skills. Individuals who suffered from a TBI often feel discouraged and hopeless when going through a recovery process that seems to be slow and long. They often notice difficulty with parking (visual spatial perception), feel unsafe with judging the distance from the other cars (depth perception), or are bothered by the sun light or reflections from the on-coming traffic (glare). It can become very frustrating. The good news is that current research studies have confirmed that the vision dysfunctions that occur after TBI are highly correctable through vision rehabilitation.
Vision rehabilitation for driving may include the following treatment modalities:
1. Compensatory lenses for nearsightedness, farsightedness, and/or astigmatism to maximize clarity of central vision when reading road signs.
2. Therapeutic prisms lenses to enhance visual-spatial awareness and/or peripheral vision when driving on the freeway, the street, and during parking.
3. Tinted lenses with Ultraviolet (UV) coating to protect against the bright sunlight and the harmful light rays.
4. Anti-glare coating to minimize glare from on-coming traffic when driving at night.
5. Optometric Vision therapy to rehabilitate any vision deficiencies such as visual tracking deficiencies, binocular vision disorders, and visual-motor dysfunctions that interfere with safe operation of a motor vehicle. An example of such a case was featured in the COVD journal (Tong & Zink, 2010)
6. Other treatment modalities as prescribed by the Optometrist who provides vision evaluation and rehabilitation for TBI patients.
Life may not be the same after a TBI, but it can still be good with the right help and support. To locate an Optometrist who provides vision rehabilitation in your area, please visit www.covd.org or www.nora.cc
Traumatic Brain Injury in the US: Facts sheet. Center for Disease Control. http://www.cdc.gov/traumaticbraininjury/get_the_facts.html accessed Sept 1, 2015
U.S. Department of Transportation National Highway Traffic Safety Administration’s National Center for Statistics and Analysis. 2008 Traffic Annual Safety Assessment-Highlights. Washington, DC. 2009:1-5. http://www-nrd.nhtsa.dot.gov/Pubs/811172.PDF accessed Sept 1, 2015
DoD worldwide number for TBI. Defense and Veterans Brain Injury Center. http://dvbic.dcoe.mil/dod-worldwide-numbers-tbi accessed Sept 1, 2015
Ciuffreda KJ, Kapoor N, Rutner D, Suchoff IB, Han ME, Craig S. Occurrence of oculomotor dysfunctions in acquired brain injury: a retrospective analysis. Optometry 2007;78(4):155-61.
Craig SB, Kapoor N, Ciuffreda KJ, Suchoff IB, Han ME, Rutner D. Profile of selected aspects of visually-symptomatic individuals with acquired brain injury: a retrospective study. J Behav Optom 2008;19(1):7-10.
Ciuffreda KJ, Rutner D, Kapoor N, Suchoff IB, Craig S, Han ME. Vision therapy for oculomotor dysfunctions in acquired brain injury: a retrospective analysis. Optometry 2008;79(1):18-22.
Ciuffreda KJ, Kapoor N. Oculomotor dysfunctions, their remediation and reading-related problems in mild traumatic brain injury. J Behav Optom2007:18(3):72-77.
Tong D, Zink C. Vision dysfunctions secondary to motor vehicle accident: a case report. Optom Vis Dev 2010;41(3)158-168.