Capó-Aponte José E, Urosevich Thomas G, Temme Leonard A, Tarbett Aaron K, Sanghera Navjit K
Visual Sciences Branch, Sensory Research Division, U.S. Army Aeromedical Research Laboratory, 6901 Andrews Avenue, Fort Rucker, AL 36330, USA.
Mil Med. 2012 Jul;177(7):804-13. doi: 10.7205/milmed-d-12-00061.
The purpose of the present study was to assess the occurrence of visual dysfunctions and associated symptoms in active duty warfighters during the subacute stage of blast-induced mild traumatic brain injury (mTBI). A comprehensive visual and oculomotor function evaluation was performed on 40 U.S. military personnel, 20 with blast-induced mTBI and 20 without. In addition, a comprehensive symptom questionnaire was used to assess the frequency of visual, vestibular, and neuropsychiatric-associated symptoms. The most common mTBI-induced visual dysfunctions were associated with near oculomotor deficits, particularly large exophoria, decreased fusion ranges, receded near point of convergence, defective pursuit and saccadic eye movements, decreased amplitude of accommodation, and monocular accommodative facility. These were associated with reduced reading speed and comprehension and an increased Convergence Insufficiency Symptom Survey score. Photosensitivity was a common visual dysfunction along with hearing, balance, and neuropsychiatric symptoms. The oculomotor testing for warfighters suspected of blast-induced mTBI should include, at a minimum, the assessment of near lateral and vertical phorias, positive fusional vergence, stereoacuity, near point of convergence, amplitude of accommodation, monocular accommodative facility, saccades, and pursuit eye movements. A reading test should be included in all routine exams as a functional assessment of the integration of oculomotor functions.
本研究的目的是评估爆炸所致轻度创伤性脑损伤（mTBI）亚急性期现役军人视觉功能障碍及相关症状的发生情况。对40名美国军事人员进行了全面的视觉和眼动功能评估，其中20名患有爆炸所致mTBI，20名未患。此外，使用一份综合症状问卷来评估视觉、前庭和神经精神相关症状的发生频率。最常见的mTBI所致视觉功能障碍与近眼动缺陷有关，特别是大外隐斜、融合范围减小、集合近点后移、追踪和扫视眼球运动缺陷、调节幅度减小以及单眼调节能力下降。这些与阅读速度和理解能力降低以及集合不足症状调查得分增加有关。光敏性是一种常见的视觉功能障碍，同时伴有听力、平衡和神经精神症状。对于疑似爆炸所致mTBI的军人，眼动测试至少应包括评估近外侧和垂直隐斜、正融合性聚散、立体视锐度、集合近点、调节幅度、单眼调节能力、扫视和追踪眼球运动。在所有常规检查中都应包括阅读测试，作为眼动功能整合的功能评估。
