Acquired Brain Injuries Flashcards Preview

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Flashcards in Acquired Brain Injuries Deck (41):

what is an acquired brain injury

any condition/event resulting in a sudden non-progressive, or non-degenerative change in neurological processing which can indicate


what are 4 categories of acquired brain injuries

traumatic brain injury, stroke or cerebral vascular accident, post surgical neurological complications and vestibular dysfunctions


what is vision rehabilitation

rehab of the entire visual system and focus on how visual processing impacts behavior and cognitive function


what does an optometrist do for brain injury patients

corrects refractive errors, assesses functional vision, and diagnoses ocular health issues


what are treatments that optometrists can do for brain injuries

lenses, prisms (fresnel, gottlieb, peli), low vision aids and visual rehabilitation


how do you place a prism on specs for a brain injury

base out on the eye of the side with the defect - superior or inferior not in center


where would you place a prism for a right hemianopsia

base out on the right lens


what things do you do differently in the exam for a brain injury

minimize movement around patient, keep room dim, speak clearly, take extensive case history, and notice orientation to person, place, time


what specific things are you going to ask a patient with a brain injury

diplopia, photophobia, headaches, VF cuts, balance and short/long term goals regarding specific vision symptoms


what do you pay special attention to during the work up

VF assessment - midline shift and neurological screening


what is visual neglect

cognitive deficit that refers to the unawareness of objects, people and visual stimuli presented in a visual space contralateral to the cerebral lesion


if a patient had a stroke to the right hemisphere, where would the neglect be

left visual spatial neglect


how is visual neglect different from VF cut

the patient with a VF cut is aware of their vision loss


what are some symptoms of visual neglect

alteration of egocenter (midline shift), bump into objects, skip words while reading, only eat half food on plate, lost in familiar/unfamiliar places, and groom half their face/hair


what are 2 tests for visual neglect

have patient draw a clock face and a specific time that incorporates both side of face - 9:15 or have patient do a line bisection (bisect center of each line)


what is a visual midline shift

mismatch of information and distorting of space due to disruption of ambient system


what are some symptoms of a visual midline shift

alteration of posture, difficulty with balance, hemiplegia, hemiparesis, flexion/extension difficulty, and neglect


how can you help treat visual midline shifts

yoked prisms


what is photophobia

extreme sensitivity to light- inducing pain


how can you treat photophobia

apply tints to lenses


what color tints are for outdoor and indoors

outdoors = brown/gray and indoors = blue or gray (blue is for fluorescent lights)


how can you help treat diplopia

can resolve on its own or use fresnel or ground in prisms


what exercises can help with oculomotor deficits

basic scanning and searching exercises: line tracing (Ann Arbor/Michigan tracking), track words while listening to book on tape, call out first and last letter on a page and create an aperture/window highlighting the text (concentrate on accuracy and speed later)


how can you help with vergence deficits

stabilize vergence in primary gaze at far and near distance and facility and sustainability of fusional vergence at far and near viewing distances


how can you help with accommodation deficits

work on improving the weaker aspect of focusing, build up and equalize accommodative amplitudes, and work on maintaining ability to rapidly change focus on command and sustain focus for extended periods of time


what exercises can help with accommodation deficits

loose lenses/flipper - use different targets at different distances


how can you help with visual-vestibular deficits

work on central- peripheral integration


how can you help impaired visual field integrity

practice scanning into the blind field, teach patient to look into their blind zone and Borderzone stimulation


what instrument is used for borderzone stimulation

Nova Vision Therapy System - maps edge of field and presents stimuli near border making small increases


how many areas of the brain are involved in visual processing



what deficits occur with oculomotor dysfunction

limitations of gaze, nystagmus, and speed and quality of pursuits and saccades


what are some potential symptoms of oculomotor dysfunction

inability to follow objects smoothly, reading problems, skipping words, re-reading words, and word/letter reversals


what are some deficits with binocular dysfunction

strabismus, muscle paresis/paralysis, convergence insufficiency, and reduced or slow fusional ability


what are some potential symptoms of binocular dysfunction

head turn/tilt, diplopia, poor depth/spacial judgements, closing one eye, headaches, asthenopia, reading difficulty, tired eyes, watering, fall asleep while reading, and task avoidance


what are some deficits with accommodative dysfunction

accommodative insufficiency, pseudo-myopia, and speed and quality of accommodative response


what are some potential symptoms of accommodative dysfunction

blue, headaches, pain, diplopia, squinting, closing one eye, reading problems, ocular discomfort, tired/watery eyes, falling asleep while reading and task avoidance


what are some deficits with visual-spatial/visual information processing dysfunction

visual-vestibular integration problems, visual-motor integration problems, difficulty understanding spacial coordination, disturbances in body image, disturbance in sustaining visual attention


what are some symptoms with visual-spatial/visual information processing dysfunction

balance issues, poor distance judgement, motor coordination problems, eye-hand problems, left/right confusion, objects appear to move, agnoisa, apraxia, inattentive, recognizing faces, visual memory and writing difficulty


what are some symptoms for VF loss/visual-spatial neglect

oculomotor related symptoms, difficulty locating objects, gait, balance, seeing at night, spatial insecurity, unable to drive


what VF loss occurs with a lesion anterior to optic chiasm

monocular visual field loss


what VF loss occurs with a lesion or tumor at the optic chiasm

bitemporal hemianopsia