Mary Vining Radomski, Marsha Finkelstein, Imelda Llanos, Mitchell Scheiman, Sharon Gowdy Wagener; Composition of a Vision Screen for Servicemembers With Traumatic Brain Injury: Consensus Using a Modified Nominal Group Technique. Am J Occup Ther 2014;68(4):422–429. https://doi.org/10.5014/ajot.2014.011445
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© 2019 American Occupational Therapy Association
Vision impairment is common in the first year after traumatic brain injury (TBI), including among service members whose brain injuries occurred during deployment in Iraq and Afghanistan. Occupational therapy practitioners provide routine vision screening to inform treatment planning and referral to vision specialists, but existing methods are lacking because many tests were developed for children and do not screen for vision dysfunction typical of TBI. An expert panel was charged with specifying the composition of a vision screening protocol for servicemembers with TBI. A modified nominal group technique fostered discussion and objective determinations of consensus. After considering 29 vision tests, the panel recommended a nine-test vision screening that examines functional performance, self-reported problems, far–near acuity, reading, accommodation, convergence, eye alignment and binocular vision, saccades, pursuits, and visual fields. Research is needed to develop reliable, valid, and clinically feasible vision screening protocols to identify TBI-related vision disorders in adults.
Servicemembers and civilians with TBI who are referred to occupational therapy practitioners are likely to have visual dysfunction.
Screening for vision impairments on all adults with TBI ensures that they are appropriately referred for full vision examination by specialists and that they receive necessary therapy and education to manage vision problems during functional activities.
An occupational therapy TBI vision screen recommended by a consensus panel using the nominal group technique may represent a “better practice” option.
Research is needed to develop a robust and clinically feasible occupational therapy vision screening protocol for adults with TBI; few options exist at present.
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