Averted Vision Training to Treat Light Sensitivity of Veterans with a History of TBI.

Background: Issues with light sensitivity, especially photophobia, may be reported by nearly half of Veterans with a history of traumatic brain injury (TBI). We designed our innovative approach, known as Averted Vision Training (AVT), to help patients find their way to optimal patterns of fixation t...

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Publicado en:Optometry & Visual Performance Vol. 12; no. 4; pp. 213 - 224
Autores principales: Morand, Timothy, Mishler, Pamela
Formato: pictorial research tables/charts Journal Article
Publicado: Optometric Extension Program Dec2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2024
      vid: 12
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      pub: Optometric Extension Program
      place: Lutherville Timonium, Maryland
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        atl: Averted Vision Training to Treat Light Sensitivity of Veterans with a History of TBI.
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        au:
          Morand, Timothy
          Mishler, Pamela
        affil: Dayton VA Medical Center • Dayton, Ohio (Ret)
      sug:
        subj:
          Photophobia Therapy
          Veterans
          Tuberculosis
          Photophobia Education
          Brain Injuries
          Biological Markers
          Evoked Potentials, Visual
          Eye Movements
          Visual Acuity
          Human
          Funding Source
          Male
          Female
          Adolescence
          Adult
          Middle Age
          Aged
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background: Issues with light sensitivity, especially photophobia, may be reported by nearly half of Veterans with a history of traumatic brain injury (TBI). We designed our innovative approach, known as Averted Vision Training (AVT), to help patients find their way to optimal patterns of fixation that may lead to improvement. Averted vision refers to looking off-center to see faint objects when the eyes are dark adapted, such as viewing a dim star in the night sky. Methods: The study has a mixed-methods design that includes two questionnaires, tests for visual evoked potentials (VEP), and functional assessments with standard contrast sensitivity charts and a microperimeter. Results: Four Veterans with comorbid history of mild or moderate TBI and post-traumatic stress disorder who complained of light sensitivity completed the study. Each was characterized with evidence of brain injury by VEP testing and reported subjective improvement in light sensitivity in response to the training. In exploring microperimetry for objective measure, we found that results for threshold sensitivity were inconclusive, yet results for fixation area were promising. A significant change (enlargement) in the mean fixation area from baseline to posttreatment yielded a large effect size of 1.67, with 55% of the variation attributed to subject performance. These results are suggestive for the use of fixation area as an outcome measure in the rehabilitation of patients with complaints of light sensitivity. Conclusion: As an addition to the basic science of the visual effects of TBI, the potential of having a change in fixation area in response to AVT as an additional valid repeatable testing modality is a substantial strength. If evaluation is left to traditional clinical tests of fixation and light sensitivity, then the opportunity to identify and benefit these Veterans may be missed.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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