Cortical Visual Impairment, Traumatic Brain Injury, and Neurological Vision Loss

2012 ◽  
2017 ◽  
Vol 10 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Austin Y. Ha ◽  
William Mangham ◽  
Sarah A. Frommer ◽  
David Choi ◽  
Petra Klinge ◽  
...  

Traumatic orbital roof fractures are rare and are managed nonoperatively in most cases. They are typically associated with severe mechanisms of injury and may be associated with significant neurologic or ophthalmologic compromise including traumatic brain injury and vision loss. Rarely, traumatic encephalocele or pulsatile exophthalmos may be present at the time of injury or develop in delayed fashion, necessitating close observation of these patients. In this article, we describe two patients with minimally displaced blow-in type orbital roof fractures that were later complicated by orbital encephalocele and pulsatile exophthalmos, prompting urgent surgical intervention. We also suggest a management algorithm for adult patients with orbital roof fractures, emphasizing careful observation and interdisciplinary management involving plastic surgery, neurosurgery, and ophthalmology.


2009 ◽  
Vol 86 (7) ◽  
pp. 817-825 ◽  
Author(s):  
Karen D. Brahm ◽  
Heidi M. Wilgenburg ◽  
Jennine Kirby ◽  
Shanida Ingalla ◽  
Chea-Yo Chang ◽  
...  

2016 ◽  
Vol 15 (2) ◽  
pp. 249-251
Author(s):  
Prastiya Indra Gunawan ◽  
Desi Primayani ◽  
Darto Saharso

Background: Acute encephalitis syndrome (AES) is one of cortical visual impairment (CVI) causes. There were only few studies about cortical visual involvement in children with AES. Objective: To describe CVI in children with AES. Methods: This study included all children with AES during January to March 2014, were examined for visual evoked potential (VEP) to evaluate cortical visual pathway. AES was defined as clinical condition characterized by acute onset of fever, a change in mental status, and/or new onset of seizures. CVI was defined as vision loss caused by central nervous system damage confirmed by VEP. Results: There were 9 children with AES and all showed bilateral CVI. The age range between 6 to 48 months old, with 7 males and 2 females. Visual evoked potential result showed 8 children with demyelinating type and 1 with axonal type. Conclusion: Type of CVI caused by AES can be demyelinating type or axonal type.Bangladesh Journal of Medical Science Vol.15(2) 2016 p.249-251


2019 ◽  
Vol 114 (1) ◽  
pp. 6-17 ◽  
Author(s):  
Michele C. McDonnall ◽  
Jennifer L. Cmar ◽  
Emily M. Lund

Introduction: The purpose of this study was to investigate how services are provided to state–federal vocational rehabilitation consumers with comorbid traumatic brain injury (TBI) and visual impairment and the prevalence of and competitive employment rates for this population. Methods: We utilized a mixed-methods approach by incorporating interview data from 51 vocational rehabilitation agency administrators (to identify strategies used to serve these consumers) and case service data (to identify prevalence and competitive employment rates at the agency level). We combined the data to examine the relationship between strategies used and the prevalence of and employment outcomes for this population. A modified grounded theory approach was used for qualitative data analysis and descriptive statistics, and analyses of variance were used for quantitative data analyses. Results: Strategies used to serve these consumers included collaboration between counselors, involvement of external organizations, specialized TBI units or caseloads, staff training in TBI, and personnel with dual expertise in TBI and visual impairment. Over a third of agency administrators reported that they did not do anything special or different to serve this population. The average percentage of consumers with visual impairments who also had TBIs being served by agencies was 2.1%. Their average competitive employment rate by agency was 43.2%. Employing staff with dual expertise in TBI and visual impairment was associated with serving a greater percentage of consumers and having a higher competitive employment rate. Discussion: No agencies had a unique service delivery program or method to serve this population, perhaps due to its low prevalence. Agencies had substantial variability in the proportion of consumers with TBI and visual impairment served and their competitive employment rates. Implications for practitioners: Training vocational rehabilitation professionals to develop expertise in both TBIs and visual impairments may help agencies better serve these consumers.


2020 ◽  
Vol 12 (1) ◽  
pp. 25-31
Author(s):  
Rojeeta Parajuli ◽  
Srijana Adhikari ◽  
Ujjowala Shrestha

Introduction: Cortical visual impairment denotes vision loss from pathology posterior to the lateral geniculate nucleus. The pathology may involve the optic radiations, as well as the occipital cortex. Objective: To find out the profiles of cortical visual impairment patients visiting the pediatric outpatient department. Materials and Methods: The study is a hospital based retrospective study in which all consecutive patients diagnosed with cortical visual impairment were included. A total of 40 patients were collected. Detailed history taking and clinical examination was done. Visual acuity was taken by fixation and follows method. Among 40 patients, only two patients were advised to use glass and the rest did not have significant refractive error. Myopia ranged from (-2D to -5D) and five patients were myopic. Astigmatism ranged from (-0.5 to -2.5 x 108°) and 10 patients had astigmatism. Suspected patients were advised for Computed Tomography/ Magnetic Resolution Imaging (CT/MRI) of the brain. Results: The male: female ratio was 3:2, the age group ranged from 4 months to 8 years old, antenatal checkup history was uneventful in 77.5% cases, history of birth asphyxia was present in 87.5% cases, postnatal checkup history was eventful in 67.5%, associated systemic illness was present in 60%, anterior segment examination was normal in 92.5%, posterior segment examination was normal in 72.5%, CT/MRI findings were abnormal in 57.5% and was not done in 30% of cases. Antenatal history was described as uneventful if there was absence of diabetes mellitus, hypertension, fever and intake of any medicine. Postnatal history was described as uneventful if there was absence of febrile convulsion, meningitis, encephalocele, encephalopathy, epilepsy or hydrocephalus. Conclusion: Birth asphyxia and postnatal infections are the major causes for cortical visual impairment. We can mitigate cortical visual impairment by limiting birth asphyxia and postnatal infections.


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