So what if I told you a one-page, 28-item questionnaire which takes a patient 30 seconds to one minute to check off could help make the diagnosis of traumatic brain injury (TBI)?
And what if I told you a score of 31 or greater indicates a significant visual disturbance. This survey exists- I will provide the link and any person can obtain it free online.
The Brain Injury Vision Symptom Survey (BIVSS) has been scientifically validated and has been shown to distinguish between TBI patients and normals. They key here is “validated”- the test has been given to normals and diagnosed TBI patients and the scores are statistically different. The higher the score, the worse the problem, but any score of 31 or over needs to be evaluated by an eye care professional.
Clearly, most patients never make it to an eye doctor after a head injury. But anyone- a health care provider, an emergency room, even a family member, can administer the test- it is simple. The results are private and quick (30 seconds to one minute to take and score, maybe two minutes if a person is tired). And the questions are simple (no trick questions) and only require circling the appropriate response.
I believe this survey should be administered to all victims of automobile accidents who experience head injuries or whiplash. This will help weed out the patients who need follow up. As I have stated previously, most individuals with head injuries get no follow-up. They might make it to an emergency room or urgent care, get a CT scan and are then sent home. Some make it to chiropractic physicians for therapy of neck and back problems (typical whiplash) but that’s it.
In last week’s blog I discussed just how many whiplash patients have visual symptoms. This article was not in chiropractic or neurologic journal but published in an important ophthalmology journal. I only wish chiropractic physicians, physical therapists, and primary health care providers would give this survey to their patients- it’s cheap and easy and it would help.
In the public space, we are always talking about cost effective care, this is free care. Individuals are being asked by the health care system to take personal responsibility for a medical condition. Home monitoring of blood sugars, blood pressure, now heart rhythm monitors, and even how many steps you take in a day. The BIVSS is low tech, high tech, online education for the public.
I think we need to stop expecting emergency rooms to diagnose chronic conditions. Symptoms of TBI often show up after the adrenaline of initial injury. I hope to see new referrals with a survey in hand. That would be progress.
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Steven H. Rauchman, M.D. is an eye physician and surgeon who has been in private practice for 30 years. He has served as a Traumatic Brain Injury (TBI) medical/legal expert for the last 6 years specializing in the area of personal injury and related traumatic brain injuries.
