TBI

Approximately 50 % of chronic traumatic brain injury (TBI) patients experience increased sensitivity to light. It can be life altering but they are rarely questioned about such complaints and usually nothing is done.

As discussed in previous blogs, automobile accidents are a major cause of TBI, but unlike young athletes who have become the center of attention when it comes to sports-related concussions, the older TBI head injuries are “left in the dark.” Every normal human being experiences the difficulty of driving on a sunny day, it can be painful. Imagine you were hypersensitive to bright light and stuck on a busy freeway.

No researchers completely understand why head injuries lead to light sensitivity, but the research definitely shows the correlation. There are large processing areas of the brain which seem to be disturbed by concussions and if these areas do not fully recover, the brain never adjusts to changes in light intensity. It’s almost as if the filter function of the seeing brain has been rewired.

Most of these TBI patients end up seeing a neurologist, which is the appropriate first step. But almost none of these individuals make it to the eye doctor. I am an ophthalmologist (a board certified physician who specializes in the medical and surgical treatment of the eye) who also specializes in TBI patients. Patients with light sensitivity need to be examined in more detail.

Light sensitivity is an important symptom of eye disease and one cannot just assume light sensitivity is a symptom of TBI- a treating doctor needs to eliminate intrinsic eye disease as a cause, and only an eye doctor can make this assessment. Missing intrinsic eye disease can be disastrous, as many corneal and inflammatory diseases of the eye can cause photophobia (or light sensitivity) and need to be treated with eye drops, not just sunglasses. Left untreated, such disease can lead to permanent loss of vision.

Also, many automobile accident injury victims experience facial trauma as a result of airbag deployment. Airbags may prevent fatal head injuries but they are a major cause of corneal (front surface of the eye) damage. Airbags can strike the eyeball directly or they release a chemical powder which can burn the surface of the eye. Only a well-trained eye doctor can diagnose and treat these problems. Many TBI patients also complain of eye redness, irritation, in addition to light sensitivity. Eye physicians should take the time to ask a detailed set of questions related to these other visual symptoms.

But let’s say the motor vehicle accident (MVA) patient has light sensitivity but no eye injury; can anything be done?
The answer is yes. First of all, they can be reassured by the eye doctor they are not going blind. Many patients carry this fear. Secondly, there are a variety of tinted and filtered eye glass lenses that can be prescribed which will help these suffering patients. The doctor may not be able to unscramble the processing centers in a victim’s brain, but special eyewear can reduce the glare and return patients to a normal life. Only eye care professionals are in a position to treat these patients.

I look forward to seeing and treating TBI patients, I examine and question them carefully. I also maintain a full optical department in my office. I personally work side by side with my well-trained opticians to find a real world pair of glasses to help these victims return to normal function.

TBI is short for Traumatic Brain Injury, but it should really be called TBEye. I think I have the title for my next article.

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