Visual dysfunction following blast-related traumatic brain injury from the battlefield

Abstract

Primary objective: To assess the occurrence of ocular and visual disorders following blast-related traumatic brain injury (TBI) in Operation Iraqi Freedom. Research design: Retrospective cohort study. Methods and procedures: A total of 2254 US service members with blast-related combat injuries were identified for analysis from the Expeditionary Medical Encounter Database. Medical record information near the point of injury was used to assess factors associated with the diagnosis of ocular/visual disorder within 12 months after injury, including severity of TBI. Main outcomes and results: Of 2254 service members, 837 (37.1%) suffered a blast-related TBI and 1417 (62.9%) had other blast-related injuries. Two-hundred and one (8.9%) were diagnosed with an ocular or visual disorder within 12 months after blast injury. Compared with service members with other injuries, odds of ocular/visual disorder were significantly higher for service members with moderate TBI (odds ratio (OR) = 1.58, 95% confidence interval (CI) = 1.02–2.45) and serious to critical TBI (OR = 14.26, 95% CI = 7.00–29.07). Conclusions: Blast-related TBI is strongly associated with visual dysfunction within 1 year after injury and the odds of disorder appears to increase with severity of brain injury. Comprehensive vision examinations following TBI in theatre may be necessary.