Visual deficits and dysfunctions associated with traumatic brain injury in patients at Mulago National Referral Hospital

Abstract

Traumatic Brain Injury (TBI) and its associated concussion are the major cause of disability and death in all ages, though children under the age of one, young adults between 15 to 19 years and the elderly are the most susceptible groups. Most of the traumatic brain injuries (TBIs) are due to falls, being struck by moving object, road traffic accidents accidents, assault, firearms, sports or recreational activities. TBI cases in Uganda are on the rise and yet little is known about the neurophysiological outcomes amongst the survivors. There is scanty information that has been documented about the visual outcomes of the patients suffering from TBI at Mulago National Referral Hospital (MNRH). Objectives 1. To find out the signs and symptoms associated with visual deficits in TBI patients at Mulago National Referral Hospital. 2. To determine the prevalence of visual dysfunctions associated with TBI victims at Mulago National Referral Hospital. 3. To assess the effect of visual deficits on the quality of life of victims associated with TBI The purpose of this study was to find out the visual deficits associated with TBI and their signs and symptoms and their prevalence in MNRH. It was a quantitative cross-sectional study that involved the use of questionnaire and comprehensive examination. All conscious patients with documented TBI, willing to consent and able to undergo ocular and visual examination were recruitted. Those who were un cooperative, or refuse to consent and unwilling to participate, those in critical condition or unconscious were excluded. 80 individuals participated in the study, 77.5% were males and 22.5% females, majority were between 21 to 40 years. Most TBIs were as a result of road traffic accidents and being hit by objects.83.8%. On assessment, 47.5% had normal distance vision, 40% mild reduction, 11.3% moderate and 1.2% severe reduction in vision. 80% had normal near vision, 10% mild, 7.5% moderate and 2.5% had severely reduced near vision, 48.8% photophobia, 27.5% stereopsis, 23.8% diplopia, 20% convergence insufficiency, 16.2% accommodative insufficiency, 5% were found with accommodative infacility, 8.8 % exophoria, 3.7% exotropia and 3.7% had color vision deficits. Patients with TBI may suffer a variety of visual problems in combination with a decline in ocular and overall health hence decreasing the vision related quality of life. Timely interventions can reduce ocular complications.