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Citation
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Winkler SL, Marszalek J, Wang X, Finch D, Rakoczy C, Delikat J, Kelleher V, Williams M, Zuniga E, Rice C, Pollard K, Cockerham G. Optom. Vis. Sci. 2021; ePub(ePub): ePub. |
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Abstract
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SIGNIFICANCE: Visual dysfunction is frequently associated with traumatic brain injury (TBI). While evidence regarding the prevalence of symptoms of this population has been published, little is known about health care utilization. A retrospective review of the data derived from the VA mandated "Traumatic Brain Injury Specific Ocular Health and Visual Functioning Examination for Polytrauma Rehabilitation Center Patients" provided a unique opportunity to investigate vision rehabilitation utilization.
PURPOSE: The purpose was to understand (a) the frequency of vision rehabilitation follow-up visits at six, 12, and 24 months, (b) the association between follow-up and demographic, comorbidity, and severity of TBI covariates, ocular and visual symptoms, geographic access, evaluating facility, and (c) why some veterans did not follow-up with recommendations.
METHODS: Retrospective and survey designs were used. The sample included 2,458 veterans who served in the Operation Enduring Freedom/Operation Iraqi Freedom conflicts and received care at one of the five VA Polytrauma Rehabilitation Centers between 1/1/2008 and 12/31/2017. Quantitative and qualitative descriptive analyses and stepwise logistic regression were performed.
RESULTS: About 60% of veterans followed up with recommended vision rehabilitation with visits equally split between VA Polytrauma Rehabilitation Centers and community VA facilities. For each 10-year increase in age, there was a corresponding reduction of 12% in the odds of follow-up. Veterans with decreased visual field had 50% greater odds of follow-up than those who did not. Veterans with difficulty reading had 59% greater odds of follow-up than those who did not. Those who had a double vision had 45% greater odds of follow-up than those who did not.
CONCLUSIONS: Our findings suggest that the need for vision rehabilitation may extend as long as two years post TBI. Access to vision rehabilitation is complicated by the paucity of available neuro-optometric services.
Language: en |