A traumatic brain injury can affect everything from memory to mobility. But a TBI causes blindness can be particularly disabling. Now a study shows surgery can restore TBI patients’ vision, even months after the injury.
Imagine waking up after an auto accident blind. The one-two punch of the TBI and the blindness could set your recovery back months, rendering you permanently disabled. But a new study says there is hope for blind TBI patients. Surgical intervention could restore 20/20 vision, even when performed months after the accident.
Researchers at Washington University School of Medicine in St. Louis, the Kresge Eye Institute at Wayne State University, and L.V. Prasad Eye Institute in India teamed up to study the effects of TBI on the eye. They studied patients who developed hemorrhaging in the eye connected to brain injuries suffered in auto accidents.
When an accident victim suffers a brain aneurysm – bleeding in the brain – it can sometimes result in increased pressure in the skull and bleeding at the back of the eye. This condition is called Terson syndrome. It can blind patients and increase the risk of mortality – from 10% to as high as 40-45%. But the eyes are often not the doctors’ top priority.
“These patients often have other issues related to brain injury, and we can’t work on the eye until a patient has stabilized.”
Said principal investigator Rajendra S. Apte, MD, PhD, the Paul A. Cibis Distinguished Professor of Ophthalmology and Visual Sciences at Washington University School of Medicine. In some cases, waiting can be a good thing. Sometimes the hemorrhage will dissipate on its own and no surgery will be necessary. But in other cases, TBI patients could be faced with a crippling loss of vision, often in both eyes.
The study tracked 20 patients (and 28 eyes) with Terson syndrome who underwent a vitrectomy, removing the vitreous gel between the eye’s lens and retina and replacing it with saline solution. In the process, the hemorrhaged blood is removed as well, allowing light to reach the photoreceptor cells on the retina and restoring the patient’s vision. The patients were divided into two groups: one that had the vitrectomy within 3 months, and the other that waited longer.
“It was important to learn how long we could wait to operate without having a negative effect on vision. In the majority of cases, it appears vision can be restored, even if the surgery is done several months after a traumatic brain injury.”
The good news is that the wait does not seem to affect patients’ vision. Before the surgery, the average vision was 20/1290. Within a few months, almost all patients had 20/20 vision.
A traumatic brain injury can take months and even years for recovery. But this surgery promises that Terson syndrome patients will likely be able to see the recovery in front of them.