"Joe" served in Iraq in 2007. While there, he experienced five head concussions from improvised explosive devices, but no penetrating injuries. When his tour of duty was complete, he returned home with no apparent head injuries other than the concussions.
However, shortly after returning home, Joe began having difficulty reading. This soon progressed to running into furniture and falling down stairs. Over the course of nine short months, Joe was declared functionally blind and was transferred to a blind rehabilitation center due to his level of visual impairment.
Sadly, Joe's story is all too common.
Blast Concussions and Vision Problems
According to Tom Zampieri, director of government relations for the Blinded Veterans Association, ophthalmologists and other military medical personnel are just beginning to realize the strong connection between vision problems and traumatic brain injuries due to concussive blasts.
"There is a lot we don't know regarding how blast injuries and shock waves to the brain affect vision," explains Zampieri. "One thing that we do know is that soldiers who have difficulty walking but who have no discernable physical reason for the altered gait likely have a vision problem."
This connection led Walter Reed Medical Center to begin screening all soldiers with traumatic brain injuries for vision problems within the last two years. And what they've found is astounding. A full 64 percent of soldiers with traumatic brain injury have a vision-related problem.
VA Polytrauma Rehab Centers Screen All TBIs for Vision Loss
For this reason, the Veterans Affairs' polytrauma rehabilitation centers followed Walter Reed's lead and began performing more frequent and more comprehensive low vision screenings on all soldiers with traumatic brain injuries. And they too found a high correlation between blast injuries and vision problems ranging from mild to severe, with two percent of all traumatic brain injury soldiers suffering legal blindness.
But what is even more concerning is the growing group of soldiers with functional blindness—soldiers like Joe. Because they don't fit the technical definition for blindness (20/200), they often fall into a sort of limbo in terms of entitlements and benefits.
And, like Joe, many of the soldiers may not realize that they have a problem as the vision problems may not manifest for one to three years after the initial injury, often starting with mild symptoms such as color blindness and growing into much more serious concerns. If the mild vision issues are caught early enough, they may improve, but the moderate to severe injuries are more likely to permanent.
Should YOU Be Concerned?
The Blinded Veterans Association believes it is critical for all soldiers who have sustained any type of traumatic brain injury or who were involved in a concussive blast during their service to have a comprehensive eye exam for low vision.
Symptoms that indicate you could have a vision problem include:
- Headaches
- Dizziness
- Light sensitivity
- Poor balance
- Double vision
- Eye strain and fatigue
- Color blindness
- Depth perception issues
Of these, light sensitivity seems to be the most common symptom and has been found in 80 percent of traumatic brain injuries. And, according to Zampieri, it is often seen as a warning that there could be a progression of visual complications within a few months of the eventual loss of peripheral field vision.
What You Can Do
If you have been involved in a concussive blast and are experiencing any of these symptoms, contact your local VA medical facility or VA medical clinic. All Iraq and Afghanistan veterans qualify for VA services within five years of service.
If it is determined that you have a traumatic brain injury, you will be referred to a facility within the VA Polytrauma System of Care; however, you must first be enrolled with the VA system.
The VA's Polytrauma System of Care includes:
According to Steven Scott, MD, polytrauma director for the James A. Haley Veterans Hospital in Tampa, the VA rehabilitation centers and network sites alike strive to give freedom back to those who fought for our freedom. "We want to give our veterans the freedom to walk, talk, see, think, function, start back to work and regain their place within their family and communities. Our goal is their independence."
Dr. Scott explains that the polytrauma rehabilitation centers are comprehensive, team-focused, inter-discipline programs dedicated to inpatient rehabilitation and to getting our veterans back home. They specialize in more complex and serious cases, working with major trauma centers across the United States.
The polytrauma network sites, on the other hand, are out-patient rehabilitation centers. Their goal is to work with veterans who are no longer considered to be acute cases and help them regain the skills they need to assimilate back into their communities.
If there is not a polytrauma rehabilitation center or network site in your area, you can inquire about working with a polytrauma support clinic team. Teams are made up of groups of rehabilitation experts who work with regional and network specialists to provide follow up services including managing the long-term effects of polytrauma through direct care, consultation and tele-rehabilitation technologies.
Resources
For more information about the services available to veterans with polytrauma and/or traumatic brain injuries, visit: