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RRP 07-339 – QUERI Project

 
RRP 07-339
Visual Dysfunction in PNS OIF/OEF Patients: A Pilot Study
Gregory L Goodrich, PhD
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, CA
Funding Period: February 2008 - August 2008
BACKGROUND/RATIONALE:
The current study began following an extensive pilot project of some 115 outpatients who completed a vision screen within the the Palo Alto Polytrauma Network Site (PNS) clinic. The pilot data suggested that binocular dysfunction was present in an unexpectedly high percentage of these patients. The current study was undertaken to expand upon these initial findings and to refine the vision screening protocol.

OBJECTIVE(S):
The project has two main objectives. The first is to refine the vision screening protocol developed at Palo Alto by adding a second PNS screening clinic (Tucson) to gain added patient information and clinical experience. The second objective was to determine if the rates of binocular dysfunction seen in the Palo Alto pilot study were unique to that population or whether the results could be replicated at another site.

METHODS:
The current study is a prospective clinical research trial. Patients are consented in accordance with current VA research and human subject policies prior to their participation. The project attempts to see all patients scheduled for screening in the Palo Alto and Tucson PNS clinics, up to a maximum of 100 subjects. The basic vision screening method has been previously described (Lew, H. L., Poole, J., Vanderploeg, R., Goodrich, G., Dekelboum, S., Guillory, S. B., et al. (2007). Program Development and Defining Characteristics of Returning Military in a VA Polytrauma Network Site. Journal of Rehabilitation Research & Development, 44(7), 1027-1034), however modifications have been made as warranted by additional experience at the two sites. The screening methodology has now been standardized.

FINDINGS/RESULTS:
Data collection has been completed with 47 cases from the Tucson site and 54 cases from Palo Alto. An analysis of the data is currently being conducted. Both sites report similar population demographics and similar rates of visual dysfunction, however final results will not be available until the data analysis is complete.

IMPACT:
Preliminary data analysis suggest that vision loss and visual dysfunction are prevalent in patients of Polytrauma Rehabilitation Centers. If the final data analysis confirms these trends the results suggest that screening for visual dysfunctions should be conducted on returning OIF/OEF troops who have had significant blast exposure. The findings will also be important in guiding future research efforts on vision status in mild traumatic brain injury.


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PUBLICATIONS:

None at this time.


DRA: Sensory Loss, Military and Environmental Exposures
DRE: none
Keywords: Operation Enduring Freedom, Operation Iraqi Freedom
MeSH Terms: none

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