{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T12:04:25Z","timestamp":1789733065544,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2009,7,1]],"date-time":"2009-07-01T00:00:00Z","timestamp":1246406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2009,7,1]],"date-time":"2009-07-01T00:00:00Z","timestamp":1246406400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["OVS"],"published-print":{"date-parts":[[2009,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose.<\/jats:title>\n                    <jats:p>The purpose of this study was to determine the frequencies of visual impairment and dysfunction among combat\u2010injured Polytrauma Rehabilitation Center (PRC) inpatient and Polytrauma Network Site (PNS) outpatient military personnel with traumatic brain injury (TBI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>A retrospective analysis of data from vision screenings of 68 PRC\u2010inpatients with moderate to severe levels of TBI and 124 PNS\u2010outpatients with mild TBI at the VA Palo Alto Health Care System was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>Eighty\u2010four percent of PRC\u2010inpatients and 90% of PNS\u2010outpatients had TBIs associated with a blast event. The majority of patients in both the PRC and PNS populations had visual acuities of 20\/60 or better (77.8% PRC, 98.4% PNS). Visual dysfunctions (e.g., convergence, accommodative, and oculomotor dysfunction) were common in both PRC and PNS populations. In the PRC\u2010inpatient population, acuity loss of 20\/100 to no light perception (13%) and visual field defects (32.3%) were found. In the PNS\u2010outpatient population, acuity loss of 20\/100 to no light perception (1.6%) and visual field defects (3.2%) were infrequently found. In both the PRC and PNS populations, visual field defects were more often associated with blast than non\u2010blast events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>Blast events were the most frequent mechanism of injury associated with TBI in combat\u2010injured servicemembers. The vision findings suggest that combat troops exposed to blast with a resulting mild TBI are at risk for visual dysfunction, and combat troops with polytrauma injuries are at risk for visual dysfunction and\/or visual impairment. The visual consequences of such injuries necessitate further study and support the need for appropriate evaluation and treatment in all severities of TBI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/opx.0b013e3181adff2d","type":"journal-article","created":{"date-parts":[[2009,6,26]],"date-time":"2009-06-26T03:19:53Z","timestamp":1245986393000},"page":"817-825","source":"Crossref","is-referenced-by-count":173,"title":["Visual Impairment and Dysfunction in Combat\u2010Injured Servicemembers With Traumatic Brain Injury"],"prefix":"10.1002","volume":"86","author":[{"given":"Karen D.","family":"Brahm","sequence":"first","affiliation":[{"name":"Western Blind Rehabilitation Center VA Palo Alto Health Care System Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi M.","family":"Wilgenburg","sequence":"additional","affiliation":[{"name":"Western Blind Rehabilitation Center VA Palo Alto Health Care System Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennine","family":"Kirby","sequence":"additional","affiliation":[{"name":"Western Blind Rehabilitation Center VA Palo Alto Health Care System Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanida","family":"Ingalla","sequence":"additional","affiliation":[{"name":"Western Blind Rehabilitation Center VA Palo Alto Health Care System Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chea\u2010Yo","family":"Chang","sequence":"additional","affiliation":[{"name":"Western Blind Rehabilitation Center VA Palo Alto Health Care System Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory L.","family":"Goodrich","sequence":"additional","affiliation":[{"name":"Western Blind Rehabilitation Center VA Palo Alto Health Care System Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,7,1]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1093\/milmed\/164.11.780","article-title":"Penetrating eye injury in war","volume":"164","author":"Biehl JW","year":"1999","journal-title":"Mil Med"},{"key":"e_1_2_6_3_2","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.ophtha.2007.04.032","article-title":"Severe eye injuries in the war in Iraq, 2003\u20132005","volume":"115","author":"Thach AB","year":"2008","journal-title":"Ophthalmology"},{"key":"e_1_2_6_4_2","volume-title":"Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations, and Deaths","author":"Langlois JA","year":"2006"},{"key":"e_1_2_6_5_2","doi-asserted-by":"crossref","first-page":"2471","DOI":"10.1056\/NEJMp048317","article-title":"Casualties of war\u2014military care for the wounded from Iraq and Afghanistan","volume":"351","author":"Gawande A","year":"2004","journal-title":"N Engl J Med"},{"key":"e_1_2_6_6_2","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/S0896-1549(05)70118-8","article-title":"The development of eye armor for the American infantryman","volume":"12","author":"La Piana FG","year":"1999","journal-title":"Ophthalmol Clin North Am"},{"key":"e_1_2_6_7_2","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.optm.2006.03.015","article-title":"Eye injuries on the battlefields of Iraq and Afghanistan: public health implications","volume":"77","author":"Ari AB","year":"2006","journal-title":"Optometry"},{"key":"e_1_2_6_8_2","unstructured":"Department of Veterans Affairs Veterans Health Administration.Polytrauma Rehabilitation Procedures. 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