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Prismatic eyeglasses for headaches and dizziness caused by traumatic brain injury appears promising, study finds

publication date
June 9, 2010
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Abstract/Introduction

Introduction: A recent retrospective study shows strong evidence that symptoms of headache, dizziness and anxiety in some patients with traumatic brain injury potentially could be alleviated or even eliminated with specialized eyeglass lenses containing prisms. These lenses resulted in 71.8 percent reduction of symptoms.

Methods: This represents a new approach to the treatment of post-concussive symptoms," says Mark S. Rosner, M.D., adjunct clinical instructor in the Department of Emergency Medicine at the University of Michigan Medical School and Emergency Department staff physician at St. Joseph Mercy Hospital in Ann Arbor. "Vision was known to be affected by TBI, but now it appears that the vision abnormalities caused by the TBI are causing the other post-concussive symptoms.

 


Conclusion/Results

Results: The study suggests that TBI appears to be causing visual image misalignment -- or vertical heterophoria. To correct this misalignment and prevent double vision, the eye muscles are utilized to force the eyes back into proper alignment. This causes the eye muscles to become overworked, strained and fatigued, which accounts for many post-concussive symptoms, including headaches, dizziness, anxiety and neck pain. The use of prismatic eyeglass lenses to realign the images and reduce or eliminate eye muscle overwork led to a 71.8 percent reduction of patient's symptoms.

TBI affects 15 to 20 percent of our servicemen and women returning from Iraq and Afghanistan -- caused mostly by explosions -- and approximately 2 million people per year in the U.S. -- caused mostly by falls, auto accidents and sports injuries. Approximately 10 to 25 percent of patients with TBI still have significant post-concussive symptoms one year after their injury.

Conclusion: Treatment involves a multifaceted approach, including physical therapy, occupational therapy and multiple medications, and can take years to complete," says Jennifer E. Doble, M.D., a physiatrist at St. Joseph Mercy Hospital, Ann Arbor. "Prismatic lens treatment seems to allow the other therapies to be effective more quickly. And as a result, patients get better quicker, reducing the time and cost of caring for this patient population."

The first patient with TBI was recognized as having vertical heterophoria in 2005 by two of the study co-authors -- Doble, a TBI rehabilitation specialist -- and Debby L. Feinberg, O.D., an optometrist at Vision Specialists of Birmingham, Birmingham, Mich. The overlap of TBI and vertical heterophoria symptoms was significant: headaches, neck ache, upper back pain, dizziness, nausea, anxiety and reading difficulties. To date, no single unifying cause of TBI symptoms had been identified.


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At Amplify with Dr Wernick I was seeking help for seemingly intractable, probably age-related dryness. I've seen other doctors about it, and that has been helpful, but what he explained to me about it and the careful way he answered all my questions gave me so much more of a clear understanding of what is going on (and is not) that I am more able to implement all his and others' recommendations than I was before. And he gave me additional resources for further follow-up. I am most grateful.


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Dr. Kavner is a gifted diagnostician and orthoptic therapist. He treated me several decades ago for a condition similar to dyslexia. I was having migraines five times per week. I worked with him for about a year and I experienced tremendous improvement (down to 3-4 per year) that has lasted.


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Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


Peter G.

Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


Kinkie F.

I have always found Dr Kavner's work, expertise and wisdom of the highest caliber. As one of the fathers of OT, occupational othomology, his depth and breadth of knowledge about the eyes' health and wellbeing of the patient is exemplary. Cannot say enough good things about him.


Allen B.
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