For unavoidable injuries, the early detection and treatment of eye and traumatic brain injuries (TBI), including concussions, can prevent further harm, injury, and accidents. This page includes educational resources, information, and news about optometry's role in treating TBI.

Clinical Practice Guideline: Comprehensive Pediatric Eye and Vision Examination

According to AOA's Evidence-based Clinical Practice Guideline: Comprehensive Pediatric Eye and Vision Examination (P. 27):

"A majority of concussions occur in the pediatric and adolescent population (5 to 17 years of age), with the 11 to 17-year-old group representing the largest proportion of those injured.170, 171 Children are particularly vulnerable to the consequences of concussion, often having a more prolonged recovery and poorer outcomes, from a cognitive and developmental perspective, than adults with concussion.172-175 A recent study found a high prevalence of vision problems in adolescents with concussion along with significant symptoms associated with these vision disorders.176 The most common binocular vision disorder occurring in postconcussion syndrome is convergence insufficiency (CI) with a prevalence of 49% in children. Other common problems are accommodative insufficiency and saccadic dysfunction.

All children with concussion should see their general practitioner in the event they should need more emergent care and should be scheduled for a comprehensive eye examination to confirm visual capabilities are protected."

For more information on pediatiric eye exam guidlines, please see AOA's Evidence-based Clinical Practice Guideline: Comprehensive Pediatric Eye and Vision Examination.

Brain Injury Electronic Resource Manual (BIERM)

Brain injury affects 2.4 million Americans each year. With many doctors of optometry already involved in the diagnoses and rehabilitation of TBIs the AOA has developed a members-only resource, the Brain Injury Electronic Resource Manual (BIERM). The BIERM serves as a comprehensive resource to aid optometrists in evaluating patients with brain injury.

The first section of the BIERM focuses on evaluation and assessment of common visual conditions associated with TBI, including binocular vision, accommodative, and eye movement disorders.To make it easier to use,  helpful elements such as a glossary, lists of commonly used equipment and an overview of the numerous tests involved in evaluation are included.  The work does not stop with the first volume.  A second volume focuses on treatment and management of brain-injured patients over time.

Interactive (UberFlip) PDF Versions
Traumatic Brain Injury Manual, Volume 1 A Traumatic Brain Injury Manual, Volume 1 A
Traumatic Brain Injury Manual, Volume 1 B Traumatic Brain Injury Manual, Volume 1 B


OMG - How Can a Primary Care OD Help to Manage Post-Concussion Vision Syndrome?
Aug. 23, 2017

Concussion - An Evidence-Based Approach to Optometric Management
Aug. 23, 2017

More Than Meets the TB-EYE TBI
Aug. 23, 2017

Concussions - Where Does Optometry Fit In
June 30, 2016

TBI in the News:

Team effort: Optometry's role in treating sports-related concussions
And with National Concussion Awareness Day on Sept. 15, the AOA Sports & Performance Vision Committee offers resources doctors of optometry can share with athletes, coaches, trainers, parents and medical professionals on the role vision plays in sports-related concussions, says Keith Smithson, O.D., the committee's chair.

5 things optometrists should know about concussions
Fall sports season offers a timely reminder for optometrists to be alert to patients' risk of concussions.

Doctors of optometry should play role in clearing children for return to class and play
Children and high school athletes should be able to return to school and be symptom free before they begin 'return-to-play' protocols.

Vision training could mitigate soccer-related concussions
In today's world of concussions and injuries, it's all about how we can keep these athletes healthy and on the field.

Multiple health problems associated with mTBI
From July 24, 2017 edition of Healio Primary Care Optometry News
Optometrists who treat veterans should be aware of the various physical and psychological health problems that occur in conjunction with mild traumatic brain injury, a researcher stated here at Optometry's Meeting.

Visual Dysfunction in Veterans After Mild Traumatic Brain Injury (P. 52)
From the April 2017 edition of AOA Focus.
"I don't think that a lot of our TBIs, especially in the military, are getting the complete picture, because not a lot of people provide vision rehab care. Even if they do, most people provide it as a secondary service or tertiary service where it is just a sideline for them." [-Dr. Clopton].