Accommodative and Vergence Dysfunctions in mTBI: Treatment Effects and Systems Correlations

Background: Traumatic brain injury (TBI) is a global, diffuse type of injury, which results in a constellation of visual dysfunctions. The extensive neural network of the oculomotor system makes it highly vulnerable following a TBI, hence the high prevalence of signs and symptoms related to accommodative and vergence dysfunctions. Methods: The present study evaluated the therapeutic effects on clinical (subjective) and laboratory (objective) measures, as well as their correlated improvements, following an equal dosage of six weeks of vergence and accommodation training in mild TBI (n=12). Results: With only three hours of training for each system, significant improvements in both static and dynamic parameters of both systems were found. Maximum amplitude of both systems increased markedly, along with faster dynamics demonstrating speedy responsivity, following training. Several key parameters between the two systems showed significant correlation (p<0.01), such as amplitudes (r = -0.87) and facilities (r = 0.88) of accommodation and vergence. Conclusions: The present findings demonstrate efficacy of oculomotor rehabilitation in TBI, with the improvements being suggestive of intact neuroplasticity in the compromised adult brain following mTBI.