Traumatic Brain Injury and Dry Eye
Traumatic brain injuries (TBI) for veterans carry numerous symptoms, side effects and comorbid conditions. A recent study showed that one of the more common issues is dry eye disease, specifically reporting that approximately 37% of veterans with TBI were also diagnosed with the condition—which is caused by a lack of lubricating tears in the eye. Ocular and other eye pain was also shown to be higher in those with a prior brain injury.1
Past research has generally supported the connection between traumatic brain injury and dry eye, with multiple studies linking the two conditions as part of larger problems related to vision.2-3 In fact, a 2013 analysis showed that more than 90% of veterans with a prior TBI had at least one positive measure of dry eye.4 Although other studies do not record it at nearly this rate, it is important to recognize the potential visual dysfunction for servicemen and women with an existing head injury.
This new data is also important because painful light sensitivity and photophobia—a common symptom of TBI in veterans—is also a prominent side effect of dry eye disease. Combined with the greater likelihood of headaches and PTSD as validated by this latest study, and this reinforces the increased risk faced by patients for long-term neurological problems. Not to mention, vets are also more likely to experience chronic pain after and as a result of their service. Therefore, preventative care and pain management are critical steps to helping our veterans with traumatic brain injuries who also manifest issues of dry eye.
A few tips for improving symptoms of dry eye include artificial tears and prescription eye drops, eyelid massages, behavioral adjustments (e.g. reducing screen time), as well as minor surgical procedures that close off tear ducts. Recommended options are further explored here and here.
References:
1 Lee CJ, Felix ER, Levitt RC, et al. Traumatic brain injury, dry eye and comorbid pain diagnoses in US veterans. British Journal of Ophthalmology Published Online First: 26 August 2017. doi: 10.1136/bjophthalmol-2017-310509.
2 Rutner D, Kapoor N, Ciuffreda KJ, Craig S, Han ME, Suchoff IB. Occurrence of ocular disease in traumatic brain injury in a selected sample: a retrospective analysis. Brain Inj. 2006 Sep;20(10):1079-86.
3 Suchoff IB, Kapoor N, Waxman R, Ference W. The occurrence of ocular and visual dysfunctions in an acquired brain-injured patient sample. J Am Optom Assoc. 1999 May;70(5):301-8.
4 Cockerham GC, Lemke S, Glynn-Milley C, Zumhagen L, Cockerham KP. Visual performance and the ocular surface in traumatic brain injury. Ocul Surf. 2013 Jan;11(1):25-34. doi: 10.1016/j.jtos.2012.09.004. Epub 2012 Oct 5.
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