Functional disorders of the accommodative system of the eye in patients with mild traumatic brain injury. Systematic review

A systematic review was carried out using the RSCI and PubMed databases, with the search keywords being “mild traumatic brain injury”, “accommodative asthenopia”, “convergence disorders”, “binocular vision”, “medico-social model of health”, “biopsychosocial model of health”. A total of 188 sources were analyzed, further using systematic review filters and the authors’ knowledge of the topic. It has been established that accommodative asthenopia is the leading (40–80 % of cases) functional disorder in patients with mild traumatic brain injury (MTBI), along with concomitant disorders of convergence (32–40 %) and saccadic/pursuit eye movements (30–60 %), as well as photosensitivity (photophobia, 50–55 %). Restorative treatment of patients with functional disorders of the visual system is carried out against the background of current or previously performed traditional conservative therapy for MTBI. At the same time, foreign ophthalmologists recommend carrying out a complex of treatment and rehabilitation measures for patients with functional visual impairment after MTBI based on the use of optical (including prismatic) correction, binasal occlusion, as well as outpatient and (or) home accommodation and convergence training using special computer programs and mini simulators. In domestic ophthalmological practice, a set of specific physiotherapeutic methods for influencing the organ of vision has been tested for accommodation disorders, but this approach in relation to patients with MTBI requires study. It is advisable to carry out rehabilitation treatment in the early stages after MTBI, which generally reflects the “medical-social” model of health, which provides for the fastest possible return of the patient to everyday activities with the original (pre-illness) indicators of quality of life.

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