Concussion Care Centre of Virginia, LTD

Im so excited to be presenting this year at Academy in Boston! Who else is going? #optometry #vision #eyecare #DryEye #concussion

I was excited to present my poster this week at the International Brain Injury Association World Congress in Brain Injury Conference in Montreal, Quebec, Canada. Dry eye is common in patients with TBI and I presented a case series describing the underlying mechanisms and overlapping symptomatology of dry eye and TBI. Most notably all of my patients complained of blur, fluctuating vision, and light sensitivity post-TBI that was due to dry eye, but few of them had any redness, ocular discomfort, or feelings of dryness. Clinically, they had minimal to no eyelid margin disease or inflammatory signs of dry eye, but all had a severely reduced tear break up time of on average 2.4 sec and reduced tear volume, and 50% had inferior corneal staining. Possible mechanisms for post-traumatic dry eye include autonomic dysfunction, brainstem dysfunction, cranial nerve dysfunction impacting the blink/lacrimal gland reflex (CN VII and V), sleep dysfunction, and of course systemic medication use. I cannot emphasize enough the importance of sleep and co-morbidities (headache, migraine, whiplash, mood disorders, etc) post-TBI, as the majority of my patients were on a medication that can cause or exacerbate dry eye, with an average of 3-4 medications that can cause dry eye. I was amazed at the number of medications patients are treated with post-TBI that were on the medication list from DEWS II. I got great feedback from neurology, neuro-surgery, PMR, Brain Injury Medicine Docs and a few optometrists from Montreal who said they are seeing the same thing! Next step is trying to figure out best treatment options for this neurosensory dry eye! #DryEye #braininjury #concussion #dysautonomia #optometry #ophthalmology #neurology #neurotrophic

I am honored and excited to present some of my research on dry eye in traumatic brain injury at the International Brain Injury Association (IBIA) World Congress in Brain Injury in Montreal, Quebec, Canada this week! Patients with a history of TBI have more dry eye than the general population but it does not present like typical inflammatory dry eye. The case series I will be presenting discusses the most common symptoms in TBI-Dry eye, as well as hypotheses for the etiology of dry eye in TBI - Hint - the etiology is multifactorial in these patients

We are getting excited to head to Montreal, Canada this week for the International Brain Injury Association (IBIA) World Congress in Brain Injury Conference. We (Sara Etheredge DPT, Jacqueline Theis OD, Nathan Zasler MD) will be presenting as a group on Neurosensitivity Spectrum Disorders in TBI - discussing diagnosis and management of topics such as hyperacusis, photophobia, visual motion sensitivity, and more! Cant wait to see everyone there! #concussion #TBI #photophobia

I had a wonderful time this week going up to Washington DC for the National Academies of Practice Annual Conference. This year's theme was "Igniting Interprofessional Collaboration" and I had a great time meeting colleagues in physical therapy, medicine, nursing, occupational therapy, speech, audiology, and public health. One of my favorite things was the ice-breaker they did to start the conference off where we went to the DC Kitchen and volunteered in one of the largest and most well organized food kitchen's I have ever been in. I always enjoy working in food kitchens, and I dont want to brag but I am a very efficient and speedy spreader of peanut butter and jelly... just havent figured out how to put that skill on my resume yet #multidisciplinary #healthcare #volunteer

Hot off the presses! This study came out TODAY on OVS and it's ABOUT 👏TIME👏we started talking about the increased fall risk that happens when people wear progressive and bifocal lenses. https://1l.ink/MTLS58H In this study, Two hundred sixty-eight participants (95.4%) were followed up for falls for 6+ months over the following 13 months: 51 bifocal glasses wearers (31.5%) suffered multiple falls compared with 15 trifocal glasses wearers (46.9%) and 33 progressive addition lens glasses wearers (44.6%) (p=0.071). When adjusting for established fall risk factors, participants wearing progressive addition lens glasses had over twice the odds of suffering multiple falls compared with bifocal glasses wearers (odds ratio, 2.23; 95% confidence interval, 1.08 to 4.58). One of the first things I do with patients with balance and visual-vestibular issues after concussion/brain injury, whiplash/neck injuries and/or acquired movement disorders due to neurologic conditions like cerebral palsy, MS or Parkinsons is get them into a single vision distance pair of impact resistant frames/lenses. Many of my patients are at a fall risk, and if they fall on their face and their glasses break, they can cause orbital/ocular injury. While multiple pairs of glasses is inconvenient for the patient, feeling safe and knowing where to put their foot when walking up and down stairs is imperative for patient safety. There are multiple problems with progressives and bifocals in my patient base: 1) DIZZY - patients with vestibular dizziness have heightened peripheral vision awareness which makes them symptomatic to the peripheral distortions in their progressives, and causes increased dizziness when making eye movements in these lenses (independent of the dizziness they get from the vestibular-oculomotor system). Patients with h/o carsickness/vestibular disorders have a VERY hard time/never adapt to this modality of lens. 2) NECK PAIN - Many patients with chronic dizziness have rebound cervical guarding (neck stiffness) and my concussion patients who also have a whiplash injury often have cervicogenic headache when in inappropriate head positions, especially on the computer. Moving their eyes down to read will exacerbate cervicogenic headaches, and tilting their head back to use their add to see their computer screen will also exacerbate their cervicogenic headaches. Single vision computer glasses and appropriate ergonomic assessment for the win! Additionally patients with neck pain or fused spines or cervical dystonia have a hard time moving their head so they cant look at their feet through the distance portion of the lens, making the stairs/curb etc blurry because of the near add they are inadvertently looking through. #vestibular #braininjury #dizziness #concussion #vision #optometry #ophthalmology #concussion #neckpain #physicaltherapy

Click on the link to register for this webinar: https://loom.ly/7vCAfGc

We have a new blog post up where Dr. Sheard discusses the importance of resilience following concussion and the role of yoga in building resilience. Come check it out at: https://loom.ly/hfs_ju8 and then comment to let us know what you think! Also, go to the Eye Brain Academy website to learn more about online brain injury adaptive yoga and to register for classes: https://loom.ly/VF8rOe0

This year, we’ve had the privilege of supporting so many courageous individuals on their recovery journeys. From small victories to big breakthroughs, every step forward has been inspiring. Here’s to an even brighter 2025, full of hope, healing, and continued growth! #Gratitude2024 #ConcussionRecovery #ThankYou #BrainHealthJourney

Have you ever heard of visual snow? This month in our practice blog I jump into what visual snow is - how it is different from floaters and migraine aura and the different treatment options available/attemptable. Not every patient responds to every treatment and I go into why science is in the infancy of understanding this complicated visual-cortical symptom. Whether you have it yourself, know someone who does or have a patient who has mentioned it and you didnt know what they were talking about... Take a read! https://1l.ink/2MNMT38