Restoration of Vision after Brain Injury Using Magnet Glasses: A Case Report

• Published in: American journal of physical medicine & rehabilitation Vol. 96; no. 4; pp. e70 - e74
• Main Authors: Houston, Kevin E., Paschalis, Eleftherios I., Angueira, Danielle C., Bronstad, P. Matthew, Barrett, A.M., Iaccarino, M. Alexis
• Format: Journal Article
• Language: English
• Published: 01-04-2017
• ISSN: 0894-9115; 1537-7385
• DOI: 10.1097/PHM.0000000000000592

Visual impairments are common after traumatic brain injury (TBI) and negatively impact quality of life. We describe a 39 year-old woman with a severe TBI who was evaluated by the inpatient optometry and vision rehabilitation service with findings of complete right homonymous hemianopia and right cranial nerve III palsy with 30° right exotropia (eye turn out) and complete right ptosis (eyelid won’t open). The 30° exotropia advantageously generated 30° of right visual field expansion when the right ptosis was treated with a magnetic levator prosthesis (MLP), which restores eyelid opening. Once opened, the patient utilized visual field expansion derived from a right exotropia to overcome functional impairments caused by right hemianopia. Field expansion improved the patient’s wheelchair mobility and reaching tasks during inpatient therapy. This is the first report of visual field expansion by strabismus facilitated by correction of ptosis. Strabismus should be considered for its potential field expansion benefits when homonymous visual deficits are present, prior to considering patching. A multidisciplinary vision rehabilitation team is well suited to make this determination.