The eyes are a window to the brain


Nothing quite catches our collective attention like clear and dire issues that need solutions and traumatic brain injuries (TBI), the leading cause of death and disability across all population demographics, are no exception.

More and more research is demonstrating the serious and widespread impacts of TBI.  Every day, about 153 people die from injuries that include TBI. In 2013 alone, the U.S. Centers for Disease Control and Prevention (CDC) estimated there were 2.8 million TBI-related emergency room visits, hospitalizations, and deaths. Even mild TBI can have serious consequences, according to a study published in January 2019 that found some individuals were at substantially increased risk of post-traumatic stress disorder and/or major depressive disorder. The good news is that national organizations and advocates are driving important discussions around this topic and how to address it. The not so good news is that more education is needed, particularly around the full impact TBI can have not only on the brain, but in all of our functioning, including our vision.

The eyes are far more than just the proverbial window to our soul. More accurately, they’re a window into the overall health of our body. In fact, eyes are the only organ that can detect both organ-specific conditions and broader health issues such as TBI, diabetes and high cholesterol. Sight might begin in the eyes, but it actually occurs in the brain, with over half of the brain dedicated to vision and visual processing.

Take Sarah, a young woman with everything ahead of her as she heads towards graduation. She is an elite high school ice hockey player planning to continue her passion when she starts college in the fall. That dream changed after two severe concussions and a neck injury. Sarah is now a sophomore in her university’s honors program, and an ardent advocate for TBI education, particularly the vision health impact concussions can have.

These injuries can have devastating consequences for both individuals and their families by severely impairing cognitive functioning. They may cause problems with memory, vision and emotional functioning and are increasingly linked to adverse mental health outcomes.

As up to 75 percent of TBI patients suffer visual dysfunction, optometrists often take a lead role in the management and detection of TBI and can often detect undiagnosed brain injuries before symptoms worsen. Undiagnosed and untreated brain injuries lead to an increased risk of brain damage, yet nearly one-third of child and adult athletes have an undiagnosed concussion, according to estimates from the National Institutes of Health. This is why ensuring patients with TBI have their visual system assessed and including doctors of optometry in the health care process is vitally important.

Additionally, optometrists can mitigate risk factors for TBI, such as vision loss, through annual eye examinations. The CDC, for example, recommends older adults receive annual comprehensive eye examinations for this reason. Nearly 4 in 5 TBI-related ER visits, hospitalizations and deaths in adults aged 65 and older were caused by falls, and more than 800,000 patients a year are hospitalized because of a fall injury, most often because of a broken hip or head injury.

Optometrists also play a critical part of TBI rehabilitation. For athletes, coaches, parents, physical therapists and others should ensure that athletes visit an optometrist, especially if any indications of brain injury emerge or if the athlete has experienced falls, blows or accidents. It is imperative that patients and their care team make the treating optometrist aware of any head injury, no matter the level of severity. It simultaneously imperative that all members of the care team coordinate in the development of a rehabilitation plan.

We are in a unique position to make a difference as the providers of more than two-thirds of primary eye care in the U.S. As primary health care providers, optometrists receive extensive, ongoing training to examine, diagnose, treat and manage ocular disorders, diseases and injuries and more than 270 systemic diseases that manifest in the eye. The AOA has taken education a step further and defined optimal optometric care when it comes to TBIs. We are also spotlighting the potential issues associated with TBI, which are of particular importance for military personnel, first responders, athletes, and others engaged in highly physical activities that provide a higher risk of TBI.

As we move into the year 2020, we are working to ensure that everyone understands the importance of a comprehensive eye exam and has access to potentially life-saving optometric care. More than 600 members of the American Optometric Association (AOA) recently descended upon Capitol Hill  to educate lawmakers about the critical role doctors of optometry play in overall health and that a healthier America starts with the eye.

Samuel Pierce is president, American Optometric Association.

Image credit:


Leave a Comment

Most Popular

Join 150,000+ subscribers

Get the best of KevinMD in your inbox

Sign me up! It's free. 
✓ Join 150,000+ subscribers 
✓ Get KevinMD's 5 most popular stories
Subscribe. It's free.