Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2023

Open Access 18-12-2023 | Diplopia | Case report

Eye movement training and gaze analysis for a patient with binocular diplopia after traumatic brain injury: a case report

Authors: Kaneharu Nakamura, Takeshi Fuchigami, Shu Morioka

Published in: Journal of Medical Case Reports | Issue 1/2023

Login to get access

Abstract

Background

Patients with traumatic brain injury often develop sequelae such as eye movement disorders, including diplopia. Eye movement training is effective in diplopia management. However, few longitudinal follow-up studies have been conducted from the subacute disease stage, owing to the complexity of methods for quantifying diplopia.

Case presentation

The patient is a 30-year-old Japanese man who presented with diplopia and underwent eye movement training for approximately 4 weeks. The angle of diplopia, distance of abduction of the eye, gaze analysis, and self-assessment of diplopia using Holmes’ diplopia questionnaire were evaluated. The degree of diplopia increased from 12° to 40° on the right side. The distance of eye abduction increased from 10.4 to 12.8 mm. The self-assessment score improved from 76 to 12 points. Analysis of gaze transition revealed a reduction in the error between the target and gaze.

Conclusion

Eye movement training was successful in ameliorating the symptoms of diplopia in the patient with binocular diplopia. Furthermore, for patients with diplopia symptoms, it was suggested that the oculomotor approach to eye movement training should not only focus on the direction of the diplopia but also on the direction opposite to the diplopia (the weak side).
Appendix
Available only for authorised users
Literature
1.
go back to reference Ciuffreda KJ, Kapoor N, Rutner D, Suchoff IB, Han ME, Craig S. Occurrence of oculomotor dysfunctions in acquired brain injury: a retrospective analysis. Optometry. 2007;78:155–61.CrossRefPubMed Ciuffreda KJ, Kapoor N, Rutner D, Suchoff IB, Han ME, Craig S. Occurrence of oculomotor dysfunctions in acquired brain injury: a retrospective analysis. Optometry. 2007;78:155–61.CrossRefPubMed
2.
go back to reference Pierrot-Deseilligny C. Nuclear, internuclear, and supranuclear ocular motor disorders. Handb Clin Neurol. 2011;102:319–31.CrossRefPubMed Pierrot-Deseilligny C. Nuclear, internuclear, and supranuclear ocular motor disorders. Handb Clin Neurol. 2011;102:319–31.CrossRefPubMed
3.
go back to reference Glisson CC. Approach to diplopia. Continuum (Minneap Minn). 2019;25:1362–75.PubMed Glisson CC. Approach to diplopia. Continuum (Minneap Minn). 2019;25:1362–75.PubMed
4.
go back to reference Pineles SL, Repka MX, Yu F, Lum F, Coleman AL. Risk of musculoskeletal injuries, fractures, and falls in medicare beneficiaries with disorders of binocular vision. JAMA Ophthalmol. 2015;133:60–5.CrossRefPubMedPubMedCentral Pineles SL, Repka MX, Yu F, Lum F, Coleman AL. Risk of musculoskeletal injuries, fractures, and falls in medicare beneficiaries with disorders of binocular vision. JAMA Ophthalmol. 2015;133:60–5.CrossRefPubMedPubMedCentral
9.
go back to reference Ciuffreda KJ, Rutner D, Kapoor N, Suchoff IB, Craig S, Han ME. Vision therapy for oculomotor dysfunctions in acquired brain injury: A retrospective analysis. Optometry. 2008;79:18–22.CrossRefPubMed Ciuffreda KJ, Rutner D, Kapoor N, Suchoff IB, Craig S, Han ME. Vision therapy for oculomotor dysfunctions in acquired brain injury: A retrospective analysis. Optometry. 2008;79:18–22.CrossRefPubMed
10.
go back to reference Thiagarajan P, Ciuffreda KJ. Effect of oculomotor rehabilitation on vergence function in mild traumatic brain injury. J Rehabil Res Dev. 2013;50:1223–40.CrossRefPubMed Thiagarajan P, Ciuffreda KJ. Effect of oculomotor rehabilitation on vergence function in mild traumatic brain injury. J Rehabil Res Dev. 2013;50:1223–40.CrossRefPubMed
11.
go back to reference Thiagarajan P, Ciuffreda KJ. Versional eye tracking in mild traumatic brain injury (mTBI): Effects of oculomotor training (OMT). Brain Inj. 2014;28:930–43.CrossRefPubMed Thiagarajan P, Ciuffreda KJ. Versional eye tracking in mild traumatic brain injury (mTBI): Effects of oculomotor training (OMT). Brain Inj. 2014;28:930–43.CrossRefPubMed
12.
go back to reference Thiagarajan P, Ciuffreda KJ. Effect of oculomotor rehabilitation on accommodative responsivity in mild traumatic brain injury. J Rehabil Res Dev. 2014;51:175–92.CrossRefPubMed Thiagarajan P, Ciuffreda KJ. Effect of oculomotor rehabilitation on accommodative responsivity in mild traumatic brain injury. J Rehabil Res Dev. 2014;51:175–92.CrossRefPubMed
13.
go back to reference Thiagarajan P, Ciuffreda KJ, Capo-Aponte JE, Ludlam DP, Kapoor N. Oculomotor rehabilitation for reading in mild traumatic brain injury (mTBI): an integrative approach. NeuroRehabilitation. 2014;34:129–46.CrossRefPubMed Thiagarajan P, Ciuffreda KJ, Capo-Aponte JE, Ludlam DP, Kapoor N. Oculomotor rehabilitation for reading in mild traumatic brain injury (mTBI): an integrative approach. NeuroRehabilitation. 2014;34:129–46.CrossRefPubMed
14.
go back to reference Thiagarajan P, Ciuffreda KJ. Short-term persistence of oculomotor rehabilitative changes in mild traumatic brain injury (mTBI): a pilot study of clinical effects. Brain Inj. 2015;29:1475–9.CrossRefPubMed Thiagarajan P, Ciuffreda KJ. Short-term persistence of oculomotor rehabilitative changes in mild traumatic brain injury (mTBI): a pilot study of clinical effects. Brain Inj. 2015;29:1475–9.CrossRefPubMed
15.
go back to reference Zhou LY, Liu TJ, Li XM, Su C, Ji XJ, Zhao M. A new interpretation and quantitative method for diplopia test: 304 cases of ocular motor nerve palsy for clinical test and verify. Int J Ophthal. 2017;10:1768–70. Zhou LY, Liu TJ, Li XM, Su C, Ji XJ, Zhao M. A new interpretation and quantitative method for diplopia test: 304 cases of ocular motor nerve palsy for clinical test and verify. Int J Ophthal. 2017;10:1768–70.
16.
go back to reference Rawstron JA, Burley CD, Elder MJ. A systematic review of the applicability and efficacy of eye exercises. J Pediatr Ophthalmol Strabismus. 2005;42:82–8.CrossRefPubMed Rawstron JA, Burley CD, Elder MJ. A systematic review of the applicability and efficacy of eye exercises. J Pediatr Ophthalmol Strabismus. 2005;42:82–8.CrossRefPubMed
17.
go back to reference Kapoor N, Ciuffreda KJ, Han Y. Oculomotor rehabilitation in acquired brain injury: a case series. Arch Phys Med Rehabil. 2004;85:1667–78.CrossRefPubMed Kapoor N, Ciuffreda KJ, Han Y. Oculomotor rehabilitation in acquired brain injury: a case series. Arch Phys Med Rehabil. 2004;85:1667–78.CrossRefPubMed
18.
go back to reference Yoshida M. Evaluation methods for ocular motility disorders [Gankyuuundoushougai no hyoukahou]. Oto-Rhino-Laryngol. 2014;57:94–100 (in Japanese). Yoshida M. Evaluation methods for ocular motility disorders [Gankyuuundoushougai no hyoukahou]. Oto-Rhino-Laryngol. 2014;57:94–100 (in Japanese).
19.
go back to reference Lee HK, Scudds RJ. Comparison of balance in older people with and without visual impairment. Age Ageing. 2003;32:643–9.CrossRefPubMed Lee HK, Scudds RJ. Comparison of balance in older people with and without visual impairment. Age Ageing. 2003;32:643–9.CrossRefPubMed
20.
go back to reference Sato M, Shiosaki A, Samoto Y, Yoshimura R. An intervention to overcome locomotion difficulties in a patient with oculomotor nerve palsy: a case study. Asian J Occup Ther. 2021;17:79–82.CrossRef Sato M, Shiosaki A, Samoto Y, Yoshimura R. An intervention to overcome locomotion difficulties in a patient with oculomotor nerve palsy: a case study. Asian J Occup Ther. 2021;17:79–82.CrossRef
Metadata
Title
Eye movement training and gaze analysis for a patient with binocular diplopia after traumatic brain injury: a case report
Authors
Kaneharu Nakamura
Takeshi Fuchigami
Shu Morioka
Publication date
18-12-2023
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2023
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-023-04221-4

Other articles of this Issue 1/2023

Journal of Medical Case Reports 1/2023 Go to the issue