Traumatic brain injury (TBI) is defined as an alteration to brain function or other evidence of brain pathology, caused by an external force. It is considered as a global health concern due to its high incidence and has shown to be one of the major causes of morbidity and mortality around the world. Globally, 10 million people are affected by TBI per year, with reported incidence rate of 106 per 100,000. By 2020, it is estimated that TBI may exceed other types of diseases as the major cause of death and disability.
Impact of TBI on the optic nerve results in a condition called traumatic optic neuropathy (TON). TON typically manifests with reductions in visual acuity, colour vision, pupil reactivity and visual field in the affected eye. Historic data suggests a prevalence of TON as 2% after TBI, whilst recent anecdotal data suggests that retinal and visual changes after TBI may be much more frequent, being present sub-clinically in many elite athletes after head injuries in sport.
This investigation aims to evaluate the structure of the retina and optic nerve head whilst assessing visual function of TBI patients longitudinally in order to detail the early changes indicative of TBI severity and prognostic of visual outcome in order to inform patient management.