Traumatic brain injury (TBI) is considered a “silent epidemic” (Rusnak, 2013)[1], remaining a growing public health concern and representing the greatest cause of death and disability globally among all trauma-related injuries (Ventsel et al., 2009)[2].
Globally, the annual incidence of TBI is variably estimated at 27 to 69 million[3], [4]. Many survivors live with significant disabilities, resulting in a major socioeconomic burden.
The World Health Organization (WHO) estimates the yearly incidence rate of brain injuries, including concussions, to be 600 per 100,000 people. Incidence of people with TBI varies between 47,3 to 694 per 100,000 population, with an incidence of 1012 cases per 100,000 people in Europe, mainly due to road traffic collisions and falls (Dewan et al., 2018 (2); Brazinova et al., 2021 (3))[5], [6]
Nearly 70% of sensory processing in the brain is vision-related. Therefore, many brain areas vulnerable to TBI are vision-related – frontal, occipital, temporal, and parietal lobes and the long axonal fibers connecting the midbrain structure to the cortex. Basic visual functions such as oculomotor functions – binocular vision, motility, etc. and sensory functions – visual acuity, visual field, etc., are critical to forming a three-dimensional perception of the world. Ability to read, fuse images mediated by the two eyes, follow moving objects, detect targets and determine distance all depends on oculomotor functions. Pursuits and saccades are conjugate eye movements coordinated by the visual process and are more frequently affected by neurological events.
[1] Rusnak M. (2013). Traumatic brain injury: giving voice to silent epidemic. Nat Rev Neurol 9:186-187. [2] Ventsel, G., Rao, V. And Fann, J.R. (2009). Neuropsychiatric problems after traumatic brain injury: unraveling the silent epidemic. Psychosomatics 50:198-205. [3] GBD 2016 Traumatic Brain Injury and Spinal Cord Injury Collaborators. Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol 2019; 18:56. [4] Dewan MC, Rattani A, Gupta S, et al. Estimating the global incidence of traumatic brain injury. J Neurosurg 2018; :1. [5] Dewan, M.C., Rattani, A., Gupta, S., Baticulon, R.E., Hung, YC., Punchak, M., Agrawal, A., Adeleye, A.O., Shrime, M.G., Rubiano, A.M., Rosenfeld, J.V. And Park, K.B. Estimating the global incidence of traumatic brain injury. Journal of Neurosurgery. 2018 Apr 1;1-18. doi: 10.3171/2017.10.JNS17352. Online ahead of print. [6] Brazinova, A., Rehorcikova, V., Taylor, M.S., Buckova, V., Majdan, M., Psota, M, Peeters, W., Feigin, V., Theadom, A., Holkovic, L and Synnot, A. Epidemiology of traumatic brain injury in Europe: A living systematic review. Journal of Neurotrauma. 2021, Vo. 38, No 10:1411-1440. DOI: 10.1089/neu.2015.4126
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