Development of an innovative tool to improve mTBI patient-provider communication of visual impairment symptoms

PROJECT SUMMARY Visual disturbances as a result of a traumatic brain injury (TBI) are an overlooked symptom. The screening identification and referral process need to be improved. Invisible injuries are challenging to describe, and imaginations are left to fill in details. Most concussion forms and questionnaires (such as the Rivermeade post-concussion symptom questionnaire) allow a patient to indicate only that vision is double, blurry or light sensitive, resulting in many overlooked visual symptoms from TBIs. Additional symptoms can include visual snow, pixilation, photopsias, etc. Because a word-based language does not fully capture visual symptoms, categories (such as "double") can be overlooked by patients, especially when the patient does not identify with the clinical word used by providers. Words such as smeared, blurred, 3D vision without the glasses on, layered, shadowed (all words from a patient perspective) may not mean the same thing to a provider and patient. These words could all describe “double vision” or something else potentially. Visual problems associated with TBI are not captured by the current standard of care for TBI patients, including using these forms which can allow symptoms that are vaguer to slip between the cracks because they are more challenging to describe. What Lies Beneath Concussion is attempting to address this gap by developing a product that will bridge the communication gap between patients and providers by using custom created imagery to reflect visual symptoms from the patient perspective to improve the standard of word-based forms, questionnaires, and oral conversations. Our tool will improve the symptom identification process, provider-patient communication, provide reports to clinicians, and provide triage information to non-eye care providers. We are revolutionizing how visual impairments are screened by optometrists and ophthalmologists and non-eye care providers by pioneering this visual tool to assess visual impairments. What Lies Beneath intends to establish core content, receive feedback from potential users on content alignment, and conduct a mixed-methods evaluation of image relevance to individual mTBI patients with visual disturbances. Completing these goals will position us for follow on studies in Phase II which will enable us to further develop our product.