Visual and Vestibular Consequences of Acquired Brain Injury.

Suchoff IB, Ciuffreda KJ, Kapoor N, eds. Santa Ana, CA 92705-5510, Optometric Extension Program Foundation Inc, 2001, paperback, 256 pp, illus, ISBN: 0-943599-42-3, $35.

This book on acquired brain injury (ABI) and its possible visual and vestibular sequelae is based on a series of lectures that were written for an optometry symposium. Although the majority of the book deals with the visual consequences of brain injury and vision therapy, an extensive overview of acquired brain injury (both traumatic brain injury and cerebrovascular accident) is included as well as a discussion of the cognitive and affective aspects of these neurological conditions. An interdisciplinary team approach is emphasized as the most effective model for managing patients with ABI, with information sharing across professions and referral to optometrists (of course) in those cases where visual symptoms are present. Several case studies are used throughout the book as examples of improved patient outcomes following the addition of optometric treatment techniques to a patient's other rehabilitation therapies.

The chapters on accommodation of vision, oculomotor consequences, and binocular vision disorders assume the reader has background knowledge of optometry. Although these chapters are somewhat interesting, as a physical therapist, I found the very technical language difficult to follow. The chapters on visual field assessment, visual neglect, and visual adaptation (light sensitivity) are more intriguing and provide more practical applications for physical therapists. By far the most interesting portion of the book is the last 3 chapters, which discuss the integration of visual and vestibular systems in balance disorders, vestibular therapy and ocular dysfunction in traumatic brain injury, and the collaboration of optometrists and physical therapists in the management of vestibular dysfunction. These chapters are coauthored by physical therapists and are full of case examples, making this information most practical and familiar to physical therapists.

Because each chapter is written by different authors, some of the facts and some of the listed references are repeated from one chapter to the next. This repetition, however, allows each chapter to stand alone as a complete entity, and the book then becomes a convenient reference for anyone researching a particular topic in this area of ABI rehabilitation.

The drawings in this book help simplify the neuroanatomy of visual and vestibular pathways. Visual field assessments are demonstrated in photographs of equipment and procedures and with illustrated samples of visual field test results. Tables are present throughout, logically organizing some of the facts and case report data for the reader.

Visual and Vestibular Consequences of Acquired Brain Injury would be most interesting to clinicians working with patients with brain injuries in acute or outpatient rehabilitation settings. The final chapters are of most interest to physical therapists, but other health care professionals working with patients with ABI--including occupational therapists, speech pathologists, neuropsychologists, and optometrists--also would find this book stimulating.

Janice Bohn, PT, NCS
Rehabilitation Institute of Chicago at
  Alexian Brothers Medical Center
Elk Grove Village, Ill

Ms Bohn is a physical therapy clinical facilitator and clinician primarily responsible for the rehabilitation of patients with neurological conditions.