Restorative Treatment of Functional Accommodation Disorders in Patients with Visually Stressful Work and Mild Traumatic Brain Injury. Case Studies
https://doi.org/10.18008/1816-5095-2026-2-413-417
Abstract
This article presents an analysis of two clinical cases illustrating variations in the accommodative system of the eye in patients with mild traumatic brain injury (MTBI) and visually demanding work. It has been established that MTBI is accompanied by disturbances in the accommodative system of the eye, manifested by characteristic signs of accommodative asthenopia (asthenic form or habitual excessive accommodative strain), diagnosed using objective accommodation imaging based on the ciliary muscle microfluctuation coefficient and “quality of life” using the «KZS-22» questionnaire. Based on the medical and social model of health, it seems appropriate for this patient population to undergo restorative treatment based on the selection of physical factors affecting the visual organ, as well as the amplitude and temporal parameters of the stimulation itself. The practical application of functional correction of asthenopia leads (compared to the traditional approach) to a significantly faster restoration of accommodation, which generally ensures the achievement of the required level of visual performance and prolongation of professional longevity.
About the Authors
I. G. Ovechkin
Branch No. 2 of the Vishnevsky National Medical Research Center for High Medical Technologies
Russian Federation
Russian Federation
Ovechkin Igor G. - MD, Professor, head of the Visual Rehabilitation Department
Levoberezhnaya str., 11, Moscow, 125445
E. V. Vitushkina
City Clinical Hospital No. 3
Russian Federation
Russian Federation
Vitushkina Elena V. - head of the Ophthalmology Department
Verkhne-Volzhskaya Emb., 21, Nizhny Novgorod, 603155
References
1. Antonov AI, Poverennova IE, Kurov MV. Mild traumatic brain injury in modern combat conditions. Russian Neurosurgical Journal named after Professor A.L. Polenov. 2024;16(4):6–11 (In Russ.). doi: 10.56618/2071-2693_2024_16_4_6.
2. Lefevre-Dognin C, Cogné M, Perdrieau V, Granger A, Heslot C, Azouvi P. Definition and epidemiology of mild traumatic brain injury. Neurochirurgie. 2021 May;67(3):218–221. doi: 10.1016/j.neuchi.2020.02.002.
3. Mona-Lisa M, Kaisa M, Taina N, Antti H, Ivan M, Susanna M, Jan J. Evaluation of Visual Disturbances After Mild Traumatic Brain Injury-A One-Year Follow-up Study. J Head Trauma Rehabil. 2025 May-Jun 01;40(3):E208–E215. doi: 10.1097/HTR.0000000000001010.
4. Langer L, Levy C, Bayley M. Increasing Incidence of Concussion: True Epidemic or Better Recognition? J Head Trauma Rehabil. 2020 Jan/Feb;35(1):E60–E66. doi: 10.1097/HTR.0000000000000503.
5. Matuseviciene G, Johansson J, Möller M, Godbolt AK, Pansell T, Deboussard CN. Longitudinal changes in oculomotor function in young adults with mild traumatic brain injury in Sweden: an exploratory prospective observational study. BMJ Open. 2018 Feb 3;8(2):e018734. doi: 10.1136/bmjopen-2017-018734.
6. Almutairi NM. Visual Dysfunctions in Mild Traumatic Brain Injury: A Focus on Accommodative System Impairments. Life (Basel). 2025 May 6;15(5):744. doi: 10.3390/life15050744.
7. Almutairi NM, Hayes J, Hampson KM, Liu C. Accommodation microfluctuation in individuals with mTBI and the potential effect of chromatic filter on this parameter. Vision Res. 2025 Feb;227:108545. doi: 10.1016/j.visres.2025.108545.
8. Carroll LJ, Cassidy JD, Holm L, Kraus J, Coronado VG; WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med. 2004 Feb;(43 Suppl):113–125. doi: 10.1080/16501960410023877.
9. Concussion (Сlinical guidelines of the Ministry of Health of the Russian Federation). 2022. 22 p. (In Russ.).
10. Belikova EI, Gatilov DV, Ovechkin IG, Eskina EN. Excimer Laser Correction of Myopia in Patients with Visually Intense Work — Is It Necessary to Determine the Form of Accommodative Asthenopia? Ophthalmology in Russia. 2023;20(2):276–282 (In Russ.). doi: 10.18008/1816-5095-2023-2-276-282.
11. Ovechkin IG, Yudin VE, Kovrigina EI, Budko AA, Matvienko VV. Methodological Principles for the Development of a Questionnaire “Quality of Life” in Patients with Computer Visual Syndrome. Ophthalmology in Russia. 2021;18(4):926–931 (In Russ.). doi: 10.18008/1816-5095-2021-4-926-931.
12. Ovechkin IG, Shavshina DA, Belikova EI, Kumar V. Clinical and Physiological Rationale for the Use of Ophthalmochromotherapy in the Complex Rehabilitation Treatment of Patients with Visually Intense Work with Accommodative Asthenopia. Ophthalmology in Russia. 2025;22(1):143–148 (In Russ.). doi: 10.18008/18165095-2025-1-143-148.
13. Yudin VE, Yaroshenko VP, Belikova EI, Gatilov DV, Ovechkin IG, Kosukhin ES. Methodological principles of medical rehabilitation of patients with visually intense work with accommodative asthenopia after excimer laser correction of myopia. Bulletin of the Medical Institute of Continuous Education. 2023;3(2):64–69 (In Russ.). doi: 10.36107/2782-1714_2023-3-2-64-69.
14. Simpson-Jones ME, Hunt AW. Vision rehabilitation interventions following mild traumatic brain injury: a scoping review. Disabil Rehabil. 2019 Sep;41(18):2206–2222. doi: 10.1080/09638288.2018.1460407.
15. Biscardi M, Grossinger Z, Colantonio A, Bayley M, Mollayeva T. Efficacy of restitutive interventions for oculomotor deficits in adults with mild traumatic brain injury: a systematic review and meta-analysis. Brain Inj. 2024 Jun 6;38(7):499–513. doi: 10.1080/02699052.2024.2320163.
16. Scheiman M, Kulp MT, Cotter SA, Lawrenson JG, Wang L, Li T. Interventions for convergence insufficiency: a network meta-analysis. Cochrane Database Syst Rev. 2020 Dec 2;12(12):CD006768. doi: 10.1002/14651858.CD006768.pub3.
17. Makhova MV, Strakhov VV. Interaction of accommodative and subjective diagnostic criteria of accommodation disorders. Russian Ophthalmological Journal. 2019;12(3):13–19 (In Russ.). doi: 10.21516/2072-0076-2019-12-3-13-19.
18. Tarutta EP, Tarasova NA. Comparative evaluation of the effectiveness of various treatment modalities for accommodation disorders and acquired progressive myopia. Russian Annals of Ophthalmology. 2015;131(1):24–29 (In Russ.). doi: 10.17116/oftalma2015131124-28.
19. Ovechkin IG, Shavshina DA, Belikova EI. Diagnostics and restorative treatment of accommodation astenopia from the position of applied methods, effectiveness and staging: systematic review. Russian Ophthalmological Journal. 2025;18(1):150–156 (In Russ.). doi: 10.21516/2072-0076-2025-18-1-150-156.
20. Ovechkin IG, Ovechkin NI, Shakula AV, Pavlov AI, Pokrovsky DF. MedicoSocial Approach to the Development of a Methodology for Assessing the “Quality of Life” after Cataract Phacoemulsification. Part 2. Ophthalmology in Russia. 2022;19(2):399–404 (In Russ.). doi: 10.18008/1816-5095-2022-2-399-404.
21. Belikova EI, Gatilov DV, Ovechkin IG, Eskina EN. Dynamics of Accommodative Asthenopia in Patients with Visually Intense Work after LASIK with Different Degrees of Myopia. Ophthalmology in Russia. 2023;20(3):479–484 (In Russ.). doi: 10.18008/1816-5095-2023-3-479-484.
22. Ovechkin IG, Gatilov DV, Belikova EI, Ovechkin NI, Kumar V. The Relationship of Various Forms of Accommodative Asthenopia with the Characteristics of the Professional Activity in Patients with Visually Intense Work and the Phenomena of Computer Visual Syndrome. Ophthalmology in Russia. 2023;20(2):308–313 (In Russ.). doi: 10.18008/1816-5095-2023-2-308-313.
Review
For citations:
Ovechkin I.G., Vitushkina E.V. Restorative Treatment of Functional Accommodation Disorders in Patients with Visually Stressful Work and Mild Traumatic Brain Injury. Case Studies. Ophthalmology in Russia. 2026;23(2):413-417. (In Russ.) https://doi.org/10.18008/1816-5095-2026-2-413-417
Views:
10
JATS XML
Email this article 