The Vision Screening Checklist for Traumatic Brain Injury (VSCTBI) is a free screening and referral tool developed by Patrick Boyd, Clinical Director & Case Manager, in consultation with Mr Ian Simmons, Consultant Paediatric Ophthalmologist and Ophthalmic Surgeon; the VSCTBI is designed for use primarily by case managers working with individuals who have sustained a traumatic brain injury, but which can be applied more widely outside of rehabilitation case management by other health and social care professionals working with TBI survivors, such as in major trauma centres in the context of post-discharge follow-up clinics.

The tool was developed after discussion between Patrick and Mr Simmons at a training event, where Patrick identified a knowledge and skills gap affecting many case managers, meaning that the various complex visual problems that can occur for those who have sustained a TBI can sometimes be missed. This is because some of the symptoms caused by visual dysfunction could perhaps go unnoticed, or even be mistaken for other conditions associated with cognitive dysfunction.

Patrick considered the way case managers assess their clients, and how they ensure they pick up on the most subtle impairments their clients might have, including those that clients might not notice, or which they cannot adequately describe. He also considered how case managers ensure symptoms are not misdiagnosed, given the similarities between some symptoms associated with both visual and cognitive dysfunction.

Patrick states that: "as case managers, it is our role to “pull on threads”, to explore the potential areas in which a client might have been affected following their injury; but of course, we cannot do this aimlessly. Our role is to pull on those threads we think might lead us somewhere, but before we can do that, we first need to find those threads we think are worth pulling.

The way to do this is to use the expertise and guidance of specialists in various fields to determine the often-basic questions that we need to be asking at the initial​ assessment and rehabilitation planning phase, to help us determine whether a closer look is required by those specialists."

The VSCTBI is a basic tool which is designed to be used at the initial assessment phase to help focus the assessor’s mind and consider whether a referral for a specialist ophthalmological assessment is required for their client. The VSCTBI should be used alongside other assessment tools to help demonstrate how assessors have reached their conclusions, and to help add further weight and justification to their recommendations - especially in those cases where an ophthalmological assessment might not be the obvious path to take.

By the sharing and use of this tool by case managers and other professionals, we can ensure that professionals are making appropriate referrals where needed (and indeed not making unnecessary referrals), “tugging on threads”, and not inadvertently missing aspects of post-TBI life which we could collectively address more comprehensively.

​

To download and use the VSCTBI for free, click here. 

​

Help us to improve and develop the VSCTBI by providing feedback here.

​​​

For enquiries, contact info@bpjcasemanagement.co.uk. 

​

© Reproductions are authorised if referenced as Boyd, P. (2024) Vision Screening Checklist for Traumatic Brain Injury (VSCTBI)

​​

Produced in consultation with:

• Mr Ian Simmons, Consultant Paediatric Ophthalmologist and Ophthalmic Surgeon, Leeds Teaching Hospitals NHS Trust.

​

Guidance and support received with thanks from:

• Dr Mark Holloway, Senior Brain Injury Case Manager and Expert Witness, Head First

​

References:​

• Ciuffreda KJ, Kapoor N, Rutner D, Suchoff IB, Han ME, Craig S. (2007) Occurrence of oculomotor dysfunctions in acquired brain injury: a retrospective analysis. Optometry;78(4):155-61.

• Abbas Farishta, R., & Farivar, R. (2022). Montreal Brain Injury Vision Screening Test for General Practitioners. Frontiers in human neuroscience, 16, 858378.

• MacDonald, S. (2015). Cognitive Communication Checklist for Acquired Brain Injury (CCCABI). CCD Publishing.

• Armstrong, R.A., 2018. Visual problems associated with traumatic brain injury. Clinical and Experimental Optometry; 101(6), pp.716-726.
   

​