When combat veterans arrive at Dr. Suzanne Wickum's service at the University Eye Institute on the University of Houston campus, they're usually pretty easy to identify. That's because Wickum is a pediatric optometrist, whose waiting room is decked out with zoo animal décor and usually inhabited by tykes.
But the warfighters who seek Wickum's care as part of the Project Victory rehabilitation program spearheaded by TIRR Memorial Hermann actually have quite a few things in common with her pintsize patients, because traumatic brain injury can produce vision disorders often seen in youngsters and can affect one's ability to communicate.
"Many people with traumatic brain injuries cannot speak like they did before, so, when they go to a normal eye doctor for an exam, the staff may be at a loss," she explained. "Coming from pediatrics, we are skilled at working with infants and toddlers who can't tell us anything, so the exam techniques translate over."
Wickum first began working with TIRR's brain-injured patients during her residency at UH's College of Optometry in 1995. Today, she serves as director of the Neuro-Optometric Rehabilitation Service housed at UHCO. So, she is comfortable treating vision disorders common among veterans and other patients with brain injuries, and she knows what to look for.
"A lot of these guys have already had military eye exams, and some things have been missed. A study in 2006 found that 26 percent of soldiers had vision problems associated with brain injuries that had been overlooked," Wickum said. "If you don't have experience with brain injuries, it's hard to diagnose what you don't know to look for."
Wickum is working to raise awareness among both military and civilian eyecare providers, often giving talks, conducting training sessions and sharing research results across the nation.
Symptoms that are most often missed stem from eye coordination, or binocular, conditions and up-close focusing, or accommodation, problems.
Wickum said many of her patients have eye muscle coordination disorders, such as convergence insufficiency, which can be remedied through office-based and/or home-based eye exercises. For those who aren't good candidates for vision therapy, often a prism incorporated into a pair of glasses will do the trick.
"The soldiers we examine also have a lot of light sensitivity, and it's so bad that they wear sunglasses indoors and brimmed hats because the lights are so intense to them," Wickum said. "A lot of them suffer from blast injuries, where they have been subjected to extremely high-pressure, high-velocity blast waves that jar the entire body."
For patients with light sensitivity, Wickum provides tinted glasses and contact lenses that filter out the spectrum of light that seems to be the culprit.
Other symptoms brain-injured patients exhibit include double vision, eye strain, dizziness and motion sickness.
"One of the first guys I evaluated through this program came in with a giant walking stick that was as tall as he was, and he used it to keep his balance," Wickum recalled. "During some of the testing, he actually felt like he was gong to throw up, and we'd give him breaks. Once we figured out that he had a vertical imbalance in his eyes, we gave him prism glasses, and, within an hour, he was significantly better, buzzing around unassisted between the clinics."
For Wickum, whose family has a history of military service, it's the least she can do.
"The soldiers are totally deserving after all they've been through. Their stories are just incredible," she said. "One had been in three helicopter crashes - and two out of three times was the sole survivor. How is that possible?"
At TIRR, eye care is just one small, but critical, step toward rehabilitating service members so that they can either stay in the military productively or reintegrate into civilian life.
"We've been amazed at the improvement in our clients after care from Dr. Wickum and the UH clinic," said Project Victory program manager Shawn Brossart. "The specialized treatment they provide is not available in many of the service members' hometowns. Dr. Wickum and the UH clinic contribute in a unique way to the successes injured military accomplish in the Project Victory program."
About Project Victory
Project Victory is a collaborative program by TIRR Foundation and TIRR Memorial Hermann. The funds from Project Victory were granted by the Iraq-Afghanistan Deployment Impact Fund, a part of the California Community Foundation, to help Americans who sustained brain injuries during their military service. The $3 million grant proposal was distributed to TIRR Foundation and TIRR Memorial Hermann for the creation of the Project Victory program.
About the University of Houston
The University of Houston, Texas' premier metropolitan research and teaching institution, is home to more than 40 research centers and institutes and sponsors more than 300 partnerships with corporate, civic and governmental entities. UH, the most diverse research university in the country, stands at the forefront of education, research and service with more than 36,000 students.
About the UH College of Optometry
For more than 50 years, the University of Houston College of Optometry (UHCO) has trained optometrists to provide the highest quality eye and vision care. One of only 17 optometry schools in the United States, UHCO offers a variety of degree programs, including Doctor of Optometry (O.D.), a combined Doctor of Optometry/Doctor of Philosophy (O.D./Ph.D.), Master of Science (M.S.) and Doctor of Philosophy (Ph.D.). UHCO consists of 65 full-time faculty, 206 adjunct faculty and 100 full-time staff.
For more information about UH, visit the university's Newsroom at http://www.uh.edu/news-events/.
But the warfighters who seek Wickum's care as part of the Project Victory rehabilitation program spearheaded by TIRR Memorial Hermann actually have quite a few things in common with her pintsize patients, because traumatic brain injury can produce vision disorders often seen in youngsters and can affect one's ability to communicate.
"Many people with traumatic brain injuries cannot speak like they did before, so, when they go to a normal eye doctor for an exam, the staff may be at a loss," she explained. "Coming from pediatrics, we are skilled at working with infants and toddlers who can't tell us anything, so the exam techniques translate over."
Wickum first began working with TIRR's brain-injured patients during her residency at UH's College of Optometry in 1995. Today, she serves as director of the Neuro-Optometric Rehabilitation Service housed at UHCO. So, she is comfortable treating vision disorders common among veterans and other patients with brain injuries, and she knows what to look for.
"A lot of these guys have already had military eye exams, and some things have been missed. A study in 2006 found that 26 percent of soldiers had vision problems associated with brain injuries that had been overlooked," Wickum said. "If you don't have experience with brain injuries, it's hard to diagnose what you don't know to look for."
Wickum is working to raise awareness among both military and civilian eyecare providers, often giving talks, conducting training sessions and sharing research results across the nation.
Symptoms that are most often missed stem from eye coordination, or binocular, conditions and up-close focusing, or accommodation, problems.
Wickum said many of her patients have eye muscle coordination disorders, such as convergence insufficiency, which can be remedied through office-based and/or home-based eye exercises. For those who aren't good candidates for vision therapy, often a prism incorporated into a pair of glasses will do the trick.
"The soldiers we examine also have a lot of light sensitivity, and it's so bad that they wear sunglasses indoors and brimmed hats because the lights are so intense to them," Wickum said. "A lot of them suffer from blast injuries, where they have been subjected to extremely high-pressure, high-velocity blast waves that jar the entire body."
For patients with light sensitivity, Wickum provides tinted glasses and contact lenses that filter out the spectrum of light that seems to be the culprit.
Other symptoms brain-injured patients exhibit include double vision, eye strain, dizziness and motion sickness.
"One of the first guys I evaluated through this program came in with a giant walking stick that was as tall as he was, and he used it to keep his balance," Wickum recalled. "During some of the testing, he actually felt like he was gong to throw up, and we'd give him breaks. Once we figured out that he had a vertical imbalance in his eyes, we gave him prism glasses, and, within an hour, he was significantly better, buzzing around unassisted between the clinics."
For Wickum, whose family has a history of military service, it's the least she can do.
"The soldiers are totally deserving after all they've been through. Their stories are just incredible," she said. "One had been in three helicopter crashes - and two out of three times was the sole survivor. How is that possible?"
At TIRR, eye care is just one small, but critical, step toward rehabilitating service members so that they can either stay in the military productively or reintegrate into civilian life.
"We've been amazed at the improvement in our clients after care from Dr. Wickum and the UH clinic," said Project Victory program manager Shawn Brossart. "The specialized treatment they provide is not available in many of the service members' hometowns. Dr. Wickum and the UH clinic contribute in a unique way to the successes injured military accomplish in the Project Victory program."
About Project Victory
Project Victory is a collaborative program by TIRR Foundation and TIRR Memorial Hermann. The funds from Project Victory were granted by the Iraq-Afghanistan Deployment Impact Fund, a part of the California Community Foundation, to help Americans who sustained brain injuries during their military service. The $3 million grant proposal was distributed to TIRR Foundation and TIRR Memorial Hermann for the creation of the Project Victory program.
About the University of Houston
The University of Houston, Texas' premier metropolitan research and teaching institution, is home to more than 40 research centers and institutes and sponsors more than 300 partnerships with corporate, civic and governmental entities. UH, the most diverse research university in the country, stands at the forefront of education, research and service with more than 36,000 students.
About the UH College of Optometry
For more than 50 years, the University of Houston College of Optometry (UHCO) has trained optometrists to provide the highest quality eye and vision care. One of only 17 optometry schools in the United States, UHCO offers a variety of degree programs, including Doctor of Optometry (O.D.), a combined Doctor of Optometry/Doctor of Philosophy (O.D./Ph.D.), Master of Science (M.S.) and Doctor of Philosophy (Ph.D.). UHCO consists of 65 full-time faculty, 206 adjunct faculty and 100 full-time staff.
For more information about UH, visit the university's Newsroom at http://www.uh.edu/news-events/.
To receive UH science news via e-mail, visit http://www.uh.edu/news-events/mailing-lists/sciencelistserv.php.