A Study on Optometrists’ Knowledge, Awareness, and Management of Traumatic Brain Injury-Related Visual Disorders in Saudi Arabia
Abstract
1. Introduction
2. Methods
2.1. Study Design and Participants
2.2. Survey Instrument
- Demographics: age, gender, years of experience, and education level.
- Awareness: frequency of encountering TBI cases, whether they inquire about concussion history, and comfort in managing such cases.
- Knowledge: formal training, symptom recognition, and knowledge of visual disorders.
- Management: Management was assessed by asking the participants to identify the evidence-based strategies they are familiar with for managing TBI-related visual dysfunctions. These included common interventions such as vision therapy, prism lenses, tinted lenses, and referral to specialists. The goal was to evaluate the general awareness of possible clinical approaches, not to determine the appropriateness of intervention in individual cases.
2.3. Scoring System
2.4. Data Collection
2.5. Statistical Analysis
3. Results
3.1. Subjects’ Profiles
3.2. Awareness
3.3. Knowledge of TBI
3.4. Differences Based on Formal Education in Concussion Management
3.5. Confidence in Diagnosis
3.6. Management
3.7. Referral Patterns for Concussion-Related Visual Disorders
4. Discussion
5. Limitations
- The data were obtained from optometrists working in various settings, including governmental hospitals with abundant facilities and optical shops with potentially fewer resources. This variability may influence the findings, as optometrists in hospitals may encounter more TBI patients and have access to more diagnostic and therapeutic tools.
- The categorical classification of experience levels prevented an in-depth analysis of the impact of experience on awareness, knowledge, and management practices.
- Finally, the survey did not include case-based or scenario-driven items to evaluate how optometrists would apply their knowledge in real-world clinical decision-making. This limits the depth of insight into actual management competence. Future studies should incorporate clinical vignettes or simulated cases to assess not only the awareness of management options but also the appropriateness of the decisions made in specific patient contexts. Although the instrument underwent expert review and pilot testing, a formal psychometric validation, including comparisons with established tools, was not conducted.
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
- 1.
- What is your age?
- A.
- Under 25
- B.
- 25–34
- C.
- 35–44
- D.
- 45–54
- E.
- 55 or older
- 2.
- What is your gender?
- A.
- Male
- B.
- Female
- 3.
- What is your level of experience in optometry?
- A.
- Less than 2 years
- B.
- 2–5 years
- C.
- 5–10 years
- D.
- More than 10 years
- 4.
- What is your highest level of education?
- A.
- Bachelor’s degree
- B.
- Master’s degree
- C.
- Doctorate degree
- 5.
- How often do you encounter patients with TBI-related visual disorders in your practice?
- A.
- Never
- B.
- Rarely
- C.
- Occasionally
- D.
- Frequently
- 6.
- Do you routinely ask patients about a history of concussion or head injury?
- A.
- Yes
- B.
- No
- 7.
- Do you feel comfortable managing patients with concussion-related visual disorders?
- A.
- Yes
- B.
- No
- 8.
- How confident are you in your ability to diagnose TBI-related visual disorders?
- 9.
- Have you received any formal education/training on concussion-related visual disorders?
- A.
- Yes
- B.
- No
- 10.
- Which visual symptoms are commonly associated with concussions? (Select all that apply)
- A.
- Blurred vision
- B.
- Double vision
- C.
- Light sensitivity
- D.
- Eye fatigue
- E.
- Eye movement problems
- F.
- None of the above
- 11.
- Which of the following is a common symptom of post-concussion syndrome?
- A.
- Dizziness
- B.
- Nausea
- C.
- Headache
- D.
- All of the above
- E.
- None of the above
- 12.
- Which of the following visual disorders are commonly associated with concussion/TBI? (Select all that apply)
- A.
- Convergence insufficiency
- B.
- Accommodative anomalies
- C.
- Eye movement dysfunction
- D.
- Delayed visual processing
- E.
- None of the above
- F.
- All of the above
- 13.
- How important do you think it is for optometrists to be knowledgeable about concussion/TBI-related visual disorders?
- 14.
- Which of the following management strategies would you recommend for a patient with a concussion-related visual disorder? (Select all that apply)
- A.
- Vision therapy
- B.
- Prism lenses
- C.
- Tinted lenses
- D.
- Referral to a neurologist or other specialist
- E.
- None of the above
- F.
- Other
- 15.
- How often do you refer patients with concussion-related visual disorders to other healthcare providers?
- A.
- Always
- B.
- Sometimes
- C.
- Rarely
- D.
- Never
- 16.
- To what healthcare providers often do you refer patients with concussion/TBI-related visual disorders? (Select all that apply)
- A.
- Ophthalmologist
- B.
- Another optometrist
- C.
- Occupational therapist
- D.
- Physical therapist
- E.
- speech/language therapist
- F.
- Neurologist
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Age (a) | Gender | Total | n (%) | |
---|---|---|---|---|
M | F | |||
Under 25 | 14 | 15 | 29 | 29 (7.1) |
25–34 | 178 | 139 | 317 | 317 (77.1) |
35–44 | 32 | 15 | 47 | 47 (11.4) |
45–54 | 9 | 4 | 13 | 13 (3.2) |
55 or older | 4 | 1 | 5 | 5 (1.2) |
Total | 237 | 174 | 411 | 411 (100.0) |
Low Knowledge | Moderate Knowledge | High Knowledge | p-Value | |
---|---|---|---|---|
(n = 21) | (n = 82) | (n = 308) | ||
Age | ||||
Under 25 | 1 (4.8%) | 3 (3.7%) | 25 (8.1%) | |
25–34 | 20 (95.2%) | 69 (84.1%) | 228 (74.0%) | 0.37 |
35–44 | 0 (0%) | 7 (8.5%) | 40 (13.0%) | |
45–54 | 0 (0%) | 2 (2.4%) | 11 (3.6%) | |
55 or older | 0 (0%) | 1 (1.2%) | 4 (1.3%) | |
Gender | ||||
Female | 6 (28.6%) | 28 (34.1%) | 140 (45.5%) | 0.0777 |
Male | 15 (71.4%) | 54 (65.9%) | 168 (54.5%) | |
Experience | ||||
Less than 2 years | 5 (23.8%) | 14 (17.1%) | 89 (28.9%) | 0.00286 |
2–5 years | 12 (57.1%) | 46 (56.1%) | 99 (32.1%) | |
5–10 years | 3 (14.3%) | 13 (15.9%) | 70 (22.7%) | |
More than 10 years | 1 (4.8%) | 9 (11.0%) | 50 (16.2%) | |
Education | ||||
Bachelor’s degree | 17 (81.0%) | 68 (82.9%) | 247 (80.2%) | 0.45 |
Master’s degree | 3 (14.3%) | 14 (17.1%) | 48 (15.6%) | |
Doctorate degree | 1 (4.8%) | 0 (0%) | 13 (4.2%) |
Overall | |
---|---|
(n = 411) | |
Encounter patients with concussion/TBI | |
Frequently | 7 (1.7%) |
Never | 118 (28.7%) |
Occasionally | 45 (10.9%) |
Rarely | 241 (58.6%) |
Routinely ask history of concussion/TBI | |
No | 201 (48.9%) |
Yes | 210 (51.1%) |
Comfortable managing patients with concussion/TBI | |
No | 193 (47.0%) |
Yes | 218 (53.0%) |
Formal education or training | |
No | 303 (73.7%) |
Yes | 108 (26.3%) |
Referral frequency to other healthcare providers | |
Always | 200 (48.7%) |
Never | 46 (11.2%) |
Rarely | 52 (12.7%) |
Sometimes | 113 (27.5%) |
Where patients are referred by optometrists (multiple options) | |
Ophthalmologist | 274 (62.0%) |
Neurologist | 274 (62.0%) |
Another optometrist | 55 (12.4%) |
Physical therapist | 47 (10.6%) |
Occupational therapist | 74 (16.7%) |
Speech/language therapist | 43 (9.7%) |
Domain | No Training (n = 303) | Formal Training (n = 108) |
---|---|---|
Frequency of encountering TBI patients (occasionally/frequently) | 38 (12.5%) | 14 (13.0%) |
Routinely ask about concussion history | 142 (46.9%) | 68 (63.0%) |
Confidence in diagnosis | 143 (47.1%) | 81 (74.9%) |
Importance of concussion knowledge | 221 (73.0%) | 83 (76.9%) |
Low Confidence | Moderate Confidence | High Confidence | p-Value | |
---|---|---|---|---|
(n = 153) | (n = 199) | (n = 59) | ||
Age | ||||
Under 25 | 10 (6.5%) | 16 (8.0%) | 3 (5.1%) | |
25–34 | 131 (85.6%) | 145 (72.9%) | 41 (69.5%) | 0.00964 |
35–44 | 12 (7.8%) | 23 (11.6%) | 12 (20.3%) | |
45–54 | 0 (0%) | 11 (5.5%) | 2 (3.4%) | |
55 or older | 0 (0%) | 4 (2.0%) | 1 (1.7%) | |
Gender | ||||
Female | 86 (56.2%) | 66 (33.2%) | 22 (37.3%) | <0.001 |
Male | 67 (43.8%) | 133 (66.8%) | 37 (62.7%) | |
Experience | ||||
Less than 2 years | 44 (28.8%) | 54 (27.1%) | 10 (16.9%) | <0.001 |
2–5 years | 72 (47.1%) | 69 (34.7%) | 16 (27.1%) | |
5–10 years | 30 (19.6%) | 41 (20.6%) | 15 (25.4%) | |
More than 10 years | 7 (4.6%) | 35 (17.6%) | 18 (30.5%) | |
Education | ||||
Bachelor’s degree | 122 (79.7%) | 167 (83.9%) | 43 (72.9%) | 0.09 |
Doctorate degree | 3 (2.0%) | 6 (3.0%) | 5 (8.5%) | |
Master’s degree | 28 (18.3%) | 26 (13.1%) | 11 (18.6%) |
Management Competency Level | Number (n) | Percentage (%) |
---|---|---|
Low | 139 | 31.5% |
Moderate | 198 | 44.9% |
High | 74 | 16.8% |
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Almutairi, N.M.; Alharbi, A.; Alharbi, A.; Alnawmasi, M.M. A Study on Optometrists’ Knowledge, Awareness, and Management of Traumatic Brain Injury-Related Visual Disorders in Saudi Arabia. Healthcare 2025, 13, 1609. https://doi.org/10.3390/healthcare13131609
Almutairi NM, Alharbi A, Alharbi A, Alnawmasi MM. A Study on Optometrists’ Knowledge, Awareness, and Management of Traumatic Brain Injury-Related Visual Disorders in Saudi Arabia. Healthcare. 2025; 13(13):1609. https://doi.org/10.3390/healthcare13131609
Chicago/Turabian StyleAlmutairi, Nawaf M., Abdulaziz Alharbi, Abdulelah Alharbi, and Mohammed M. Alnawmasi. 2025. "A Study on Optometrists’ Knowledge, Awareness, and Management of Traumatic Brain Injury-Related Visual Disorders in Saudi Arabia" Healthcare 13, no. 13: 1609. https://doi.org/10.3390/healthcare13131609
APA StyleAlmutairi, N. M., Alharbi, A., Alharbi, A., & Alnawmasi, M. M. (2025). A Study on Optometrists’ Knowledge, Awareness, and Management of Traumatic Brain Injury-Related Visual Disorders in Saudi Arabia. Healthcare, 13(13), 1609. https://doi.org/10.3390/healthcare13131609