Some Veterans Return With 'Hidden' Vision Problems At least 6,000 Iraq and Afghanistan vets have suffered visual damage as a result of brain injury, but many may not even realize it. Sometimes just being near an IED blast can be enough to cause brain injury called hemianopsia and a partial loss of vision.
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Some Veterans Return With 'Hidden' Vision Problems

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Some Veterans Return With 'Hidden' Vision Problems

Some Veterans Return With 'Hidden' Vision Problems

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Two doctors have made a discovery in veterans returning from Iraq and Afghanistan. They made the discovery in Palo Alto, California. It's an injury that had gone unnoticed in thousands of veterans. Amy Standen reports from member station KQED.

AMY STANDEN: When he first got back from Iraq, Staff Sergeant Jay Wilkerson says he couldnt stop watching this video.�

Staff Sergeant JAY WILKERSON: What I'm going to do, I'm going to rewind it. Start it from the beginning.

STANDEN: The date stamp says March 28, 2006.

(Soundbite of vehicles)

STANDEN: A convoy of Humvees is making its way back to Baghdad after a day in Habbinaya.

Sgt. WILKERSON: Right there. You can barely see us.�

STANDEN: Just as the convoy curves to the right, there is an explosion.

Sgt. WILKERSON:�Now, this is the IED that hit me.�

STANDEN: There's a huge cloud of dust, as Jay Wilkersons Humvee careens off the side of the road. The others slow down and form a perimeter.

Unidentified Man #1: Sniper 25.

Unidentified Man #2: M4, M4, M4.

Unidentified Man #1: 5s and 25s.

Unidentified Man #2: M4. Take your time. Give them...

Sgt. WILKERSON: I remember everything just went black. I was talking and then all of a sudden I heard the vehicle exploding. And I heard the people in the truck screaming at the same time.

STANDEN: Wilkerson was in a coma for 12 days. He'd severed two fingers and blown open the left side of his face. He couldnt walk for months. Given the extent of those injuries, it's easy to see why doctors, and even Wilkerson himself, failed to realize for a full year that something else was wrong with him too. To demonstrate, Wilkerson holds up his left hand, as if he were taking an oath in the courtroom.

Staff Sgt. WILKERSON: If its right here, I couldnt see it. And then thats true today. If its right here I cant see it.

STANDEN: This is whats known as a hemianopsia. Its a problem not of the eyes but of the brain. In Jays case, his brain doesnt recognize signals from either of his eyes left visual fields.

Dr. GREG GOODRICH (VA Medical Center): Often people don't realize they have the problem.

STANDEN: Greg Goodrich is a vision researcher at the VA Medical Center in Palo Alto. In 2003, he and another doctor here started noticing something surprising in the young vets they were treating. According to their charts, these men and women could see just fine.

STANDEN: 20/20.

Dr. GOODRICH: 20/20, full visual fields. But they have this huge hemianopsia. Half their visual world's gone. And the most common tests used didnt catch it.

Dr. GLENN COCKERHAM (VA Medical Center): If you just ask them how theyre doing, theyll say Im doing fine.

STANDEN: Glenn Cockerham is chief of ophthalmology, also at the VA, in Palo Alto.

Dr. COCKERHAM: But if you ask specific questions, and you compare them to other people, theyre not doing so well.

STANDEN: Many vets had trouble concentrating. They bumped into things.

Dr. GOODRICH: Another would be that, well, I dont have a priority for reading. Did you have that before? Well, no, I didnt. But now I seem to.

STANDEN: The vets chalked it up to stress, PTSD, or other injuries. They figured thats just the way life is now.

Dr. GOODRICH: Its a tremendous, tremendous psychological readjustment to go through. And sorting out symptoms that can be subtle, or you dont recognize, is a real challenge.

STANDEN: Goodrich estimates that at least 6,000 vets have suffered visual damage as a result of brain injury. That's far more than anyone had realized. Often, roadside bombs are to blame. Even just being near an explosion can be enough to cause brain damage, and consequently vision problems.

Dr. GOODRICH: And because some of these are very subtle, we dont catch them as often as we would like to.

STANDEN: That's changing. Goodrich and Cockerham have developed a new, advanced vision test. Its now part of the routine screening that veterans receive if they come to the hospital with major injuries. And that means that more veterans are getting treated.

Mr. CHRIS RADER: Up top corner, bottom cabinet, top corner door.

STANDEN: As he makes his way down a hallway at the VA, Chris Rader, an Iraq veteran, is methodically turning his head from left to right, as if hes watching a tennis match.

Mr. RADER: Bottom corner door.

STANDEN: Hes looking for pink Post-it notes that have been placed here and there by Raders vision therapist, John Kingston.

Mr. JOHN KINGSTON (Vision Therapist): You've got a lot more of them this time, which is really good.

STANDEN: Learning how to scan a scene is one ways that hemianopsia patients like Chris Rader can learn to get around better. Hes also been prescribed special glasses. But Goodrich says that as far as he's concerned, what comes first is just as important - that is, taking the time to simply figure out what's wrong.

Dr. GOODRICH: Part of my motivation is Im a Vietnam vet. And for some of my comrades, diagnosing the problems that happened to them took 15, 20 years.

STANDEN: Take Agent Orange, he says. It took 20 years for the VA to recognize the toll that that chemical was continuing to take on Vietnam vets. Goodrich says the Iraq and Afghanistan wars are an opportunity to get it right the first time.

For NPR News, Im Amy Standen.

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