Ocular Manifestations in Traumatic Brain Injury

Traumatic brain injury (TBI) represents a significant global health burden with diverse clinical manifestations. Ocular manifestations constitute particularly valuable diagnostic and prognostic indicators due to the extensive neuroanatomical substrate underlying visual function. This comprehensive review examines the spectrum of ocular manifestations in TBI, including optic nerve sheath diameter alterations as markers of intracranial pressure, oculomotor dysfunction affecting saccades and smooth pursuit, convergence insufficiency, vestibuloocular reflex impairment, pupillary abnormalities, cranial nerve palsies, visual field defects, and retinal pathology. Assessment methodologies range from bedside clinical examination to advanced eye-tracking technology and optical coherence tomography. The prognostic significance of these findings is discussed, along with current rehabilitation approaches and their evidence base. Understanding ocular manifestations in TBI facilitates early diagnosis, appropriate management, and prognostic counseling for affected patients.