The Mid-Atlantic Regional Group

Blinded Veterans Association

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The War Comes Home

May 5, 2008

I think it is very important for all Blinded Veterans Association members and contacts to know that this war has produced not only the usual direct combat battle eye injured, but a growing generation of Traumatic Brain Injured (TBI) with Visual Impairments. As mentioned in this article, the VA Poly Trauma Center in Palo Alto VA Medical Center has published several reports on there findings of 63% of TBI veterans having some sort of visual impairments. While some are mild, to moderate, they have found about 5% are legally blinded from the force of the blasts that are causing brain injuries that disrupt the visual pathways.

There are some experts who feel that as time goes on the VA will eventually find thousands more in the years to come because the visual complications do not always show up early, and many are occurring months to years after the initial injuries.

THE WAR COMES HOME
For many war veterans, blindness becomes a bitter legacy
      Darryl E. Owens, Sentinel (Florida) Staff Writer

Sgt. David Kinney realized he had a problem when he struggled to read the e-mails his wife sent him in Afghanistan.

He suffered headaches and his vision grew steadily worse. Before long, the military shipped him home to DeLand. Now he's considered legally blind.

"I didn't get blown up or knocked out, or have a big piece of my head missing like some of these guys," said Kinney, who served in Orlando's 2nd Battalion, 124th Infantry Regiment of the Florida National Guard. "You didn't see it coming."

Kinney, 46, is among an increasing number of Iraq and Afghanistan veterans losing their eyesight not because of bullet or bomb wounds but in what doctors suspect is a delayed reaction to the constant pounding of nearby explosives.

His eyes aren't the problem. His brain is.

Studies conducted by the military have estimated that up to 20 percent of the 1.7 million troops who have served and returned from Iraq and Afghanistan suffer from mild traumatic brain injury, most often as a result of roadside bombs, rocket-propelled grenades and mortars.

Bill Wilson, a blindness-rehabilitation specialist at the Orlando VA Medical Center, sees a coming wave of woe.

"We won't know for months," he said. "We can see the individuals and they may be perfectly fine, and then down the line they have problems."

No one knows how many of the veterans may eventually be blind or have to deal with other vision problems, but research suggests there could be thousands.

The military is just beginning to study the problem, said Gregory Goodrich, supervisory research psychologist and coordinator of the optometry-research fellowship at the Department of Veterans Affairs' Palo Alto (Calif.) Healthcare System.

Preliminary results from a pilot study suggested that as many as 70 percent of severely wounded soldiers treated for traumatic brain injuries also complain of double vision, difficulties in reading, blindness and other vision problems.

'Boom-boom-boom'

At first Kinney's doctors thought he'd had a stroke. Later, he learned he had suffered mild Traumatic Brain Injury, or TBI, and an Orlando neurologist eventually blamed his condition on exposure to bombs.

In Afghanistan, part of Kinney's job had been to help blow up old Soviet munitions. He earlier had served in Iraq, where he often felt the concussive effects of roadside bombs.

"It [was] like riding around in a car with kids and their boomboxes," Kinney said of his time in Iraq. "It's a constant boom-boom-boom. It would shake the ground, crack windows and knock plaster off the wall."

Experts say brain injuries such as Kinney's are often difficult to detect. Even more challenging is making the connection between TBI and blindness. It's so early in the research that there has been little success in developing cures or treatments to reverse deficits.

"Even if the eyes are working perfectly, brain injuries can lead to blindness," said Glenn Cockerham, chief of ophthalmology at the VA Palo Alto.

Certain parts of the brain, such as the occipital lobe, the region of the brain that controls vision, can take a pounding from blast shock waves. Kinney suffered occipital-lobe damage.

It's difficult to diagnose because there's no apparent head injury, as is the case when a football player gets hit hard on the head. In this instance, it's sound waves, not blunt trauma, that do the damage.

Preliminary research in a small study by Cockerham found 26 percent of soldiers who had been injured in blasts had severe visual impairment, including blindness.

Kinney said the blasts he survived were "nothing special. We knew when explosions went off, we were being protected," he said of his body armor.

But the armor, even though it included a helmet, didn't protect the vision center of his brain.

'I'm not bitter'

For now, the objects Kinney is able to see are framed with a line. Sometimes he reaches for shadows.

He uses a white cane that "lets everybody know I'm blind," he says. "I look like I'm drunk sometimes, and I don't drink."

He can't drive anymore or climb on the roof to patch leaks. Relatives must take him to his eight monthly doctor appointments from his rural home. He is still on active duty while he serves out his time. After that, because he can't work, his family will live on his wife's salary and his disability pay.

Then there are the relentless headaches. On his self-devised pain scale, they range from a 3 to an 8 (he judges broken bones a "10"). That pain forces him into darkness for relief.

"I volunteered for the Army, I volunteered for the mission, I know what happens and I know what decisions I made," he said. "I'm not bitter."

Still, he finds his condition "aggravating." For a soldier-husband used to providing and protecting, it has meant tension-filled moments with his wife, Antonia, 43.

"Something falls, and I'll try to pick it up and plow right into her," he said.

His wife says she has taken over more of the job of keeping the household.

"Basically you have to adjust," she said. "He can't run errands and do stuff like he could. It's putting a strain on me. But you do like you did when he was in Iraq: take one day at a time. You've got to deal with whatever comes up."

Fears for his comrades

The military is gearing up to offer more help to Kinney and other soldiers losing their sight.

This year, the Veterans Health Administration is spending $40 million to add 55 outpatient vision-rehabilitation clinics nationwide and to increase staff at existing facilities, said James Orcutt, national program director of ophthalmology for the VA.

Kinney will spend four to six weeks at the Southeastern Blind Rehabilitation Center in Birmingham, Ala. There he'll learn how to live with his blindness, building upon what he's using at home.

Already, his microwave speaks to him. The device, provided by the VA, utters the cooking time and temperature setting.

When he fills his coffee cup, a tiny device that he inserts plays "It's a Small World" when the liquid reaches the brim.

Even as he adapts, Kinney worries about his comrades in the military.

"We're putting in so many deployments. . . . There are a lot more people who are hurt out there," he said. "There are guys who are still out there in the Guard and the Army that aren't aware of their condition because doctors told them it was a headache and to take aspirin."

His interest is personal.

His son David, 24, an Army sergeant and military policeman, left earlier this month for Germany -- his third tour overseas after a deployment in Afghanistan and a previous stint in Germany.

"I don't want it to happen to him," he said.

I think it is very important for all Blinded Veterans Association Regional Groups to be aware of these veterans and try to make contact with them and invite them to your meetings and offer them support. Along with the 1,348 eye wounded who we know about that have been evacuated with variety of visual injuries, there is this other large and growing group that may show up in the months to years ahead that we should try to reach our and help….

Thomas Zampieri

Blinded Veterans Association

Director Government Relations

Washington, DC