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Brain Injury Vision Symptom Survey (BIVSS) Questionnaire

Laukkanen, Hannu; Scheiman, Mitchell; Hayes, John R.

doi: 10.1097/OPX.0000000000000940

Purpose Validation of the Brain Injury Vision Symptom Survey (BIVSS), a self-administered survey for vision symptoms related to traumatic brain injury (TBI).

Methods A 28-item vision symptom questionnaire was completed by 107 adult subjects (mean age 42.1, 16.2 SD, range 18–75) who self-reported as having sustained mild-to-moderate TBI and two groups of reference adult subjects (first-year optometry students: mean age 23.2, 2.8 SD, range 20–39; and 71 third-year optometry students: mean age 26.0, 2.9 SD, range 22–42) without TBI. Both a Likert-style method of analysis with factor analysis and a Rasch analysis were used. Logistic regression was used to determine sensitivity and specificity.

Results At least 27 of 28 questions were completed by 93.5% of TBI subjects, and all 28 items were completed by all of the 157 reference subjects. BIVSS sensitivity was 82.2% for correctly predicting TBI and 90.4% for correctly predicting the optometry students. Factor analysis identified eight latent variables; six factors were positive in their risk for TBI. Other than dry eye and double vision, the TBI patients were significantly more symptomatic than either cohort of optometry students by at least one standard deviation (p < 0.001). Twenty-five of 28 questions were within limits for creating a single-dimension Rasch scale.

Conclusions Nearly all of the adult TBI subjects were able to self-complete the BIVSS, and there was significant mean score separation between TBI and non-TBI groups. The Rasch analysis revealed a single dimension associated with TBI. Using the Likert method with the BIVSS, it may be possible to identify different vision symptom profiles with TBI patients. The BIVSS seems to be a promising tool for better understanding the complex and diverse nature of vision symptoms that are associated with brain injury.

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Pacific University College of Optometry, Forest Grove, Oregon (HL, JRH); and Pennsylvania College of Optometry at Salus University, Philadelphia, Pennsylvania (MS).

Hannu Laukkanen, Pacific University College of Optometry, 2043 College Way, Forest Grove, OR 97116, e-mail:

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© 2017 American Academy of Optometry