Traumatic Brain Injury in Hispanic Communities: Why Awareness and Communication Matter for Optometrists

By: Deann Fitzgerald, OD

Traumatic brain injury (TBI) is a significant public health concern in the United States, affecting millions of individuals each year. According to the Centers for Disease Control and Prevention, there were approximately 214,110 TBI-related hospitalizations in 2020 and 69,473 TBI-related deaths in 2021—representing more than 586 hospitalizations and 190 deaths every day.¹

These figures likely underestimate the true scope of the problem. Many traumatic brain injuries are treated outside hospital settings or go unreported altogether. Falls, motor vehicle crashes, sports injuries, and workplace incidents remain among the most common causes of TBI in the United States.²

In addition to the immediate neurological effects, traumatic brain injury can have lasting consequences that affect daily functioning and quality of life. Because a substantial portion of the brain is involved in visual processing, research suggests that up to 60–70 percent of individuals with TBI experience vision-related symptoms during recovery.³ Patients may present with headaches, reading difficulty, dizziness, light sensitivity, or problems concentrating—symptoms that are not always immediately recognized as vision-related.

As the Hispanic population continues to grow in the United States, understanding how neurological conditions affect these communities is increasingly important for healthcare providers. Research suggests that Hispanic patients recovering from traumatic brain injury may face additional challenges during recovery, including barriers to specialized rehabilitation services and differences in long-term outcomes. Studies have found that Hispanic individuals with TBI may report more persistent symptoms and lower levels of functional independence following injury than non-Hispanic White patients.⁴

These differences are often linked not to biological factors, but to social and structural influences such as access to care, health literacy, and communication barriers.

Communication plays an important role in identifying these issues. According to the Pew Research Center, about 73 percent of Hispanics in the United States speak a language other than English at home, and roughly one-third report limited English proficiency.⁵ When language barriers exist, patients may have difficulty describing symptoms such as dizziness, headaches, visual discomfort, or difficulty concentrating following a head injury.

Cultural factors may also shape how health concerns are discussed. In many Hispanic families, healthcare conversations and decisions often involve close family members. Spouses, parents, or adult children may accompany patients to appointments, help interpret symptoms, or provide additional details about changes they have observed since an injury. In some cases, family members may be the first to notice difficulties with reading, light sensitivity, balance, or concentration following a concussion or other head trauma.

Research has shown that when patients are able to communicate with healthcare providers in their preferred language, trust, understanding, and adherence to treatment recommendations improve significantly.⁶ Recognizing the potential role of family members in the clinical conversation—and ensuring that communication is clear and culturally responsive—can help uncover important information that might otherwise go unrecognized.

Optometrists are often among the healthcare professionals patients see most regularly, placing them in a unique position to help identify individuals who may have experienced a traumatic brain injury. Patients presenting with headaches, dizziness, difficulty reading, or light sensitivity may not always connect these symptoms with a prior concussion or head injury, particularly if the injury occurred months or years earlier. Asking a few additional questions about prior falls, accidents, sports injuries, or concussions can sometimes reveal an important part of a patient’s health history.

When visual concerns appear to be associated with neurological injury, referral to optometrists who specialize in neuro-optometric rehabilitation may be appropriate. These clinicians focus on evaluating and managing visual problems that arise following concussion, traumatic brain injury, stroke, and other neurological conditions.

The Neuro-Optometric Rehabilitation Association, International (NORA), is an interdisciplinary professional organization dedicated to advancing the understanding and treatment of vision disorders associated with acquired brain injury and other neurological conditions. The organization promotes education, research, and collaboration among clinicians involved in rehabilitation care. Additional information and resources can be found at www.noravisionrehab.org.

As awareness of traumatic brain injury continues to grow, optometrists have an important role to play in recognizing potential visual consequences and helping guide patients toward appropriate care. For those serving Hispanic and Latino communities, thoughtful communication, attention to cultural context, and awareness of family involvement can help ensure that important symptoms are identified and addressed earlier in the recovery process.

Bio

Dr. DeAnn Fitzgerald is an optometrist with more than 40 years of experience and Immediate Past President of the Neuro-Optometric Rehabilitation Association. She has lectured nationally on concussion and neuro-rehabilitation and focuses her clinical work on patients with traumatic brain injury and other neurological conditions.

Footnotes

1. Centers for Disease Control and Prevention. Traumatic Brain Injury & Concussion Data and Statistics.
2. Centers for Disease Control and Prevention. Facts About Traumatic Brain Injury.
3. Ciuffreda KJ, Ludlam DP. Vision dysfunctions following mild traumatic brain injury. Vision Development & Rehabilitation.
4. Arango-Lasprilla JC et al. Racial and ethnic disparities in outcomes following traumatic brain injury. Journal of Head Trauma Rehabilitation.
5. Pew Research Center. Language Use Among Hispanics in the United States.
6. Agency for Healthcare Research and Quality. Improving patient outcomes through language-concordant care.