Vision Therapy

Vision Problems after Concussion

An Acquired Brain Injury can come in many forms but all are an insult to the brain.

A Traumatic Brain Injury (TBI) may be caused by an external force to the head, face, neck, or elsewhere on the body that causes the head and brain to move rapidly back and forth.  This may be caused by a motor vehicle accident, fall, sports, among others.  A concussion is a type of mild traumatic brain injury (mTBI).

One does not need to be knocked unconscious in order for the injury to be classified as a concussion.  Neuropathological changes may result in functional changes rather than structural changes that are not seen on structural neuroimaging, such as an MRI or a CT scan.  The purpose of neuroimaging is to determine if there is a contusion (brain bruise) or intracranial hemorrhage.  When the brain moves inside the skull after a concussion, sheering or stretching of the axons, thin fibers that enable communication between nerve cells, occur.   This neurometabolic cascade, in addition to cellular changes and dysfunction, cause the signs and symptoms of a concussion.

Most people don’t realize that the eyes are part of the brain. Therefore, if there is damage to the brain, vision can be significantly affected. Visual processing involves the connection between our eyes and the brain. Visual processing problems are very common following brain injury. The flow of information between the eye and brain is often jumbled after a brain injury.  Symptoms lasting more than a month are considered to be a "Prolonged or Persistent Concussion Symptoms", which research shows occurs in 30-40% of patients.  Studies have shown that concussion from high school sports occurs 1.5x more in females than males.

Vision involves more than seeing the letters on the eye chart clearly, 20/20 eyesight. Eyesight occurs in your eyes, but vision occurs in your brain where the visual image is processed. Over half of your brain is used for vision and visual processing. Therefore, if there is damage to the brain, vision can be significantly affected.  But, visual problems are overlooked during initial treatment of the injury.

How often is vision affected in concussions?

A recent study found that over 90% of patients with a concussion had one or more of the following vision problems:

• blurred vision
• double vision
• sensitivity to light
• headaches with visual tasks
• reading difficulty
• movement of print on the page
• poor reading comprehension
• poor depth perception
• difficulty focusing your eyes on things in your environment
• difficulty moving your eyes
• processing visual information
• poor eye-hand coordination or problems judging stairs.
• things moving may make you feel ill

If you or a loved one have experienced a concussion, call Family Eyecare Solutions to schedule a Neuro-Optometric Vision Evaluation with Dr. Vasilakos.

Post Trauma Vision Syndrome (PVTS) is the common after a mTBI resulting from damage to the midbrain, which is the place subject to trauma from whiplash and rotational forces in traumatic injury.

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What tests are needed to detect these visual problems?

If you had an eye examination and have been told that there is nothing wrong, that is because regular eye examinations are not designed to test visual processing problems. A Neuro-Optometric Vision Evaluation involves testing how well the eyes move, how they work together, how they focus and how you understand what you see all while performing normal activities of daily living.

Treatment varies depending on the depth of the problem. Treatment may include lenses, special tints, prism to improve visual comfort and/or Neuro-Optometric Rehabilitation to increase the range of visual comfort and tolerance in activities of daily living.

Neuro-Optometric rehabilitation is part of an interdisciplinary team (OT, PT, SPL, CPT, PCP, etc.) approach to holistically address visual impairments and to achieve the common goal of improving your quality of life.

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