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Concussions: When the Visual System Takes a Hit

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People are becoming continually more aware of concussions and the long term impact they can have on a person’s life. Approximately 70% of people who suffer a concussion will experience a vision problem as determined in the study “Vision Diagnoses Are Common After Concussion in Adolescents”. Common problems include:

  • Binocular Vision Problem (difficulty using the 2 eyes together)
  • Accommodation Problem (difficulty making things clear quickly and efficiently)
  • Oculomotor Problem (difficulty tracking or keeping place while reading)

Many people wonder- “I hit my head, not my eyes, how could I have a vision problem?” Vision is the only sensory system that is processed in every part of the brain. It’s also important to realize, the eyes are simply an extension of the brain. Just like if you get hit in the nose, your nose may be injured and hurt, but you will likely still be able to smell. However, if you injure your brain you can lose your sense of smell. Just like the nose simply detects the information, the eyes simply detect the information and you see with your brain.

Another reason vision problems are common after a brain injury is that our 2 eyes are the only parts of the body with separate neural pathways to control movements that must work perfectly together. Arms and legs move and are controlled separately, however, they do not have to coordinate perfectly. If the eyes do not coordinate perfectly people suffer vision problems. With poor coordination of the eyes a person will experience double vision or the brain will try to turn one of the eyes off.

Because these vision problems are so common after a concussion or other type of head injury, it is important to know the symptoms you or someone you know may experience:

  • Blurry or fluctuating vision
  • Headaches with or worsened by reading
  • Light sensitivity
  • Double vision
  • Eye strain or tired eyes
  • Words move or run together on a page
  • Losing place while reading
  • Bothered by visually busy environments (grocery store, mall, etc.)
  • Bothered by patterns (like carpets or patterned fabrics)
  • Reduced or poor concentration
  • Difficulty comprehending or remembering reading material
  • Dizziness
  • Dry eyes
  • Spatial Disorientation
  • Poor depth perception
  • Difficulty walking straight
  • Reduced balance

If the symptoms do not resolve within 3-6 weeks after the injury it is important to seek an evaluation and possibly treatment from an optometrist that specializes in these problems. Dr. Bolin here at Heartland Eye Consultants specializes in such problems. After completing her doctorate at the Southern College of Optometry she completed a one year residency focused specifically on how the visual system is affected by concussions and brain injuries.
Treatment often involves Neuro-Visual Rehabilitation, also known as Optometric Vision Therapy. The same study mentioned before also looked at the success of patients who completed therapy:

  • 85% of patients with Binocular Vision Problems successfully resolved their deficiencies & symptoms with therapy and 15% improved
  • 33% of patients with Accommodative Problems successfully resolved their deficiencies & symptoms with therapy and 67% improved

Vision is often overlooked when a person is evaluated after a concussion, as we have seen with our patients and many other doctors have seen, a vision problem can significantly decrease a person’s quality of life. Don’t let your vision or the vision of someone you love take a hit and inhibit future potential success.

Master, Christina L., et al. “Vision Diagnoses Are Common After Concussion in Adolescents.” Clinical Pediatrics, vol. 55, no. 3, 2015, pp. 260–267., doi:10.1177/0009922815594367

Additional resources about vision and brain injuries:

Written by Dr. Holly Ternus

Dr. Holly Ternus is originally from Torrington, Wyoming, and graduated from the University of Nebraska-Lincoln with a degree in biological sciences. She graduated with Honors from The New England College of Optometry and completed internships with Honors at South Boston Community Health Center with an emphasis in glaucoma and narrow-angle glaucoma, Togus Veterans Affairs Medical Center with an emphasis in ocular disease, Lifetime Eyecare in Houston fitting specialty contact lenses, and Brooke Army Medical Center in San Antonio.

Dr. Ternus practiced with ophthalmology in the Dallas/Fort Worth area, specializing in ocular disease, dry eye disease, and emergency care. She then transitioned into primary care, fitting specialty contacts for keratoconus, post-RK, corneal ectasia, and irregular corneas.

Dr. Ternus is an active member of the Nebraska Optometric Association, American Optometry Association, and American Academy of Optometry. She received her fellowship with the American Academy of Optometry in 2018 and is a graduate of the Nebraska Optometric Association’s Leadership Institute. She also received her fellowship in the Scleral Lens Education Society and is the first in Nebraska to have completed this honor.

Outside of work, Dr. Ternus enjoys spending time with her husband and 2 children, snowboarding, skiing, water sports, watching Husker football, and everything that involves being outdoors.

More Articles By Dr. Holly Ternus

Vision Therapy

Vision therapy is an effective, non-surgical, doctor-supervised treatment that retrains the brain and eyes to work together more efficiently. Rather than compensate for vision problems, vision therapy aims to treat and correct the visual system itself.

Discover how we can help you or your child overcome vision problems such as strabismus and amblyopia, and build a greater sense of confidence. Take our vision therapy quiz today!

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