Concussion – Acquired Brain Injury (ABI)

Acquired brain injury can come in many forms including: traumatic brain injury (TBI), mild acquired brain injury (mABI), cerebral vascular accident, post-concussion syndrome, and stroke. ABI is damage to any area of the brain. The damage may be mild, as in the case of concussions or it can be severe as in TBI or stroke. Often visual problems resulting from ABI are overlooked during initial treatment of an injury. Frequently these problems are hidden or neglected, lengthening and impairing rehabilitation.

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Signs and symptoms indicating a vision problem are:

  • Headaches with visual tasks especially with screen use.
  • Eyes hurt or ache.
  • Accommodative Insufficiency – This condition is a reduction in eye focusing ability that results in blurry vision at near, even in young athletes. Near vision may be constantly blurry or may blur in and out during near activities such as reading.
  • Blurry Vision – Blurry vision following a concussion can occur at distance, near or both.
  • Convergence Insufficiency – The inability to use the eyes comfortably at near can result in a number of symptoms including: headaches, eyestrain, fatigue, or even double vision during near activities.
  • Double Vision – There are several causes of double vision, which is why anyone who sees double (even intermittently) should be evaluated by an optometrist with advanced training in neuro-optometry, binocular vision and vision therapy.
  • Light Sensitivity – Photophobia, or light sensitivity, can result from various types of acquired brain injuries (including concussions).
  • Ocular-Motor Dysfunction – Deficiencies in eye movement abilities are quite common following concussions and other forms of mild traumatic brain injuries. These eye movement deficits can pose challenges with many activities of daily life, including reading and driving.
  • Reduced Cognitive Abilities with Visual Tasks – Visual perceptual deficits can be caused by concussions and have dramatic effects on academic, occupational, and even athletic success.
    • Visual Discrimination – Seeing small detailed differences between objects
    • Visual Memory – Keeping a visual image in your head in order to retain information better
    • Visual Sequential Memory – Remembering a sequence of information, like a phone number, or several items on a to-do list
    • Visual Figure Ground – Finding objects in a crowded area, working with spreadsheets on a computer
  • Reduced Visual Processing Speed or Reaction Time – Prolonged visual processing speed can slow down an athlete both on and off the field. The speed with which an athlete processes visual information affects many aspects of athletic competition, including: reading the field of play, judging the speed of a moving ball or puck, and judging the speed of other players on the field.
  • Visual Field Defects – Stroke patients may experience a lack of vision in one section of their field of sight. In some cases, the entire right or left side of their vision may disappear following a stroke.  Lenses, prisms, vision therapy, and occupational therapy can all be helpful to patients who need to re-learn spatial judgment after experiencing visual field loss.

Treatment options:

Treatment may include a multi-disciplinary approach including physicians, physical therapists, occupational therapists, psychologists, speech pathologists, chiropractors, and other specialists depending on the associated symptoms.

  • Initial assessment at our office includes evaluation of visual acuity, eye-teaming, eye movements, balance, and posture.
  • Special glasses with prism lenses may be utilized to help a patient recover their center of balance or improve their eye-teaming. Binasal occlusion (frosting the inside-corners of the lenses) can significantly reduce “sensory information overload,” calming the visual system.
  • Vision therapy involves working both sides of the body so that both hemispheres of the brain communicate together. Patients will learn techniques to improve their peripheral awareness and eye tracking, as well as near-far focusing and eye-teaming.  The length of therapy varies depending on the severity of injury.

Do you feel like you may have sustained a concussion? Take a look at this checklist…BIVSS General Symptom Survey