Vision Symptoms

30% of patients with concussion or other brain injury have vision problems

The most common vision related symptoms of brain injuries include the following. A concussion sufferer may have one or more of these symptoms:

Dizziness
Fatigue
Computer eye strain
Light-sensitivity
Glare
Double vision
Poor eye tracking ability
Difficulties with shifting gaze quickly from one point to another
Focusing
Loss of binocular vision (eye alignment)
Eye strain
Inability to maintain visual contact
Headaches
Blurred near vision
The extent of the injury can also impact a person’s visual information processing ability. This can cause the following symptoms:
Spatial disorientation
Shifts in ability to judge location of objects
Difficulties with balance and posture
Poor depth perception
Memory loss
Poor handwriting

Lets look at the science

A very large number of studies have looked at the vision problems that are present in people with concussions or other mTBI. According to the three studies listed at the end of this section, concussion and mTBI patients complain of :
• loss of balance,
• dizziness,
• eyestrain and headaches with near work,
• loss of place while reading,
• distance and near blur
• visual field defects,
• reduced or diminished stereopsis,
• reduced reaction time,
• reduced accommodative ability and flexibility,
• dry eye symptoms from a decreased blink rate, and
• reduced hand-eye coordination

Source:
• Kapoor N, Ciuffreda KJ. Vision disturbances following traumatic brain injury. Curr Treat Options Neurol. 2002 Jul;4(4):271-80.
• Cilo M, Politzer T, Ripley DL, Weintraub A. Vision examination of TBI patients in an acute rehabilitation hospital. NeuroRehabilitation. 2010;27(3):237-42.
• Greenwald BD, Kapoor N, Singh AD. Visual impairments in the first year after a traumatic brain injury. Brain Inj. 2012;26(11):1338-59.

We diagnose eye movement disorders in concussion patients

Concussion patients often suffer from disorders of the vision systems relating to the way the eyes move or the way the work together as a team. These are known as oculomotor and binocular vision disorders, respectively. One study involving 557 people with brain injuries, found that the following conditions were present:

• Convergence insufficiency both with and without simultaneous diagnoses (23.3% )

• Convergence insufficiency without simultaneous diagnoses (9%)

• Cranial nerve palsies (26.9%)

• Accommodative dysfunction (24.4%)

• Visual field deficits or unilateral visual spatial inattention/neglect (29.6%)

• Within the convergence insufficiency subgroup light sensitivity (16.3%) and dizziness / vestibular dysfunction (18.5%) were detected.

Source:

Alvarez TL, Kim EH, Vicci VR, Dhar SK, Biswal BB, Barrett AM. Concurrent vision dysfunctions in convergence insufficiency with traumatic brain injury. Optom Vis Sci. 2012 Dec;89 (12):1740-51.