Concussion and Vision

Concussions

Concussions are finally getting the long due attention that they deserve. The CDC estimates “1.6 to 3.8 million concussion occur in sports and recreational activities annually(1)”. The symptoms of many concussion may resolve spontaneously and never get reported so the incidence may be higher.

A concussion is a mild brain injury that occurs as a result of a direct or indirect blow to the head or face. There may or may not be a loss of consciousness. Concussions may result in several symptoms including

  • behavioral changes
  • cognitive impairment
  • balance problems
  • headaches
  • nausea
  • light sensitivity

Vision Changes after Concussion

Of 100 adolescents examined after concussion 69% had visual symptoms associated with near vision focusing including(2):

  • accommodative disorders
  • convergence problems
  • saccade inaccuracies
  • over 46% had two of these symptoms

These patients frequently complained of headaches, light sensitivity and balance problems. The writer has seen these symptoms linger for years without appropriate diagnosis resulting in poor academic performance and emotional frustration for the patient and family alike.

Diagnosis of the Vision Problems

The first obstacle is finding an optometrist or ophthalmologist to perform a binocular assessment and diagnose the problem efficiently. Optometrists trained by the Neuro Optometric Rehab Association would be first choice as these doctors have training in the assessment and treatment of these disorders. Second choice would be a COVD doctor, who is also going to have experience assessing eye movements and finding the problems common in concussion. These doctors may also offer treatment to help resolve the symptoms.

The techniques to treat these near vision focusing problems do not differ greatly from the techniques used to treat other eye movement problems, though the writer has found that the interventions may take longer and complaints may vary.

The Multi Disciplinary Team

The treatment of concussion is evolving. An interdisciplinary team approach is developing which is including physical therapy, occupational therapy, neurology, neuropsychology and developmental optometry all working to together to efficiently identify and treat the lingering symptoms of concussion.

Report the symptoms

Concussions are a not simple “bump on the head”. They can have serious consequences. The best way insure proper treatment for a concussion is for athletes to report their symptoms to coaches and parents, learn proper techniques for their activity and always wear appropriate protective gear.

(1)Daneshvar, D. H., Nowinski, C. J., McKee, A. C., & Cantu, R. C. (2011, January). The epidemiology of sport-related concussion. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987636/

(2)Master, C. L., Scheiman, M., Gallaway, M., Goodman, A., Robinson, R. L., Master, S. R., & Grady, M. F. (2016, March). Vision Diagnoses Are Common After Concussion in Adolescents. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26156977

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