Visual Impairments and Treatment Options Following a Concussion

Did you know that nearly 50% of the brain is dedicated to visual processing? Brain injuries can affect more than just memory and coordination — they can also significantly impact vision. Whether you're a current patient, a healthcare provider, or someone who is supporting a loved one with a brain injury, understanding the visual issues that often arise after a concussion is essential for recovery. In this newsletter, we’ll explore common visual impairments and treatment options following a concussion, tips for managing these challenges, and how healthcare providers can help patients regain visual function and improve quality of life.

Brain Injuries and Visual Issues: What You Need to Know

A brain injury, whether it’s a mild concussion or a more severe traumatic brain injury (TBI), can have a significant impact on many aspects of a person's life. Among the most overlooked consequences are the visual disturbances that often accompany these injuries.

Some of the most common visual issues following a brain injury include:

• Convergence Insufficiency (CI): Difficulty bringing the eyes together to focus on near objects, which can cause double vision, eyestrain, and headaches. This can impact daily activities like reading or using a computer, as discussed in our last newsletter.

• Visual Processing Disorders: Difficulty interpreting what is seen, often leading to confusion, poor reading comprehension, and problems with spatial awareness and motion sensitivity.

• Oculomotor Dysfunction: Difficulty with eye movement coordination, leading to issues with tracking, focusing, and reading.

• Photophobia: Sensitivity to light or glare, which can worsen headaches and eyestrain.

• Vestibular-ocular Dysfunction: Imbalance and dizziness, affecting both visual and motor functions.

  
  

Tips for Patients: Managing Visual Impairments After a Brain Injury

If you or someone you know has experienced a brain injury and is dealing with visual disturbances, here are some helpful tips:

1. Rest Your Eyes: After a brain injury, it’s essential to allow your visual system time to recover. Limit screen time and take frequent breaks when reading or doing near work.

2. Create a Well-Lit Environment: Ensure that lighting is adequate but not too bright – natural lighting is ideal. Lighting that is too dim or too bright may exacerbate photophobia and glare sensitivity.

3. Avoid Fluorescent Lighting: Limit exposure to fluorescent lighting which can exacerbate visual symptoms due to its flickering and harsh lighting. A brimmed hat or tinted lenses can help in these conditions.

4. Avoid Multitasking: Focus on one task at a time taking breaks in between. Avoid activities that may overstimulate your visual, auditory, other sensory systems.

5. Multidisciplinary Care: Brain injuries often require a team of healthcare professionals such as physiotherapists, occupational therapists, chiropractors, physicians, optometrists and other healthcare providers. This integrated approach helps address all aspects of your recovery.

6. Consider Vision Therapy: Vision therapy, when performed under the guidance of a trained optometrist, can help retrain the brain and eyes to work together effectively.

   
   

Tips for Healthcare Providers: Evaluating Patients with Brain Injuries

As healthcare providers, it’s crucial to be vigilant when assessing patients who have experienced a brain injury. While many of these visual issues may not be immediately apparent, a thorough evaluation can uncover hidden impairments that may be contributing to the patient’s symptoms. Here are some key considerations during an evaluation:

1. Symptoms Checklists: The Brain Injury Visual Symptoms Survey (BIVSS) is a validated self-administered survey to assess visual symptoms related to a brain injury. Based on the results, further testing or appropriate referrals can be considered.

2. Screen for Visual Processing Disorders: Inquire about how the patient interprets visual information, including tracking, spatial awareness, and reading comprehension to determine if further investigation is needed.

3. Consider the Role of the Vestibular System: Brain injuries often involve both visual and vestibular dysfunction. Incorporating balance and motion assessments can help identify vestibular-ocular issues. The validated Vestibular Ocular-Motor Screening (VOMS) for Concussion is a valuable tool to screen for these common issues.

4. Comprehensive Visual Testing: In addition to standard eye exams, optometrists should assess the patient’s binocular vision (eye teaming), accommodation (focusing ability), eye movements, and dry eye symptoms. Particular attention should be paid to the near point of convergence, vergence abilities, oculomotor function, and any related symptoms experienced with testing.

5. Collaboration with Neuro-Optometrists: You may also consider referring patients to optometrists trained in Neuro-Optometric Rehabilitation for in-depth assessments and treatment plans. These providers can be found through the Vision Therapy Canada website.

Treatment Options at the Vision Development Centre

At the Vision Development Centre, we offer specialized vision therapy programs tailored to the needs of individuals recovering from brain injuries. Our approach helps retrain the brain and eyes to work together effectively, improving visual comfort and function. Here are some of the treatment options we provide:

• Vision Therapy: Customized therapeutic procedures designed to improve eye coordination, tracking, focusing, and visual processing. These exercises can be done in-office and at home.

• Prism Lenses: These can be prescribed to help manage issues with spatial awareness, headaches and eyestrain, and eye alignment.

• Neuro-Optometric Rehabilitation: For individuals with more complex visual processing issues, neuro-optometric rehabilitation combines therapy to address both visual and cognitive functions. More information can be found on the Neuro-Optometric Rehabilitation Association website.

• Recommendations for Returning to Work or School: Tips for managing visual symptoms, light sensitivity, and workplace ergonomics, to ensure a smooth transition back to daily activities.

Insurance and Billing Information: Making Care Accessible

At the Vision Development Centre, we strive to make vision therapy as accessible as possible. We offer direct billing for various services related to brain injury recovery, including auto insurance for Motor Vehicle Accidents (MVA), WSIB for workplace injuries, and Veteran Affairs for eligible service-related injuries. If you’re unsure about your coverage or need assistance navigating the billing process, our team is happy to assist. Please contact us directly for more information or to verify your insurance benefits.

Get the Support You Need

If you or a loved one is experiencing visual impairments after a brain injury, don’t wait to get help. Contact us to schedule a consultation or learn more about how our vision therapy programs can support your recovery. 

• Call us: 343-333-2211

• Email us: napaneevisiontherapy@gmail.com

• Follow us: Stay up-to-date on Facebook and Instagram for tips, updates, and success stories!

  
  

Don’t hesitate to reach out with any questions or to book an appointment! We’re here to guide you every step of the way toward better vision and improved quality of life.

Warmly,

Dr. Zoe Briggs, OD, FAAO, FOVDR