How are the Eyes and Visual System Affected by a Brain Injury? by Charles Watson


Posted on February 4, 2022

Concussion or other traumatic brain injuries (TBI) can affect a person in many ways, ranging from physical limitations to changes in thinking, perception, and neurological processing. Vision problems are also common TBI and concussion symptoms. Research indicates that 90% of TBI patients experience some form of vision disruption. Visual problems are caused by a disorder of communication between the eyes and the brain.

Visual problems related to a head injury can be as follows:

  • Blurred vision
  • Sensitiveness to light
  • Sensitivity to glare
  • Reading difficulty- words appearing to move
  • Difficulty in understanding
  • Concentration and attention issues
  • Memory problems
  • Double vision
  • pain in eyes
  • Headaches with visual work
  • Unable to maintain focus or eye contact
  • Decrease or Visual Field Loss

A TBI can also cause specific problems with eye motions, such as:

  • Ocular pursuits -eye-tracking ability
  • Saccades - shifting gaze from one point to the other
  •  quickly
  • Inability to focus 
  • Binocular vision-3D vision, stereopsis
  • Eye alignment (eye turn)

How are visual deficits from a brain injury resolved?

Problems with vision that arises because of a brain injury can be resolved by one or more of these methods:

  • Optometric vision therapy
  • Neuro-visual processing rehabilitation or also known as neuro-optometric rehabilitation therapy. 
  • Corrective lenses, such as yoked prism lenses
  • Phototherapy programs (syntonic optometry, light therapy)
  • Eye muscle surgery (strabismus) is only suggested 
  • if the eye turns are significant because surgery cannot treat the underlying cause of the eye turn, which stems from the eye-brain connection.

For all TBIs, vision problems must be treated early in order to obtain optimal results.

Therefore, it is vital to visit a neuro-optometrist as soon as possible who is specialised in detecting and treating vision problems related to TBI. A neuro-optometrist will help determine an appropriate treatment plan based on the individual needs of the patient

Also, following a traumatic brain injury, communication between the eyes and the brain is often interrupted. According to studies conducted by the Neuro-Optometric Rehabilitation Association (NORA), 90 percent of TBI patients suffer from vision problems following a brain injury which includes:

  • Hazy vision
  • Light Sensitivity
  • Difficulties in reading
  • Headaches when doing visual tasks
  • vision loss on the periphery
  • Double vision
  • Problems with eye rotations

Vision problems are commonly associated with concussions among teenagers. In a study of 100 adolescents diagnosed with a concussion, 69% also were diagnosed with a functional vision problem.

 TBI and concussion-related vision problems can have severe outcomes if left untreated, such as balance and posture problems, loss of ability to organize and make sense of visual information, reduced depth perception, reduced concentration, and reading comprehension, and chronic headaches. 

See an eye doctor

Two types of eye doctors specialize in detecting and treating TBI and concussion-related vision problems: neuro-ophthalmologists and neuro-optometrists.

Neuro-optometrist

A neuro-optometrist is Doctor of Optometry (OD) who has clinical experience and special training in diagnosing and treating neurological issues that affect the visual system.

Treatment of TBI and concussion-related vision issues given by a neuro-optometrist typically is called Neuro-Optometric Rehabilitation or Vision Rehabilitation. 

Neuro-ophthalmologist

A neuro-ophthalmologist is a medically proficient eye doctor and surgeon (eye MD) specializing in vision problems related to the nervous system, which includes loss of sight due to injury to the brain or the optic nerve that conveys visual signals from the eye to the brain. These injuries can be caused by strokes, trauma, inflammation,  tumors, toxicities, and injections.

Neuro-ophthalmologists also see patients with strabismus (misaligned eyes) or problems controlling eye movements, sometimes treated with surgical procedures.

Neuro-optometrists and neuro-ophthalmologists, strokes, are both skilled at identifying TBI and concussion-related vision problems. Based on the severity and type of vision problems detected, they might offer similar or dissimilar treatment plans.

A traumatic brain injury can produce sensory, cognitive, or physical impairments. TBIs result from blows to the head, stroke, or neurological dysfunction. It can result in major vision problems; unfortunately, these often remain undiagnosed for years.