Vision Problems After a Concussion or TBI?

The Centers for Disease Control estimates that around 2.8 million people in the United States suffer from a traumatic brain injury (TBI) every year, and vision can be affected.  Concussions are a type of TBI.

The rate of childhood TBI visits to the emergency department more than doubled between 2001 and 2009, making children more likely than any other group to go to the ER with concussion symptoms.

It was once assumed that the hallmark of a concussion was a loss of consciousness. More recent evidence, however, does not support that. In fact, the majority of people diagnosed with a concussion do not experience any loss of consciousness. The most common immediate symptoms are amnesia and confusion.

There also are multiple visual symptoms that can occur with a concussion, either initially or during the recovery phase.

Visual symptoms after a concussion include:

  • Blurred vision.

  • Difficulty reading.

  • Double vision.

  • Light sensitivity.

  • Headaches accompanying visual tasks.

  • Loss of peripheral vision.

Most people with visual complaints after a concussion have 20/20 distance visual acuity, so more specific testing of near acuity, convergence amplitudes, ocular motility, and peripheral vision must be done.

In a study done at the Minds Matter Concussion Program at the Children's Hospital of Philadelphia, patients with a concussion diagnosis underwent extensive vision testing, which assessed symptoms, visual acuity, eye alignment, near point of convergence, vergence amplitude and facility, accommodative amplitude and facility, and saccadic eye movement speed and accuracy.

A total of 72 children (mean age 14.6 years) were examined, and 49 (68%) of those were found to have one or more vision symptoms after concussion. The most common problems were convergence insufficiency (47.2%); accommodative insufficiency (33.3%); saccadic dysfunction (30.5%); and accommodative infacility (11.1%). The investigators also found that 64% of the children with convergence insufficiency also had an accommodative disorder.

Difficulties with accommodation and convergence make it very hard to read for any length of time, with blurring and fatigue and then loss of concentration occurring after a fairly short period of reading time.

For the majority of people suffering a mild to moderate TBI, most of these symptoms resolve in one to three weeks but in some they can persist much longer.

If your visual symptoms after a concussion persist past three weeks, a visit with an eye care specialist is recommended. There may be several options to help improve the symptoms with either prescription eyeglasses or prisms to assist the two eyes to focus together.

My Eyes Feel Like a Desert!

Itching, burning, watering, red, irritated, tired eyes... what is a person to do? These symptoms are classic signs of Dry Eye Syndrome (DES), which affects millions of adults and children.

What causes this?  Dry eye syndrome can be brought on by many factors: aging, geographical location, lid hygiene, contact lens wear, medications, dehydration, etc. The lacrimal gland in the eye that produces tears, in a person over forty years old, starts slowly losing function. Females with hormonal changes have a higher incidence of DES (dry eye syndrome). Dry, arid climates or areas with high allergy rates tend to have higher incidences of DES as well. Another major cause is increased screentime--when we stare at a computer screen or phone, our blink reflex slows way down. A normal eye blinks 17,000 times per day, usually producing enough tears to be symptom free, if not contenting with other factors.  But blink rates go way down while using screens.

Blepharities, a condition of the eyelids, can cause a dandruff-like situation for the eye, exacerbating a dry eye condition. Contact lenses can add to DES, so make sure you are in high oxygen contact lens material if you suffer from DES. Certain medications such as antihistamines, cholesterol and blood pressure meds, hormonal and birth control medications, can also cause symptoms of a dry eye. Check with your pharmacist if you are not sure if your medication could be contributing to the problem.

And finally, overall dehydration can cause DES. Some studies show we need 1/2 our body weight in ounces of water per day. For example, if you weigh 150 lbs, you need approximately 75 ounces of water per day to be fully hydrated. If you are not at that level, it could affect your eyes.

Treatment for DES is varied, but the main treatment is a tear supplement to replace the evaporated tears. These come in the form of topical ophthalmic artificial tears. Oral agents that can help are Omega 3 supplements such as fish oil or flax seed oil pills. They supplement the function of meibomian glands located at the lid margin. Ophthalmic gels used at night, as well as humidifiers, can help keep your eyes moisturized. Simply blinking hard more often can cause the lacrimal gland to produce more tears automatically.

For stubborn dry eyes, retaining tears on the eye can be aided by punctal plugs. They act like a stopper for a sink, and they are painless and can be inserted by your eye care practitioner in the office. Moisture chamber goggles can also be used in severe cases to hydrate the eyes with their body’s own natural humidity. This may sound far out but it gets the job done.

Being aware of the symptoms and treatments for dry eye syndrome can prevent frustration and allow your eyes to work more smoothly and efficiently in your daily routine. If your eyes feel dry as the Sahara or they water too much, know that help is on the way through proven techniques and products. You do not need to suffer needlessly in the case of Dry Eye Syndrome anymore. Make an appointment to talk with your eye doctor about the best treatments for you!

Subcategories

Mission Statement

Our doctors and staff are committed to providing thorough care with personal attention. At Eye Doctors of Madison, you will find the compassionate care of a small-town doctors' office with the knowledge of a big-city institution. It is our mission to not only treat each patient uniquely but also like family.

Latest News

Why Are My Eyes Red?
Why Are My Eyes Red? There are many things that can cause your eye to turn red. The eye looks red when the blood vessels that are in the conjunctiva (the mucous membrane that covers the white of y...
Solar Eclipse Safety: Safe Viewing of t...
  Solar Eclipse Safety:  Safe and Fun Viewing of the April 8 Solar Eclipse   Dr. Michael Baker Wants to Help You Take in the Stellar Moment On April 8th, a total solar eclip...