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Vision Symptoms After a Concussion

visual symptoms after a concussion

The Centers for Disease Control estimates that over 1.6 million people in the US suffer a concussion, or traumatic brain injury (TBI), every year and that the rate of childhood traumatic brain injury visits to the emergency department more than doubled between 2001 and 2009.  This makes children more likely than any other group to present to the ER with symptoms of a concussion.

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

There are also 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 with 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 testing must be done.

In a study done at the Minds Matter Concussion Program at the Children's Hospital of Philadelphia, patients with the diagnosis of concussion underwent extensive vision testing.  The testing included an assessment of visual 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 difficult to read for any length of time, with blurring and fatigue and then loss of concentration occurring after a fairly short period of time reading.

For the majority of people suffering a mild to moderate TBI, most of these symptoms resolve in one to three weeks but in some people they can persist for 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 assists the two eyes to focus together.

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Wednesday, 01 December 2021

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