What are common vision problems after brain injury and stroke?
Most people are unaware that the tissue of the back of the eye is actually brain tissue. Information travels from the eye directly to visual cortex which is located at the back of the brain. From here, information is relayed to various parts of the brain. This visual information is integrated with our vestibular system, for example, to help us with our sense of balance. Visual information helps us relate to how objects are perceived in space and help us visualize necessary steps in motor planning. Research shows that 40-60% of our brain’s surface is dedicated to eye movement. So if the brain is injured in any way, there is a high probability that vision is affected.
Common problems that I frequently see in my clinic include: blurry vision, double vision, focusing difficulties, light sensitivity, headaches, and visual field loss, to name a few. Sometime patients are unaware that their symptoms are a visual problem. Their complaints may be vague, such as frequent clumsiness, bumping into objects, dizziness, balance difficult, or a sense of being overwhelmed in crowded environments.
Are these vision problems temporary or permanent?
It is difficulty to answer this question since every brain and injury are unique to a patient. Some problems may resolve over time; however, after an initial injury, the brain needs to establish ‘new’ ways of completing tasks to bypass the damaged areas. Without any formal guidance, this process is left to chance and patients may develop poor habits leading them to function inefficiently. This is why I often recommend early intervention and therapy to help guide the recovery process and improve a patient’s quality of life much sooner.
How soon after the brain injury or stroke should one have an eye exam or start rehabilitation?
We recommend a vision examination and appropriate visual rehabilitation as soon as patients are medically stable. If patients are starting rehabilitation with occupational or physiotherapists, their vision rehabilitation can be integrated into their existing therapies.
What can be done to help those who have vision problems after injury or stroke?
First, I would recommend patients start by having a functional vision examination. Some patients simply need an updated pair of prescription glasses. Some may need special eyewear such as prism eyeglasses to help them cope with missing visual field or tinted eyewear to address light sensitivity. Some may need one-on-one therapy to help recover specific visual skills, such as eye teaming.
Many of our patients have benefited from engaging in visual rehabilitation to speed up their recovery and facility therapies that they are receiving elsewhere. Ideally, an interdisciplinary team works best. Vision is a dominant sense and vision rehabilitation, specifically through the use of lenses, prisms, and other optical means, is one of the many tools that can help guide patients to a more productive recovery process.
For local resources, check out Brain Injury Association of Tennessee.
This topic has been presented to various support groups in the Greater Nashville area. If you are interested in having Dr. Jamie Ho come speak at an event, please contact the practice.