Last week, Dr. Ho presented “Concussion for the Primary Care Optometrist” at her local optometric society meeting (http://www.midtnods.com). This continuing education seminar provided clinical pearls and signs of the types of vision problems that occur following a concussion.
Concussions are considered mild traumatic brain injury (TBI) and are responsible for 7500 yearly ER visits in Tennessee yearly. TBI is caused by a bump, blow, or jolt to the head or neck that can change the way the brain normally functions. These changes may not be detected immediately but can occur hours, days, or even months after the event.
About 50-70% of all sensory information in entire body gets directed by information coming from the visual system and over 50% of the surface of the brain is dedicated to vision and vision processing so any brain injury, including a concussion, can affect the visual system.
Visual symptoms associated with Concussion
Visual symptoms associated with a concussion can include: blur, eyestrain, headaches, double vision, light sensitivity. Dizziness, nausea, vertigo, motion sensitivity, balance / coordination are other less known visual problems that can result from a concussion. A more extensive validate symptoms survey is the Brain Injury Visual Symptom Survey (https://noravisionrehab.org/uploads/media/brain_injury_vision_symptom_survey.pdf). Dr. Ho frequently uses this survey at her own office.
Sensory information from vision, vestibular, and proprioception (body) needs to sync together for orientation and balance. When these systems create a mismatch of signals, patient often report different types of symptoms. These symptoms can range from dizziness, motion sensitivity, disequilibrium, to vertigo-like symptoms. Vision and vestibular systems are heavily intertwined to maintain gaze stabilization of eyes during brief head movement.
Dr. Ho stresses early identification for these concussion patients and referring them to appropriate rehabilitation specialists. Assessing for falls risk in the elderly is also a high priority.
Resources for providers and patients:
- College of Optometrist in Vision Development (www.covd.org)
- Neuro-Optometric Rehabilitation Association (www.noravisionrehab.org)
- Brain Injury Association of Tennessee (www.braininjurytn.org)
- TN Brain Links (https://www.tndisability.org/toolkit-healthcare-providers)