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Vision deficits after TBI

The term traumatic brain injury (TBI) refers to an injury to the brain caused not by degenerative or congenital causes but by an external physical force that may result in a diminished or altered state of consciousness.

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Vision is a Bimodal System

There are 2 main pathways that carry visual information from the eye to the brain. The focal system which tells our brain what the object is we are looking at and the ambient system that tells us where that object is placed. They are designed to simultaneously process different types of visual information. Neither works in isolation of the other; both reinforce one another. A disconnected ambient system can cause balance problems and bumping into things.

Why is vision rehabilitation so important following brain injury?

Why is vision rehabilitation so important following brain injury?

The sense of vision is the dominant sense we possess as human beings. Vision is prevalent throughout our brain. Every aspect of our lives is impacted by our vision, whether it is how we think, what we say, or what we do. There is a high rate of visual problems following TBIs, but they are often overlooked in the rehab process. That’s why you should always consult an eye doctor who has experience with brain injury patients.

What visual problems can be caused by traumatic brain injuries?

What visual problems can be caused by traumatic brain injuries?

Following are the several characteristics of post trauma vision syndrome (PTVS):

  • Binocular coordination dysfunctions which can cause double vision
  • Inability to perceive spatial relationships between objects
  • Difficulty fixating on object and following when it moves
  • Abnormal posture
  • Dizziness and balance problems
  • Poor visual memory
  • Poor concentration and visual attention
  • Difficulty with visually guided movements (bumping/tripping, knocking things over)
  • Light sensitivity also known as photophobia
  • Visual midline shift syndrome
  • Visual spatial difficulties
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What are the functional implications of post trauma vision syndrome (PTVS)?

What are the functional implications of post trauma vision syndrome (PTVS)?

Visual field defect

It can cause you to have a poor sense of balance. Furthermore, it can make you bump into things. You might have difficulty with eating and reading a book.

Binocular vision dysfunction

Patients with binocular vision dysfunction can have difficulty judging distance or depth. They might have a tendency to knock things over. They might bump or trip over obstacles. They might also have a hard time playing any kind of sport.

Poor visual processing information

Poor visual processing information can cause you to avoid crowded or busy places. Additionally, you might have a short memory and forget familiar routes. Additionally, it can slow down your ability to process information.

Visual midline shift syndrome

A TBI patient with visual midline shift syndrome can experience the following symptoms:

  • Floor may appear tilted
  • Walls and/or floor may appear to shift and move
  • Veering during mobility
  • Person leans away from the affected side
  • Feelings of imbalance or disorientation similar to vertigo

Visual Spatial Inattention after TBI

When someone suffers a TBI or stroke, they fail to process information on one side of their body, also known as visual neglect or hemi-neglect. Although this is not a field defect, it can coexist with one. It is possible for patients to become unaware of a part of their body in severe cases.

If these visual symptoms are affecting your ability to perform basic daily activities such as reading, driving on busy roads, consult with our neuro-optometrist who has experience treating brain injury patients.

How can our neuro-optometrist and experienced staff help your loved one?

Patient education

A lot of people are not aware of the connection between vision and our brain. Therefore our eye doctor will explain that connection in simple terms during a neuro-optometric vision assessment. They will discuss with patients how their specific condition can affect their lives and limit their daily functions once a diagnosis has been made. We also advise you to bring your family members to a neuro-optometric vision assessment.

Managing your symptoms

Another most important thing to do after a TBI is to alleviate your symptoms so you can function normally. 

Filters following a traumatic brain injury

Our eye doctor may prescribe filters to reduce eye strain, fatigue and headaches. Filters may also be prescribed to reduce glare and light sensitivity. 

Practice frequent and full blinking when using digital devices

You should also blink more often and completely while working on a computer to alleviate the symptoms of dry eyes. 

Diagnose and treat the cause of your dry eye symptoms

If you have more severe dry eye symptoms or your symptoms are ongoing, come in for a dry eye evaluation to assess the cause of your symptoms so that it can be treated. 

Take breaks from visually demanding tasks

Taking frequent breaks from visually demanding tasks is also essential. We suggest that you follow the 20-20-20 rule which means look at an object that is 20 feet away for 20 seconds every 20 minutes.

Managing double vision

The occurrence of double vision after a traumatic brain injury is a common problem that needs to be addressed as soon as possible. If blurry, fuzzy, or double vision is impacting your quality of life and vision, take our online double vision assessment to help identify if you may have an underlying vision problem that is causing diplopia (double vision).  Take our double vision quiz.   The following strategies can help you deal with double vision:

  • A translucent patch (not dark opaque patch)
  • Spot patch
  • Sector patch
  • Binasal occlusion
  • Vision therapy activities to improve binocular function such as:
    • Eye Stretches
    • Tactile Control
    • Spatial Localization
    • Brock String
Why is vision rehabilitation so important following brain injury?
What visual problems can be caused by traumatic brain injuries?

Medical interventions for vision problems after a concussion, stroke, or traumatic brain injury

Prisms

Prisms bend light towards the base, which causes the image to move in the opposite direction. They have implications to change spatial orientation and eye alignment

Lenses

They provide optical correction of refractive conditions. They also help to locate objects in space and help with visual comfort.

Filters

They block specific light frequencies that cause visual discomfort which can improve visual performance.

Vision Therapy 

In office exercises under the guidance of our neuro optometrist and vision therapist that retrain the visual system following an injury.

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Amplify EyeCare is a team of a passionate and experienced optometrists practicing eye care at the cutting edge of technology and vision science. We are growing with new locations coming across the US.
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Common Questions

Every lobe of the brain is involved in processing visual information. Researchers have identified over 300 intracortical pathways linking 32 different cortical areas involved in vision function. More than half of our gray matter and multiple subcortical areas are involved in processing vision. There is more area of the brain dedicated to vision than to all the other senses combined. Therefore, trauma to our brain could result in vision disorders, in fact according to the Neuro Optometric Rehabilitation Association 90% of people will experience visual deficits following a traumatic brain injury.
Prisms are shaped to bend light in a specific direction, and can be used to correct problems with eye alignment, such as double vision, or to help people with visual field loss use their remaining vision more effectively. Prisms can be prescribed by an eye doctor that specializes in neuro optometric rehabilitation as part of a comprehensive treatment plan for PTVS and other vision problems, and can be used in conjunction with other therapies, such as medications, physical therapy, vision therapy, or low vision aids, to help optimize visual function and improve quality of life.
Vision deficits after TBI
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The term traumatic brain injury (TBI) refers to an injury to the brain caused not by degenerative or congenital causes but by an external physical force that may result in a diminished or altered state of consciousness. There is more area of the brain dedicated to vision than to all the other senses combined. Therefore, trauma to our brain could result in vision disorders. These visual disorders can affect your ability to perform basic daily activities such as reading and driving on busy roads.

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