BRAIN INJURY CAN AFFECT VISION

A concussion, also known as a traumatic brain injury (TBI) or an acquired brain injury, can adversely affect vision. Unfortunately, possible visual problems are often overlooked during the initial treatment of a concussion. Perhaps a coach or doctor will move a finger in front of the patient’s eyes to see how they track movement, but this cursory examination does not get to the deeper repercussions of the injury.

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VISION AND CLOSE WORK

It is interesting to note how eyesight has evolved. The vision system used to be more about looking far afield for what could be hunted and eaten – and what could hunt and eat us.  These days, people are spending more time with their gazes fixed on their computer or TV screens or cell phones. There are certain physical dynamics to this everyday phenomenon.  There is a lens inside the eye that flexes and focuses, so when we look at things up close, that lens has to work extra hard.

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SEE HOW YOU’RE DRIVING

Unlike some other skills we use in our everyday lives, driving relies almost exclusively on our sense of sight. We feel our feet on the ground as we move about or know we are sitting in a chair; we are fully aware of our surroundings. This sensory information lets us know where the ground or chair is. When you are driving, there is no movement of your body. It is totally about your vision and how precisely your two eyes work together. If your eyes are not aligned perfectly, you may think an object is closer or farther away....

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BRAIN INJURY CAN AFFECT VISION

A concussion, also known as a traumatic brain injury (TBI) or an acquired brain injury, can adversely affect vision. Unfortunately, possible visual problems are often overlooked during the initial treatment of a concussion. Perhaps a coach or doctor will move a finger in front of the patient’s eyes to see how they track movement, but this cursory examination does not get to the deeper repercussions of the injury.


What happens with a TBI is that the brain gets shaken, incurring multifunctional problems and often disrupting neural pathways, including the two visual pathways (focal and ambient). This irregular movement in the brain can affect motor skills, balance and general orientation.


Some of the symptoms of visual problems that can result from a TBI include headache, blurred vision, increased sensitivity to light, reading difficulties and difficulty concentrating. Memory and attention are often impacted as well. The patient may also have problems with eye tracking (the ability to move the eye smoothly across a printed page or while following a moving object); focusing (looking quickly from far to near and back without any blurring); eye teaming (using the eyes together as a team – smoothly, equally and accurately); and depth perception (judging relative distances of objects – how far or near they are). These vision problems are hidden disabilities a physician should look for following any sort of acquired brain injury. If these symptoms are ignored and

rehabilitation is delayed, the long-term effects of the TBI can result in an ongoing disruption in the receiving and processing of information, since the eyes and the brain are interdependent.


Visual field loss or reduction is another possible result of a TBI. The visual field is the complete central and peripheral range. Many patients who have had a major brain trauma usually have hemianopia, which is decreased vision or blindness in half the visual field. Basically, you are unable to see anything to the right or left. It is always best to seek treatment as soon as possible. However, even if there is permanent visual field loss, vision therapy can make you more functional with the field that remains.


These problems can be successfully decreased or eliminated with various vision therapy treatments, such as neuro-optometric rehabilitation therapy, low-vision aides, specially tinted lenses that reduce light sensitivity and prism lenses. Through vision therapy and the proper use of lenses, a behavioral optometrist specifically trained to work with TBI patients can help improve the flow and processing of information between the eyes and the brain, thus increasing vision

efficiency. The damaged pathways can be retrained and restored. The patient receives positive feedback just as he would with physical or occupational therapy.


Any time you have a head incident, be sure to have yourself thoroughly checked, including your vision. It is always better to be safe than sorry. For more information about neuro-optometric rehabilitation therapy, visit the Web page of the Neuro-Optometric Rehabilitation Association at www.nora.cc.

DR. RICK GRAEBE

Dr. Graebe received both his B.S degree in Visual Science and Doctorate of Optometry from Indiana University. He is a Behavioral Optometrist and learning expert. He has been in private practice here in the Bluegrass area for the past 32 years.

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