Vision Therapy for Concussions
Vision Therapy for Concussions:
Understanding the Effect of a Concussion
on Vision and Visual Processing
With so much of the brain dedicated to vision, it is important that people understand the effect of a concussion on vision and visual processing and how Vision Therapy for Concussions can help. Experts say that the majority of neural connections in the brain (approx. 70%) are involved with some aspect of vision.
Testimonial About Vision Therapy for Concussions
"We were ecstatic to find Dr. Collier. A severe concussion left our daughter with convergence insufficiency which meant that she could not focus her eyes properly and not read for long periods of time. This being her senior year in high school, there was much work to do.
We were so happy to find Dr. Collier and the coaches. Their care and expertise really helped our daughter complete her senior year and be ready for college. Most concussion specialists are not aware that a concussion can create converegence issues with the eyes."
~ Donna R., Parent of 4D Graduate
Read more about this story here: Testimonial on VT for Concussions
A concussion is defined as temporary unconsciousness caused by a bump, hit or blow to the head. However, an article in Pediatrics in 2010 dispelled this myth that someone has to have “blacked out” to have had a concussion.
A concussion is a type of traumatic brain injury (TBI) that can change the way your brain works. It can also occur if the body is hit or falls causing the head to move back and forth suddenly, or from a stroke or neurological dysfunction.
Did You Know This About Concussions?
- After you have one concussion, you are more susceptible to having another.
- The main causes of concussions in adults are car accidents and falls.
- An estimated 4 to 5 million concussions occur annually. Head injuries are on the rise for athletes at all levels of play, with increases emerging among athletes in middle school.
- Even mild bumps on the head can have a major neurological effect which can impact the visual system.
- Visual problems are very common following a concussion.
Warning Signs of Impacted Vision
There are several types of concussions, identified by the symptoms they exhibit:
1. vestibular (balance issues)
2. mood and anxiety
3. migraine headaches
4. cervical (problems with the neck)
5. ocular (vision problems)
Concussions are usually not life-threatening, but their effects to the visual process can be serious.
• Double Vision
• Headaches Doing Visual Tasks
• Poor Reading Comprehension
• Head Tilting
• Problems with Balance
• Poor Depth Perception
• Sensitivity to Light
• Aching Eyes
• Loss of Visual Field
If the eye was directly injured, an eye doctor should be consulted and may recommend surgery, contact lenses/glasses or medication.
When a person gets a concussion, a Behavioral Optometrist should be part of the rehabilitation team, along with a physical therapist, speech therapist, and occupational therapist, as needed. The optometrist can minimize the impact of a concussion on the visual system.
The Impact of a Concussion on Vision
It is often said that the eyes are the window to the soul. A concussion is a kind of traumatic brain injury that can affect a variety of functions within the body. One of these functions is the vision.
Traumatic brain injuries, including concussions, affect the way that the brain functions. The sending and receiving of messages are often interrupted by loss of consciousness and the injury itself. It can be a challenge to diagnose each and every result of a concussion.
Everything from a sports injury to simply falling off of a bicycle can be classified as potential causes for traumatic brain injuries. After an injury, the vision is frequently blurred or even double. These neurological effects can greatly impact the body in its daily tasks.
Here are a few common vision issues to watch for from a concussion:
This can happen for both close and distant objects.
This could be from a variety of causes. If this happens it is important to be seen by an optometrist who has advanced training in neuro-optometry as well as binocular vision.
--Ocular Motor Dysfunction
This occurs any time the eyes are having problems tracking or moving.
Light sensitivity (photo phobia) is the result of a variety of brain injuries including concussions.
--Reduced Cognitive Abilities
Perceptual deficits may also be caused by a concussion. They can have a huge effect on school students who are struggling to get through classes and studies.
This results in the inability to see things close up. It may also include headaches as well as eyestrain, double vision and fatigue.
--Reduced Visual Processing Speed
Reaction times may be slowed down. This is why it can be dangerous to drive or operate machinery after a concussion.
This results in a reduction of the eyes' ability to focus leading to blurred vision. It may affect the close vision (near) more than the distance (far) vision. There may be a pulsing type sensation as things move in and out of focus.
After a concussion, it may be difficult if not impossible to simply read, watch television, look at a computer, or drive a car safely. A headache may also ensue.
The brain requires time to recover from this injury and, depending upon the severity of the injury, it may take several days to several weeks.
In some cases, the full potential of the injury may be longer lasting. A doctor can help to evaluate this and recommend the proper treatment.
It is important for anyone who is having visual problems and has also suffered a concussion or even a simple bump to the head be evaluated immediately by a medical professional. The sooner the person is evaluated, the sooner proper treatment can begin. A behavioral optometrist, experienced in both neuro-optometry as well as binocular vision, will be the best person to assess the patient.
What are the Treatment Options?
Visual issues can be successfully decreased or eliminated with various treatments, such as:
• Corrective lenses, such as prism lenses
• Neuro-Optometric Rehabilitation Therapy
• Phototherapy programs (Syntonic Optometry, Light Therapy)
• Optometry Vision Therapy
Getting Started with Vision Therapy
A concussion may impact the functional aspects of a patient’s vision. A functional vision evaluation by a Behavioral Optometrist can determine the appropriate treatment for any affected visual skills. This evaluation will help the docttor assess the patient's visual status. The Behavioral Optometrist, as part of a rehabilitative team, will prescribe a customized program of care to relieve the effects of an impacted visual system.
Vision Therapy for Concussions
Optometric Vision Therapy can be very effective in remediating the visual challenges of concussed patients and is a crucial part of the treatment plan.
At the functional vision evaluation, Dr. Collier of 4D Vision Gym will determine if corrective lenses, Vision Therapy, or a combination is best to address the visual conditions caused by the concussion. She understands the nuances of the visual process and is experienced with managing the visual issues associated with TBI (traumatic brain injury).
Most of the common visual effects of mild traumatic brain injury are all conditions that respond to Vision Therapy (like convergence insufficiency, ocular motor dysfunction, and accommodative insufficiency).
Post-Concussion Vision Therapy, sometimes referred to as Neuro-Optometric Rehabilitation, can lead to recovery of the visual system and minimize the effect of a concussion on vision and visual processing.
4D Vision Gym, Vision Therapy works as part of a multidisciplinary team to help athletes recover from concussions.
Coaches Can Use this Test to Determine if a Player has had a Concussion
The King-Devick oculomotor test (K-D test) may be used to determine if your child has had a concussion.
This test accurately identifies real-time, symptomatic concussions in adolescents and may also detect asymptomatic concussions. Scores in concussed players may remain abnormal over time. Athletes should undergo real-time assessment of suspected concussions and K-D testing during pre- and post-season.
ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is the most scientifically-validated and most-widely used computerized concussion evaluation system. ImPACT provides trained professionals with neurocognitive assessment services and tools that have been medically accepted for determining when it is time to return to play.
ImPACT concussion testing has included many visual perceptual components to the testing protocol. Some of the areas of visual perception that are assessed using the ImPACT system include:
- Non-verbal problem solving
- Visual recognition memory
- Visual attention span
- Design discrimination
- Visual working memory
- Visual processing speed
- Selective attention time
- Visual reaction time
Read more about Vision Therapy After Concussions
Read this press release about concussions among young athletes to learn more.
Learn more here: Post-Concussive Testing
Mandatory Concussion Education
"The State legislature (CT) has mandated that by the academic calendar of 2015-16 every student athlete, as a part of their medical eligibility, will have to read and sign off on a concussion education and symptoms document."
Read more: Mandatory Concussion Education
Other Concussion Resources:
--"A recent study found that 85% of concussions go undiagnosed, and another found that nearly 63% of varsity soccer players had concussion symptoms, but only about 19% actually knew it."
Read more: Undiagnosed Concussions
--"Adding a vision test helps to identify more athletes with a concussion."
Read more: Detect Concussions
--A new test was just approved a month ago by the Food and Drug Administration that may better diagnose concussions in younger athletes. It is called the BNA (Brain Network Activation). It maps the brain and allows researchers to see how nerve cells are firing in the brain, which shows dysfunction within the brain that may be the result of a concussion.
Read more: New Test for Concussions
--Because unaddressed and multiple concussions can lead to second impact syndrome (when the brain swells after a person suffers a second concussion before the symptoms from an earlier concussion have subsided) and have a devastating effect on a child’s life, parents and the public at large should speak out to advocate for early detection of concussions.
Learn more: Early Concussion Detection
--Precautionary Device: Jolt Sensor — a roughly inch-and-a-half-sized wearable sensor that allows parents and coaches to keep track of a young athlete’s head impacts in real time.
Learn more: Precautionary Device for Concussions
--A new test (vestibular/ocular motor screening or VOMS) concerns the vestibular ocular system, which is responsible for integrating vision, balance and movement. It’s what allows us to keep our eyes focused and stable when we move our head around. VOMS can tell clinicians what type of a concussion a patient has suffered.
Read more: VOMS for Concussions
--Concussions are under reported by athletes because they don't want to be removed from play and don't realize how dangerous it is to play while experiencing symptoms. "Athletes who play or practice while they have symptoms of concussion are at risk of far more serious injury, including repeated concussions. This can lead to cumulative neurological damage and even, in the long term, cognitive impairment and depression."
Learn more: Concealing Concussion Symptoms
Please note: In-office, Optometric Vision therapy, under the direction of a Behavioral Optometrist using prisms, filters and lenses, as used with our patients, is far more effective than home-based therapy.