TBI, Concussions & Eyesight

A concussion is a head injury or a blow to the head. It may be mild, moderate, or severe. It is often called a traumatic brain injury or TBI. 

Concussions are often caused by car accidents, sports injuries, or blows to the head.

A blow to the head has many signs and symptoms. Some of these directly affect eyesight, such as blurry vision, double vision, and extreme sensitivity to light. Other signs of visual disturbance may be feeling dizzy or off balance.

According to CDC data, there were about 223,135 TBI-related hospitalizations in 2019 and 64,362 TBI-related deaths in 2020. These numbers do not include people who go untreated or those who go to emergency rooms or urgent care clinics.

Traumatic Brain Injury vs. Concussion: What’s the Difference?

You can have a traumatic brain injury without a concussion and vice versa.

With a concussion, your brain hits against your skull, resulting in some bruising. 

Millions of mild concussions happen every year in the U.S. Yet many of these do not require a trip to the emergency room and only have mild impact. 

While concussions can be serious medical issues, TBIs are generally more serious. TBIs are usually caused by more severe blows or an object penetrating the brain. 

It is important to seek treatment, as a sudden blow to the head can damage brain cells. The symptoms can last just a day, a few days, months, or even longer. A doctor will determine whether an injury is a concussion or TBI.

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Common Causes of Concussion & TBI

Concussions often require emergency treatment if they are the result of trauma, such as a car accident, assault, or sports injury. Athletes are at a higher risk for concussions. 

Children, adolescents, and older people are at greater risk of traumatic brain injuries. For elderly adults, falls are often the cause of concussion.

Adolescents are at the highest risk of any age group. This may be because their brains are still developing. Children may get mild concussions during sports activities, such as bike riding, playing football, ice hockey, or wrestling.

Symptoms of Concussion 

Some of the concussion symptoms that affect your vision include blurriness, dizziness, and seeing double.

Other symptoms of concussion may include headache, vomiting, nausea, balance challenges, and memory problems. You may have difficulty walking, feel fatigued, have mood changes, and experience changes in your sleep. 

It is important to realize that you may feel these symptoms immediately, or they may develop in the weeks and months following the injury.

How Concussions Impact Your Vision

After a concussion, you may have problems with eyesight and with the visual system of the brain. According to the American Academy of Ophthalmology, the visual system plays a big role in concussion rehabilitation.

• Vision problems: You may have double vision or blurry vision. 
• Trouble reading: You may have difficulty reading and need to read a line of text several times and lose your place. Words may appear as shaking, out of place, or blurred. 
• Eye strain: Your eyes may feel fatigued, tired, and extremely watery. You may also experience overall body fatigue, headaches, and nausea.
• Balance and depth perception: After an injury, you may notice that your balance is wobbly. You may have difficulty walking or changing positions.
• Light sensitivity: You may be extremely intolerant to bright lights, sunlight, and glare.
• Screen intolerance: You may find that you can’t tolerate looking at screens. This could include playing video games, using your phone, working on the computer, or watching television.
• Motion sensitivity: You might be intolerant to things that move, such as crowds of people, watching sports events, or scrolling on your phone.
• Memory and concentration problems: You might find that it’s hard to remember visual information. This can impact your ability to concentrate, read, or recall content.

It’s common to experience immediate visual symptoms after a concussion, such as blurry or double vision and sensitivity to light. These symptoms often resolve, but they may persist or worsen. See a doctor promptly if they do not improve.

After Concussions

After a concussion, you may have delayed symptoms. This range of symptoms is known as post-trauma vision syndrome. These symptoms may arise from the changes in your brain. 

Many of these symptoms are not picked up on standard optical testing, but they can still be disruptive. These can affect your ability to function well in daily life.

If your symptoms do not resolve within about a week or two, contact your doctor.

Permanent Effects 

According to the University of California, Irvine, there are potential long-term concussion complications. These may include difficulty concentrating, problems paying attention, chronic headaches, depression, and difficulty with sleep. 

Naturally, with these changes, long-term effects can take a toll on your performance at school, work, or in sports. You may also notice that daily tasks and organization are difficult. Additionally, you may experience mood changes.

Unfortunately, if you have had one concussion, there is a greater risk of having another one. This is important to realize, whether or not you are an athlete. 

When to See a Doctor

If you think you have a concussion or TBI, it is important to see a doctor right away. 

If you or your child has a non-emergency mild blow to the head, seeing your family doctor is a good first step. Your doctor will evaluate the injury, assess if you lost consciousness, and gather information about your symptoms. You may be asked questions to assess your memory as well as perform physical tasks to confirm how your brain is working. 

To get a better look at your brain, you may have further tests such as a CT or MRI.

After a thorough evaluation, your doctor may recommend specialists who can further evaluate the concussion and develop a treatment plan. Your treatment options will be customized to your needs and specific injury.

Some of the experts you may be referred to include neurologists, neuropsychologists, and neurosurgeons. 

For vision problems, you may be referred to a neuro-ophthalmologist. If dizziness or cervical pain is present, vestibular therapists specialize in working with these symptoms.  You may also talk with your optometrist and find a specialist in vision therapy or vision rehabilitation.

For athletes, referrals may include medical experts in sports medicine, exercise medicine physicians, or athletic trainers.

If the concussion is moderate to severe, seek emergency medical treatment.

Treatment for Concussion

The best treatment for a concussion is often complete rest. This includes physical rest, such as no participation in athletic events, no working out, and no weight lifting. 

Rest is not just important for your body. It’s also important for your brain. 

Giving your brain rest means taking time away from screens. This includes using phones, playing video games, watching television, and working on the computer. During the healing period, you need to rest more and take naps as needed. 

It’s important to become aware of which activities trigger your concussion symptoms. While rest is essential, total mental rest may potentially prolong the recovery period. 

If you find that you can do light mental activities without triggering symptoms, do these in small amounts. Limit activities that make you feel worse. Over time, you may find that you can add more of your activities into your schedule.

Recovery Timeline

Recovery time varies from weeks to months. If your symptoms persist for more than three months, you may have a syndrome known as post-concussion syndrome.

In addition to rest, if your symptoms don’t improve or go away, you may need to see a concussion specialist. Your medical team can help you evaluate the best ways to treat your concussion.

Will My Eyesight Return to Normal After Concussion Treatment?

According to the Australian Journal of General Practice, oculomotor rehabilitation may help people who have persistent visual problems. Schedule a complete ocular exam with an ophthalmologist.

Oculomotor rehabilitation may include eye-tracking and specific exercises that can speed recovery. According to oculomotor rehabilitation research, this approach resolved symptoms in almost 90 percent of patients who had persistent visual defects after a concussion. 

TBI, Concussions & Vision FAQs

Can a concussion affect your eyesight?

Yes, many people who sustain a concussion report vision symptoms. These may include sensitivity to light, blurriness, or double vision. Some of these visual symptoms may appear immediately, while others could show up later in the day or several days after the injury.

How long do vision problems last after a concussion?

Vision problems usually resolve within a week or two after a concussion. If they persist, see a doctor who may refer you to a concussion specialist.

How are concussion-related vision symptoms treated?

Vision problems can be addressed with vision therapy. This therapy uses exercises and tools to improve the control, focusing, and coordination of the eyes.

Some vision problems may show up as balance issues, as vision plays a critical role in balance. Active treatment can help to improve balance, eye coordination, and vertigo.

How does TBI affect vision?

TBI can negatively affect vision since the normal functioning of the brain is disturbed. Vision issues can include blurry vision, double vision, focusing issues, tracking problems, and difficulty with eye movement control.

Can vision be restored after TBI?

Yes, surgery can often restore vision after TBI-related eye hemorrhaging. 

References

1. Concussion Signs and Symptoms. Centers for Disease Control and Prevention.

2. Common Vision Problems & Symptoms Following a Brain Injury. Neuro-Optometric Rehabilitation Association.

3. TBI Data. Centers for Disease Control and Prevention.

4. The U.S. Is Failing to Care for Traumatic Brain Injury Survivors, Experts Say. (February 2022). Science Daily

5. Concussion. John Hopkins Medicine.

6. Concussion. Cleveland Clinic.

7. Vision Problems and Traumatic Brain Injury. Model Systems Translation Center.

8. Concussion – Injuries, First Aid. National Health Service.

9. Delayed Concussion Symptoms. Queensland Brain Institute, The University of Queensland.

10. What Are the Symptoms of Concussions, and What Are the Best Ways for Athletes to Deal With Them? Tufts Now.

11. Traumatic Brain Injury. University of California, Irvine.

12. Concussion. University of California, Irvine.

13. Persistent Visual Disturbances After Concussion. (August 2019). Australian Journal of General Practice.

14. Concussion Care. American Academy of Ophthalmology.

15. Vision Therapy for Oculomotor Dysfunctions in Acquired Brain Injury: A Retrospective Analysis. (January 2008). Journal of Optometry.

16. Surgery, Even if Delayed, Can Restore Vision in Patients With Brain Injuries. (December 2016). Washington University School of Medicine in St. Louis.

17. Traumatic Brain Injury and Visual Disorders: What Every Ophthalmologist Should Know. (March 2014). American Academy of Ophthalmology.

18. Visual Deficits and Dysfunctions Associated With Traumatic Brain Injury: A Systematic Review and Meta-Analysis. (August 2019). Optometry and Vision Science.

19. An Insight Into the Vision Impairment Following Traumatic Brain Injury. (February 2017). Neurochemistry International.

20. Recognizing TBI-Related Vision Disorders. (December 2015). Review of Optometry.

21. Vision and Concussion: Symptoms, Signs, Evaluation, and Treatment. (July 2022). Pediatrics.