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Holding Hands

Traumatic Brain Injury

Common Visual Symptoms: Double vision, blurry vision, eye strain, light sensitivity, headaches or migraines, motion sensitivity, difficulty reading, reduced peripheral vision awareness, impaired balance, reduced depth perception, and overwhelmed by visual information (example: grocery shopping or large crowds). 

GLVR is the only vision clinic who is a proud member of the Michigan Brain Injury Provider Council.

During the event of a traumatic brain injury, a neuro-chemical cascade occurs that may disrupt the normal function of the visual system. When the axons (neurons that pass information through the brain) swell following the injury, the information is not relayed properly. In the brain, depending on the literature, vision is found in over 50% of the brain. Vision is our strongest sense and given its large footprint in the brain, it is not uncommon for symptoms to occur after the injury. Vision symptoms following traumatic brain injury may occur in up to 50-60% of patients.


The most common symptoms following TBI are photophobia (light sensitivity), blurred vision, double vision, headaches, difficulty focusing or concentrating with reading, balance issues, and more! These symptoms are usually associated with visual diagnoses of convergence insufficiency, accommodation insufficiency (inability to focus clearly on print), fusion with defective stereopsis (the brain can use the two eyes together as team, but not see in 3-D vision as strong as before the injury), visual midline shift syndrome, and poor tracking (i.e., saccades and pursuits).


If these symptoms or diagnoses are present, then a full neuro-optometric rehabilitation assessment is warranted. This assessment includes ocular health assessment, refraction, sensorimotor evaluation (eye alignment and 3-D vision), tint assessment, prism assessment, tracking skills, and accommodation or focusing. In addition to the comprehensive vision exam that assesses 17 visual skills, it is also important to assess visual information processing (VIP) skills and the visual evoked potential (VEP). 


VIP skills are important to assess how well the patient can process or perceive the information gathered by the eyes and the visual system. The first examination assesses how well the eyes move to gather information, then the VIP assessment assesses how well they process the gathered information. In addition to VIP skills, it is important to assess for primitive reflexes that may have re-emerged, balance, and visual projection skills.


The VEP is a purely objective test that is crucial in the assessment of many TBI patients. 

Treatment for traumatic brain injury patients with vision deficits includes prescribing glasses, tints, prism, vision therapy, optometric phototherapy, and co-management with a multi-disciplinary approach. At Excel, our doctors and team are well versed and trained in the treatment of TBI patients. We have great relationships with many clinics or doctors in the area that can assist in getting the best treatment results!

PLEASE CALL TODAY IF YOU HAVE HAD A TBI AND ARE EXPERIENCING ANY VISION SYMPTOMS!

Resources:

1. Ciuffreda KJ, Tannen B, Rutner D, et. al. Objective Vision Based Training in Mild Traumatic Brain Injury: A Bibliography. Vision Development & Rehabilitation 2023;9(2):127.

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