Computer Vision Syndrome - man at his laptop rubbing his tired eyes

Optometric Treatment of Concussion Patients at Perspective Optometry Vancouver

Concussions, a type of traumatic brain injury (TBI), can significantly impact various aspects of a person's health, including their vision. At Perspective Optometry Vancouver, we specialize in the optometric treatment of concussion patients, addressing the visual disturbances often associated with these injuries. This article explores the nature of concussions, their effects on vision, and the role of our clinic in managing these conditions.

Understanding Concussions

What is a Concussion?

A concussion is a mild traumatic brain injury caused by a blow to the head, a fall, or any event that shakes the brain within the skull. Concussions can disrupt normal brain function and lead to a variety of symptoms. While they are often considered less severe than other types of brain injuries, concussions can still have long-lasting effects if not properly treated.

Symptoms of Concussions

Concussion symptoms can be broadly categorized into physical, cognitive, emotional, and sleep-related issues:

Physical Symptoms: Headaches, dizziness, balance problems, nausea, vomiting, fatigue, and sensitivity to light or noise.
Cognitive Symptoms: Difficulty concentrating, memory problems, confusion, and feeling slowed down.
Emotional Symptoms: Irritability, depression, anxiety, and mood swings.
Sleep-Related Symptoms: Trouble falling asleep, sleeping more or less than usual.

Concussions and Vision

Approximately 90% of TBI patients experience some form of visual disturbance (Ciuffreda et al., 2007). These disturbances can be particularly debilitating, affecting daily activities and quality of life.

Visual Problems Associated with Concussions

Concussions can lead to various visual issues, including:

Convergence Insufficiency

Convergence insufficiency (CI) is a condition where the eyes do not work together properly when looking at close objects. This leads to symptoms like double vision, headaches, and difficulty reading. Concussions can exacerbate or even cause CI.

Accommodative Dysfunction

The ability of the eyes to focus on near objects, known as accommodation, can be impaired following a concussion. This results in blurred vision, difficulty reading, and eye strain.

Oculomotor Dysfunction

Oculomotor dysfunction involves problems with the muscles that control eye movement. This can lead to issues like difficulty tracking moving objects, poor eye-hand coordination, and problems with reading.

Photophobia

Increased sensitivity to light, or photophobia, is a common symptom following a concussion. It can make it difficult to be in brightly lit environments or use screens for extended periods.

Visual Field Loss

Some patients may experience loss of peripheral vision, which can affect spatial awareness and increase the risk of accidents.

Our Approach to Treating Concussion-Related Vision Problems

At Perspective Optometry Vancouver, we are dedicated to diagnosing and treating the visual disturbances resulting from concussions. Our treatment approach typically involves a combination of thorough evaluation, vision therapy, and the use of specialized lenses or prisms.

Comprehensive Visual Evaluation

A comprehensive visual evaluation is the first step in identifying and addressing visual problems associated with concussions. This evaluation includes:

Visual Acuity Testing

This test measures the clarity of vision at different distances and helps determine if corrective lenses are needed.

Binocular Vision Assessment

Assessing how well the eyes work together is crucial for identifying conditions like convergence insufficiency and accommodative dysfunction.

Oculomotor Function Testing

Evaluating eye movements helps detect issues with tracking and saccadic function, which are often impaired following a concussion.

Visual Field Testing

This test assesses peripheral vision and identifies any areas of vision loss.

Sensory Integration Testing

This involves evaluating how the visual system works with other sensory systems, such as balance and coordination, which can be affected by a concussion.

Vision Therapy

Vision therapy is a customized program of visual activities designed to improve visual skills and processing. It is particularly effective for treating convergence insufficiency, accommodative dysfunction, and oculomotor dysfunction.

Components of Vision Therapy

Vision therapy typically includes exercises that target specific visual skills:

Eye Tracking Exercises: These help improve the ability to follow moving objects smoothly and accurately.
Convergence Exercises: Activities like pencil push-ups or using a Brock string to enhance the ability to focus on close objects.
Accommodation Exercises: Techniques to improve the eyes' ability to change focus between near and far objects.
Saccadic Training: Exercises to improve quick, accurate eye movements from one target to another.
Peripheral Awareness Training: Activities designed to enhance awareness of the visual field.

Benefits of Vision Therapy

Vision therapy can lead to significant improvements in visual function and reduce symptoms such as headaches, eye strain, and double vision. Research has shown that vision therapy can be particularly effective for patients with convergence insufficiency and other binocular vision disorders (Scheiman et al., 2005).

Use of Specialized Lenses and Prisms

Our optometrists may also prescribe specialized lenses or prisms to help manage visual symptoms following a concussion.

Prisms

Prism lenses can help align the eyes and reduce double vision. They work by bending light before it enters the eye, which can help compensate for misalignment.

Tinted Lenses

Tinted lenses, such as those with FL-41 tint, can reduce light sensitivity and alleviate photophobia. These lenses filter out specific wavelengths of light that are known to trigger discomfort.

Bifocal or Multifocal Lenses

For patients with accommodative dysfunction, bifocal or multifocal lenses can help reduce the strain of focusing on near tasks.

Rehabilitation and Interdisciplinary Care

Optometric care for concussion patients often involves collaboration with other healthcare professionals, such as neurologists, physical therapists, and occupational therapists. This interdisciplinary approach ensures comprehensive care and addresses all aspects of the patient's recovery.

Physical Therapy

Physical therapists can help address balance and coordination issues that may be related to visual problems. They can also provide exercises to improve overall physical function.

Occupational Therapy

Occupational therapists can assist with strategies to manage daily activities and improve cognitive function. They often work closely with optometrists to integrate visual rehabilitation into the patient's overall therapy plan.

Neurology

Neurologists can provide medical management of concussion symptoms and coordinate care with other specialists, including optometrists.

Case Studies and Research Findings

Case Study: Vision Therapy for Concussion Recovery

A study by Thiagarajan et al. (2014) followed a 15-year-old female who experienced a concussion during a soccer game. She reported symptoms of blurred vision, headaches, and difficulty concentrating on schoolwork. After a comprehensive visual evaluation, she was diagnosed with convergence insufficiency and accommodative dysfunction.

The patient underwent a 12-week vision therapy program that included exercises for eye tracking, convergence, and accommodation. By the end of the program, she reported significant improvement in her symptoms, and her academic performance also improved. Follow-up assessments showed enhanced visual function, supporting the effectiveness of vision therapy in managing concussion-related visual disturbances.

Research Findings: Effectiveness of Vision Therapy

A randomized clinical trial conducted by Ciuffreda et al. (2008) examined the effectiveness of vision therapy in treating post-concussion visual symptoms. The study included 60 patients with persistent visual symptoms following a concussion. Participants were divided into two groups: one received vision therapy, and the other received placebo therapy.

The results showed that the vision therapy group experienced significant improvements in visual symptoms, including reduced headaches, improved eye coordination, and enhanced reading ability. The study concluded that vision therapy is an effective treatment for managing

To book an appointment with Dr. Randhawa, please book online or call Perspective Optomterty Vancouver at (604) 435-EYE1.

An eye exam is one of the best things for your health

An doctor's eye exam is one of the best things you can do for your overall health. It can even save your life. Brain tumors, cancer and diabetes are often diagnosed first in the eyes - early enough to initiate treatment which could save your life. Remember, the earlier we catch a disease the easier it is to beat it.

Technology-related vision problems are prevalent

A recent survey by the American Optometric Association found that 68% of young adults report a technology related vision problem.

One in ten infants has an undiagnosed vision problem

A survey conducted in the United States shows that most adults are unaware that 10 percent of infants have an undetected vision problem, which, if left untreated, could become serious and lead to other problems. It is recommended that a child go to an optometrist for a comprehensive eye examination before the age of one. However, only 18 percent of parents who participated in the American Optometric Association's American Eye-Q survey reported taking their child to an eye doctor before the child's first birthday. Optometrists have special tests for babies to diagnose eye conditions, which allow babies to be examined before they can read or even speak. It is recommended that you take your baby to the optometrist for her first eye examination at six months of age. Read more.