Vision Therapy For Traumatic Brain Injury
Serving Caledon, Mississauga, Vaughan, North York, York Region and Brampton ON
How Does Traumatic Brain Injury Affect My Vision?
Eyesight measured by reading the small letters on an eye chart. After a concussion, you may be told that you have 20/20 vision. But vision is more than seeing those small letters. Vision happens in the brain, not in the eyes.
Information from the eyes travels through about 70% of the brain including the frontal cortex, the midbrain, the occipital cortex and more.
Their connections with other sensory inputs like touch, hearing, and balance are made. Information travels back and forth through these connections.
When the communication within the brain is affected by concussion, the components of vision that combine central and peripheral inputs with other senses can have difficulty and symptoms will result.
Brain Injuries such as whiplash and concussions can cause serious vision issues that make it difficult to do many of the tasks we take for granted.
Common vision issues from TBI are:
- Blurry vision
- Double vision
- A loss of side vision (peripheral vision)
- Pain or achy eyes
- Difficulty with spatial assessment (depth perception, sports, balance)
- Loss of visual clarity
- Light sensitivity
- Focusing problems
- Loss of visual field
- Difficulties in visual perception
- Problems reading
- Problems using the computer
- Hand-eye coordination problems
- Balance problems
- Avoiding crowds
- Avoiding visually busy environments like grocery stores or malls
There are many different types of brain injuries that can affect vision including Traumatic Brain Injury, Acquired Brain Injury, Mild Closed Head Injury, Concussion, Whiplash, Stroke (CerebralVascular Accident), and Cerebral Palsy. These may result in Hemianopsia or Hemianopia, Post-Concussion Syndrome, Cervical Trauma Syndrome, Post Traumatic Vision Syndrome, or other visual disorders.
An optometrist that focuses on traumatic acquired brain injury will work with a vision therapist to assess how the brain acquires and processes visual information prior to developing a rehabilitation program for the patient. The focus of vision therapy for an acquired brain injury is to treat the visual symptoms which will then allow the patient to pursue other forms of rehabilitation more effectively.
OHIP does not cover Vision Therapy. In most cases, insurance companies with vision plans, do not include Vision Therapy. There are exceptions and Bolton Optometry will be happy to provide you with a letter for your insurance company so you can inquire about your coverage.
Any trauma to the head can cause a brain injury that leads to some kind of vision loss. Car accidents with whiplash, sports injuries, strokes, brain tumors, infections or inflammation of the brain are some of the more common causes of vision loss from acquired brain injuries.
When treating vision issues that have arisen from traumatic brain injury such as a concussion, it is important to choose a doctor that is trained in Neuro Visual Rehabilitation or vision therapy with a focus on TBI. Our Optometrist, Dr. McKenzie, and associates are members of the Canadian Optometrists in Vision Therapy & Rehabilitation, the premier organization for Canadian optometrists that help patients with Traumatic Brain Injury.
Common Vision Conditions that Arise From TBI/Concussions
Binocular Vision Issues/Eye Teaming:
Binocular vision refers to the ability of the brain to use both eyes simultaneously to focus on one object. This task is used to create depth perception and a wider field of view among other important visual tasks. The most common Binocular issue is convergence insufficiency which affects reading, balance and spatial perception.
Accommodative Eye Focusing:
Accommodative focusing problems lead to a variety of symptoms such as blurry vision, eye strain, difficulty focusing, and headaches.
Eye Movement and Tracking/Oculomotor Dysfunction:
Some experts estimate that up to 90% of people with traumatic brain injury experience some form of oculomotor dysfunction. This visual skill is essential for reading, using the computer, and other skills.
The person who has difficulties with their eyes after a traumatic accident should be seen by an optometrist who has specific training and experience with eye and vision problems related to brain injury. The evaluation will include:
Complete vision examination including health assessment
- Focussing evaluation
- Eye muscle evaluation
- Binocular vision assessment
- Evaluation of double or single vision
- Evaluation of depth perception
- Visual field examination
- Visual perception
- Visual impact on balance, posture and head tilt
Over 80,000 people in Ontario will suffer from a traumatic brain injury this year:
20-40% will experience vision loss
Vision & Brain Injuries: What Does The Research Say?
This video series is taken from my keynote speech at the Neuro-Optometric Rehabilitation Association conference.
A.M. Barrett, MD, is a cognitive neurologist, specialized in neurorehabilitation, and Director of Stroke Rehabilitation Research.