I've Had a Concussion or Traumatic Brain Injury: What Do I Ask My Eye Doctor?

by Gregory L. Goodrich, Ph.D.

Visual Symptoms of a Concussion or Brain Injury

Having a concussion or a brain injury does not automatically cause visual symptoms. Sometimes, when these symptoms initially occur, they go away in a few hours or days. If you think you have symptoms that have not gone away, it may be time to consider an appointment with an eye doctor.

The symptoms can be range from blurry vision to loss of visual field, including, but not limited to the following:

  • Difficulty reading can occur with symptoms such as fuzzy or double letters, losing one's place, and not being able to track from the end of one line of text to the next.
  • Sometimes people experience balance problems or dizziness.
  • Some people will cover one eye to read. Or you may be able to read for a short period of time, but fatigue easily.
  • Glare can be another symptom, as can discomfort or pain in or around the eyes.
  • In some cases, family or friends may ask about your vision if you frequently bump into things or consistently miss people or objects on one side of your body.
  • The Defense and Veterans Brain Injury Center lists a number of symptoms that suggest a visit to the eye doctor may be in order.

Questions about Symptoms You Might Have

  • Have you had any change in vision since your concussion?
  • Has your vision been blurry since the injury?
  • Do you have double vision?
  • Have you lost your vision at all, even for a short time?
  • Do you see differently with each eye?
  • Are you more sensitive to light?
  • Have you felt dizzy while driving or watching TV?
  • Is it hard to maintain visual focus when reading a book or using a computer?
  • Does the room sometimes appear to shift or to rock back and forth?
  • Do you see better if you tilt or turn your head?

These symptoms may arise after a fall, a sports concussion, a fight, or an accident in which you hit your head. The symptoms we're concerned with will be those that are new since this event. If these symptoms don't go away, it may be time to consult an eye doctor – an ophthalmologist or optometrist.

If Your Eye Doctor Refers You to a Specialist

Your eye doctor may refer you to a specialist who has experience in this area, such as a neuro-ophthalmologist, neuro-optometrist, or one who has expertise in binocular/oculomotor dysfunctions. Binocular/oculomotor dysfunctions are related to how well your two eyes function together, which is important for many visual activities.

Should you decide to see someone for your vision, follow the advice in Questions to Ask Your Eye Care Specialist: Take a friend or relative with you, bring your lists of symptoms and questions, and take notes during the appointment.

Bringing along a list of your symptoms will help the doctor in taking your history. Listing such things as the date of the injury, the nature of the injury, noting whether or not you lost consciousness, what symptoms you had immediately after the injury, and changes in these symptoms since injury are helpful details for the doctor.

If there are specific visual tasks that you could do before the injury but can't do now (or only with difficulty), include them in your list for the doctor. They are part of your history and can help in making an accurate diagnosis.

Questions to Ask the Specialist

  • What is my visual acuity?
  • Do I have a visual field loss?
  • Is my binocular (both eyes) vision okay?
  • Why do I have the visual symptoms that I have?
  • Do I need glasses or prisms?
  • What will these do to help me?
  • When should I use them and when should I not?
  • Are these permanent or temporary?
  • Do I need treatment?
  • What will the treatment do to help me?
  • How effective is this treatment?
  • How long does the treatment take?
  • What symptoms should I be mindful of in the future?
  • Do I need to limit any activities?
  • What medical and rehabilitation resources are available to me?
  • If you are bothered by glare, ask about tinted lenses and which color/light transmission would be best for you.

For most people, the visual symptoms experienced in the first hours or days following a head injury will go away as the brain recovers. If the symptoms persist, especially if they persist for several weeks, or if they interfere with your ability to do normal activities, a comprehensive eye examination is in order.

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