Concussions: Treating Vision Issues
Concussion awareness has never been higher in the U.S. parents, who increasingly realize the importance of taking all head injuries seriously.
After all, concussion is just another word for brain injury.
We’ve all become familiar with concussion symptoms such as dizziness, confusion, slurred speech, memory loss and depression.
Concussion sufferers also regularly endure vision problems, including light sensitivity, eyestrain and focusing and reading troubles.
Routinely, these symptoms persist long after the concussion, sometimes even years later. And just as routinely, an eye chart exam finds nothing wrong with the person’s vision.
That’s because the person has not suffered an eye injury. Those muscles are intact and unharmed, according to Dr. Rick Graebe, a behavioral optometrist in Versailles.
Dr. Graebe addressed the Kentucky Osteopathic Physicians conference this summer on the subject of vision and concussions.
He pointed out that head injuries can wreak havoc with the visual system, especially when you consider that of the 12 cranial nerves, four involve vision.
The swelling that accompanies a brain injury puts pressure on the neural pathways in the brain. This affects the way the eyes coordinate with the brain.
To diagnose visual problems, Dr. Graebe recommends a complete series of tests that measure not merely eyesight (the ability to read an eye chart) but the full visual system.
“Each test is a piece of the puzzle that helps identify which part of the visual system has been affected,” he said.
Frequently, a concussion sufferer experiences eye movement and eye pointing problems.
This can cause headaches and make reading difficult. Without proper eye tracking skills, a reader will struggle to follow words across the page.
Dr. Graebe has treated hundreds of such patients, many of whom have seen other doctors to no avail.
Dr. Graebe recommends a multi-sensory treatment plan that includes lenses, prisms, a balance beam and other physical therapy-like strategies that help with sensory integration and balance.
A patient might walk on a balance beam inches off the ground while reading a chart on the wall while wearing glasses with prisms.
“The key is to create an environment that’s like a new world for the patient so he gets feedback to his senses,” Dr. Graebe said.
“We have to get the visual system integrated so that the brain makes sense out of what the eyes are seeing.”