WHAT IS A BRAIN INJURY?
An Acquired Brain Injury is an insult to the brain. It can result from trauma to the head, stroke, or neurological dysfunction. This may produce a diminished or altered state of consciousness and may result in impairment in cognitive abilities, sensory processing and/or physical function. Impairments may be mild or severe; most are amenable to rehabilitation. A concussion is medically defined as a mild form of brain injury, but often times the symptoms and issues are not so mild. A concussion will typically not be detected by standard brain scans, but that does not mean there was no damage or disruption to brain functioning.
CONCUSSION AND VISION
HIDDEN VISUAL PROBLEMS
Visual problems resulting from concussion and more severe brain injury are often overlooked during initial treatment of the injury. Frequently these problems are hidden and neglected, lengthening rehabilitation and impairing full recovery. Vision is one of the most important sources of sensory information, consisting of a sophisticated complex of subsystems involving the flow and processing of information to the brain. Because there is a close relationship between vision and the brain, a concussion will often disrupt the visual process, interfering with the acquisition and processing of information, and resulting is a brain-based vision problem. These problems go beyond normal eyesight and impact many life skills.
Symptoms indicating a neurological vision problem following concussion are:
Tired, achy eye
Headaches with visual tasks
Loss of visual field/peripheral vision
Difficulty with balance, vertigo, car sickness
Sensitivity to light, photophobia
Reading difficulties; words appear to move
Attention and concentration difficulty
Difficulty with memory
Good visual skills are necessary for efficient information processing. When there is a deficiency in processing visual information, one may “try harder,” thus straining without even knowing it as the effort is subconscious. If the visual system is inefficient, every task can seem difficult, using more energy than required.
Visual skills affected by Concussion and Brain Injury include:
Tracking: the ability of the eye to move smoothly across a printed page or while following a moving object.
Fixation: quickly and accurately locating and inspecting a series of stationary objects, such as words while reading.
Focus change: looking quickly from far too near and back without blur or delay.
Depth perception: judging distance of objects – how far or near they are relative to self.
Peripheral vision: monitoring and interpreting what is happening in the surrounding field of vision.
Binocularity: using both eyes together as a team – smoothly, equally and accurately- allowing for appropriate distance spatial estimates and depth.
Sustained attention: keeping focused on a particular activity while interference, such as noise, may be present.
Visualization: accurately picturing images in the “mind’s eye,” and storing them for future recall in cognitive processing.
Near vision acuity: clearly seeing, inspecting, identifying and understanding objects viewed within arm’s length.
Distance acuity: clearly seeing, inspecting, identifying and understanding objects viewed at a distance.
Visual perception: gathering appropriate information from what is seen allowing for accurate understanding and meaning
OPTOMETRY AND CONCUSSION REHABILITATION
Few in the health care professions, including head trauma rehabilitation centers, are adequately aware of visual problems resulting from Concussion and Acquired Brain Injury and the visual-perception consequences. Unfortunately, this creates a gap in rehabilitative services, resulting in incomplete treatment and frustration for the patient, as well as the family and treatment team. The vision care professional can play an incredibly important role in the rehabilitation effort. Through vision rehabilitation therapy, an optometrist specifically trained to work with concussion and brain injury patients can help improve the acquisition and processing of information between the eyes and the brain. Vision therapy can be very practical and effective. After examination and consultation, the optometrist determines how a person processes information after an injury and where that person’s strengths and weaknesses lie. The optometrist then prescribes a treatment regimen of vision therapy incorporating lenses, prisms, and specific activities designed to improve control of a person’s visual system and increase visual efficiency. This in turn can help support many other activities in daily living and allow for optimal rehabilitation.
WHAT IS NEURO-OPTOMETRY
Neuro-optometry is based on the core principle that vision is a learned process and can be rehabilitated at any age following concussion or brain injury. Eye doctors working with concussion and brain injury patients have advanced education in the use of lenses, prisms, and vision therapy to enhance a patient’s visual capabilities, reduce visual stress, prevent and rehabilitate vision problems. As a member of the rehabilitative team, neuro-optometrists have extensive experience treating the vision problems stemming from concussion and brain injury.
Nebraska Visual Integration Center is a specialty vision care office in Omaha that provides vision therapy / rehabilitation to patients following concussion and brain injury. Our eye doctors have extensive training in providing the best rehabilitative vision therapy to patients of all ages. Dr. Gates serves as the Director of Vision Rehabilitation at Madonna Rehabilitation Hospitals and is a rehabilitative optometric consultant to various other brain injury rehabilitation centers in the Omaha and Lincoln area.
If you or a loved one has suffered a Concussion or Brain Injury and may have undiagnosed neurological vision problems, please contact our office at (402) 502-0043 or email [email protected] so we can provide the necessary information to begin the steps to vision rehabilitation recovery.