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Concussion, Stroke & other Brain Injury

Concussion

  • It is estimated that nearly 10 million brain injuries occur every year across the globe. Studies show that almost 90% of traumatic brain injury patients suffer from visual dysfunction.

  • Out of 100 adolescents diagnosed with a concussion, 69% were also diagnosed with a functional vision problem.

Visual problems can often be overlooked during the initial treatment of a brain injury; symptoms may not fully present themselves until some time after the injury.

  • These problems may include but are not limited to the following: 

    • Blurred vision

    • Eye focusing à shifting between objects near and far may be compromised, along with the ability to scan across a page (reading) 

    • Sensitivity to light

    • Eye teaming your eyes may not work together as a team, potentially leading to double vision. 

    • Reduction or loss of visual field

    • Motion sensitivity 

    • Headaches with visual tasks

    • Reading difficulty 

    • Difficulty with eye movements

    • Eye Strain

 
College football player having senior doctor review his concussion injury..jpg

Post-concussion  syndrome

  • The post-concussion syndrome occurs when various initial injury symptoms persist for an extended period. Post-trauma vision syndrome can occur in addition to post-concussion syndrome.

    • Symptoms can include:

      • Problems with the focusing mechanism (accommodation)

      • Tracking (ocular motor function)

      • Delayed visual memory/processing

      • Convergence (how the eyes come together),

      • Visual-spatial distortions (visual-vestibular) and associated neuro-motor (visual-motor output) deficits.

      • Poor balance

      • Headaches/migraines

      • Inability to concentrate (reading/computer or even conversation)

      • Dizziness/nausea

      • Inability to tolerate crowded or busy places

      • Disorientation

      • Fatigue

      • Delayed visual memory

      • Visual Midline Shift

  • Neuro-Optometric Rehabilitation is a rehabilitation process for visual, perceptual, and motor disorders. 

    • This is an individualized treatment regime for rehabilitation of visual, perceptual, and motor disorders.

    • Therapy is not typically performed to ‘strengthen’ eye muscles but is initiated to treat functional deficiencies. 

 
Brain Nervous System concept.Science is something that children should study and learn.Thi

Vision and Stroke

  • A Stroke occurs when the blood supply to part of the brain is suddenly interrupted or when a blood vessel in the brain bursts. Brain cells die when they no longer receive oxygen and nutrients from the blood or sudden bleeding into or around the brain.

  • In the United States, more than 700,000 people suffer a stroke each year, and approximately two-thirds of these individuals survive and require rehabilitation. Stroke is the fifth leading cause of death in America and is a significant cause of severe disability for adults.

  • Although stroke is a brain disorder, it can affect the entire body. Depending on the stroke location, people may suffer loss of motor, neurological and perceptual function and experience double vision, blurring, headaches, or inability to detect obstacles.

  • About two-thirds of stroke survivors have visual problems related to decreased central or peripheral vision, difficulties with eye movements, or perceptual defects. A wide range of visual disorders can occur following a stroke.

    • Such as:

      • Blurred vision

      • Double vision

      • Visual Field loss

      • Difficulty reading

      • Sensitivity to light (can be extreme)

      • inability to recognize familiar objects or people

      • Trouble with balance

      • Fatigue

      • Most people who experience vision loss due to stroke don’t fully regain their vision.  But at least some recovery is possible.

  • Vision impairment following a stroke can lead to problems such as

    • Driving

    • Actives of daily living

    • Reaction time

    • Cognition and more

  • Stroke survivors have a high rate of visual symptoms and their impact on all aspects of life. It is recommended that patients receive comprehensive screening for visual disorders in the early days following a stroke. They may warrant referral for a specialist’s assessment and targeted treatment specific to their type of visual impairment.

  • Like Traumatic Brain Injury (TBI), there is a need for collaborative rehabilitation.

  • Rehabilitation following a stroke requires extensive neuro-optometric therapy physical and occupational therapy. An individual’s visual rehabilitative needs should be addressed as early as possible by a Neuro-Optometric Rehabilitation Optometrist, who will work with other rehabilitation team members to learn new ways of performing tasks to circumvent or compensate for any residual disabilities.