Vision Problems After Concussion: Symptoms and Treatment
There are four main causes of vision problems after a concussion: dysfunction of the autonomic nervous system (ANS), neurovascular coupling (NVC) disruption, pre-existing visual dysfunction, and mismatched signaling. These changes are functional rather than structural and cannot be detected by medical imaging. Treating the root of the problem that is causing visual symptoms is paramount to successful treatment. Oftentimes “vision therapy” is performed without simultaneous recognition and treatment of the underlying issue causing the visual dysfunction. “Vision therapy” alone is not effective in decreasing post-concussion symptoms.
Here are the most common underlying causes of visual disturbance after concussion:
Autonomic Nervous System
Disruption of the autonomic nervous system can affect the visual system in the brain and lead to vision changes. The two main branches of the autonomic nervous system are the sympathetic nervous system (SNS), which prepares the body to face an emergency (fight or flight), and the parasympathetic nervous system (PNS), which maintains a resting state (rest and digest). Under normal circumstances, these two sections work together to control a variety of bodily functions, such as breathing rates, heart rate, blood pressure, and pupil size. A concussion can break this balance. For most people who have suffered a concussion, the SNS goes into overdrive and the body is in a constant state of alert. SNS dominance causes changes in how pupils react to light resulting in light sensitivity. Disruption of the ANS can be responsible for a variety of other post-concussion symptoms, including fatigue, sleep disturbances, memory problems, and headaches. Being in a constant state of “fight or flight” is very fatiguing for the brain and body. The good news is that autonomic nervous system dysfunction can be treated! Using a variety of special tests a heart rate specific exercise program can be established to get your body working properly again.
Neurovascular Coupling Dysfunction
Visual problems can be due to brain cells not receiving the resources they need. A network of blood vessels brings nutrients and oxygen to the nerve cells in a delicate, dynamic call-and-response relationship, called neurovascular coupling (NVC) When this mechanism is disrupted, the brain struggles to function normally. If this disruption involves any of the areas of the brain linked with visual function (as described in “Part 1”), visual information will not be processed accurately and will result in visual dysfunction.
Mismatched Signaling
Some vision-related symptoms come from the messages sent between the brain, body (via proprioception-the body’s ability to sense where the joints are in space), eyes, and vestibular system (inner). Normally, these parts of your body work together automatically. Just like a GPS, your inner ear, body, and eyes are like satellites and your brain is like the phone that’s triangulating your position. When all the information is consistent, your brain has a clear picture of where you are relative to everything around you. After a brain injury, signals from one or more of these sources may be mismatched and your brain is forced to work harder. If your eyes and your vestibular system are sending conflicting information, the result can manifest in vision-related symptoms.
Pre-Injury Related Deficits
If you develop visual symptoms after a brain injury, it could be due to pre-existing oculomotor deficits that you were unaware of. For example, sometimes people have what is known as “lazy eye” but don’t have any functional issues. The brain has an impressive ability to adapt and can often compensate without you even realizing it. After a brain injury, when the brain is working extra hard it may be too difficult to continue compensating for those visual deficits. As a result, a condition that wasn’t previously bothersome can cause obnoxious symptoms.
Concussion eye strain, blurred vision, headache, and dizziness are never “normal”. You absolutely can get better by participating in an integrative concussion rehabilitation program. “Waiting” for concussion symptoms to go away will only make you feel worse and result in longer treatment times.
How to Treat Concussion Symptoms
The most effective way to treat concussion symptoms is to perform specific exercises that are designed to retrain your brain and body to function efficiently. Specifically there are 5 systems these exercises will retrain:
The Neck
The Visual System
The Vestibular System
The Autonomic Nervous System
The Cognitive System
Properly retraining each of these systems will help your brain and body to heal so that you can get back to being you and doing the things that you love to do.
To learn more about what is a concussion, concussion management strategies, and the specific physical therapy exercises you should be doing to heal your brain and body, visit The Concussion Solution: Master Program. The Concussion Solution: Master Program is an online treatment program that is systematic and based on current research and follows the American Physical Therapy Association’s published clinical practice guidelines of weaving together the different systems that are affected by concussion. You can also visit our clinic in Park City, Utah.
If you would like to learn more about treating your concussion symptoms, please call us: 203 822 2098 or email us at annie@happybrainpt.com
