Traumatic Brain Injury Visual Symptoms

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Traumatic Brain Injury Visual Symptoms

Brain injury sufferers may experience persistent visual symptoms such as blurred vision, eye strain, and light sensitivity that reduce their quality of life. 

This page explains the common visual symptoms, neurological causes, emerging vision therapies, and self-care tips for managing TBI vision problems. Arm yourself with knowledge about TBI visual struggles.

Common Visual Problems After a Brain Injury

Traumatic brain injury patients experience persistent visual dysfunction such as blurred vision, light sensitivity, eye strain, double vision, and reading problems. 

Inflammation and damage to visual pathways give rise to these troubling symptoms.

Blurred Vision:

Blurred vision is a common visual deficit after a TBI due to inflammation, swelling, bleeding inside the brain, and damage to visual processing areas. Both short and long-term blurry sight may occur.

Light Sensitivity:

Increased light sensitivity (photophobia) is a common symptom after TBI, affecting up to 60% of sufferers, according to some studies. Sunlight, room lights, and LED screens can appear uncomfortably bright due to overstimulation of light-sensitive retinal cells. Recent research suggests that the trigeminal nerve may also play a role in photophobia after TBI.

Double Vision:

Double vision stems from disrupted coordination between the eyes when cranial nerves and pathways controlling eye movements swell or sustain axonal damage after blows to the head.

Reading Difficulties:

Reading difficulties frequently arise post-TBI since the process relies heavily on rapid eye movements, sustained focus, visual acuity, and neural connections—all vulnerable to concussions.

Eye Strain and Fatigue:

Eye strain and fatigue are common complaints after TBI. Several factors can contribute to these symptoms, including damage to the visual pathways, increased effort required for visual tasks, and disruptions in cognitive processes. The exact mechanisms are still being explored, but researchers believe inflammation and metabolic stress may play a role. Pacing activities and seeking professional guidance can help manage these challenges.

Causes of Visual Problems From Brain Injuries

Imagine intricate highways carrying information – these are the axons and blood vessels that make up our vision pathways. When a traumatic blow hits the brain, it’s like a major accident: these “highways” stretch, tear, or even rupture. This disrupts communication between the eyes and brain areas responsible for seeing, like a city losing connections to its power grid.

This shearing damage and bleeding disrupt critical communication between the eyes and dozens of cortical areas decoding visual inputs. 

Communication Disruption Between Eyes & Brain:

Vision relies on complex highways transmitting information from eyes to the brain:

  1. Light signals cascade through retinas into optic nerves. Nerve impulses traverse optic tracts to reach the occipital lobe for initial visual processing.
  2. Over 30 distinct brain areas distribute inputs to extract details like motion, color, and objects.
  3. Associative regions confer meaning upon visual stimuli. Imagine seeing a red stop sign. Your eyes send the signal to your brain, but it’s the “associative regions” that remember what stop signs mean and tell you to stop the car. These regions are like the storytellers of your vision, turning basic shapes and colors into meaningful information.

Your vision relies on tiny highways (axons and blood vessels) carrying messages (electrical signals) from your eyes to different brain areas. An injury can stretch or even break these highways, like a car accident damaging roads. This disrupts the flow of messages, causing swelling and inflammation, further hindering communication.


Specific Areas of Brain Damage:

When someone has a brain injury, specific areas responsible for vision can be affected:

  • Occipital and Parietal Lobes: These areas handle tasks like seeing clearly, adapting to light, and judging depth. Damage can cause blurry vision, trouble seeing in different light conditions, and difficulty perceiving space.
  • Brainstem and Cranial Nerves: These control eye movements and how your pupils react to light. Damage can make it hard to follow objects with your eyes, causing double vision or adjust your pupils to bright light.
  • Cerebellum: This area helps coordinate smooth eye movements. Damage can make it difficult to track objects smoothly or follow moving targets.
  • Memory Centers: These areas store visual memories of objects, faces, and places. Damage can make it hard to recognize familiar things or remember what you’ve seen.

Symptoms of Visual Dysfunction Post-Brain Injury

Common vision-related symptoms signaling neurological disruption after head trauma include headaches around the eyes, skipping words/lines while reading, blurred or double vision, eye pain/fatigue, light sensitivity, and difficulty smoothly tracking moving objects.


Headaches & Eye Pain

Headaches and eye pain represent key markers of visual system dysfunction following traumatic brain injury. 

Post-traumatic headaches frequently localize around the eyes and temples, signaling inflammation of cranial nerves III, IV, and VI passing through the brainstem. 

Optic nerve irritation also provokes ocular headaches. Sharp, stabbing pain, burning sensations, and blurred vision around the eyes can be symptoms of post-TBI headaches. These symptoms occur when the nerves responsible for eye movement and vision, located in the brainstem and connected to the eyes, are injured by the trauma.

Losing Place While Reading

Reading relies on several “teams” in your brain working together: convergence (focusing), accommodation (fine-tuning eye focus), and conjugate gaze (smooth eye movements). A brain injury can disrupt these teams, causing:

  • Tracking problems: Eyes jump around instead of smoothly following the line (losing your place).
  • Focusing issues: Difficulty keeping words clear, like a blurry camera.
  • Memory trouble: Forgetting what you just read, as information doesn’t stick.


Difficulty Tracking Moving Objects

Significantly degraded ability to track moving objects stems from damage to cranial nerves III, IV, and VI and cerebellar structures governing predictive and catch-up saccades. 

Fast eye movements fall out of sync with a target’s motion. Blurred or lagging vision trails the tracked object’s actual position. 

Such dynamic visual acuity loss during self or external motion hinders driving, mobility, judging trajectory, and sports performance. Retraining precise eye-target lock-on helps overcome motion-tracking symptoms.

Poor Depth Perception

During binocular fusion, partial or complete loss of depth perception follows TBI events, causing misaligned eyes to no longer point accurately at the same position in space. 

Retinal disparity interpretation centers in the brain also frequently incur damage, resulting in compromised stereopsis. 

Clumsiness, uncertainty moving through environments, and poor eye-hand coordination are common symptoms of individuals with post concussion vision syndrome.


Vision Therapy

Once assessed, patients undergo vision therapy rehabilitation sessions to retrain damaged visual skills and develop improve visual motor skills. Neurodevelopmental optometrists tailor exercises based on the patient’s visual deficits. 

Activities strengthen eye movements, light sensitivity, depth perception, motion processing, and dynamic visual acuity via structured repetition. Reorganizing synaptic pathways lays the foundation for eventual vision function recovery.

Treatments to Improve Vision After Brain Injury

Key treatments for post-TBI vision problems include:

  • Prism lenses to realign misaligned eyes.
  • Vision therapy exercises to strengthen impaired visual skills.
  • Spot patching to restore unified sight when double vision persists. 

These techniques help remediate visual dysfunction and to rebuild pathways damaged by traumatic injury events.

  1. Prism Lenses: Imagine your eyes are like two cameras that need to work together to see one clear picture. Sometimes, after a brain injury, these cameras don’t quite line up precisely to point at the same object, causing double vision. Prism lenses act like special glasses that gently nudge the light entering your eyes, altering its path, helping them work together again and eliminate double vision. They can also be helpful for expanding lost areas of vision.
  2. Vision Therapy: Think of your brain like a muscle. Just like you can strengthen your body with exercise, you can strengthen your visual skills with vision therapy. These personalized exercises target specific weaknesses like eye focusing, tracking objects, and coordinating eye movements. By practicing these exercises regularly, you can retrain your brain and improve your vision.

These treatments, along with others, can help “re-wire” the pathways in your brain that were damaged by the injury. Research shows that the brain is very adaptable (neuroplasticity), and with targeted training, you can make significant gains in your vision skills.