This site is best viewed using Mozilla Firefox browser.

Vision

2010-07-01 12:04:00

Head trauma linked to vision problems

My son recently suffered a traumatic brain injury as a result of a car accident and he complains of loss of peripheral vision, lack of concentration and difficulty reading. Is this common?

Answer: Unfortunately, the answer is yes. However, the good news is that it can be rectified in many cases by healthcare professionals who are trained in providing neurological rehabilitation. Emphasis on recovery requires a team effort to fully accomplish the task.

The problem is beyond the needs of sight (visual acuity), but about visual function due to the abruptness of the inability to use the eyes and other sensory modalities together. This may result in poor capability for adaptation, due to cognitive and motor dysfunction that cannot interact with past vision and motor processes. This severely affects recovery of visual processing, making early intervention critical. Common visual manifestations of difficulty after acquired or traumatic brain injury include staring, decreased comprehension, lack of concentration and attention during near activities, spatial disorientation and visual field loss, to name a few. In studies of patients seen by the Veterans Administration as a result of head injury and neurological trauma, 84% had reading problems. Seventy-five percent had visual problems, which included eye movement. These included convergence insufficiency, pursuit and saccadic eye movements (46% and 25%) along with accommodation and focusing of the lens inside in the eye (21%). Convergence insufficiency occurs when your eyes don’t turn inward properly while you’re focusing on a nearby object. When you read or look at a close object, your eyes should converge, turn inward together to focus so that they provide binocular vision and you see a single image. But if you have convergence insufficiency, eyes do not move inward to focus normally. Persons with a Traumatic Brain Injury (TBI) or Cerebral Vascular Accident (CVA) will frequently experience symptoms of double vision, movement of print or stationary objects, eye strain, visual fatigue, headaches and problems with balance, to name several. Frequently, people will report problems with their vision to rehabilitation professionals and be referred for eye examination. Unfortunately, many will be told that there is nothing wrong with their eye and that it is the effects of their TBI or CVA. Others will be told that their symptoms are not related to their vision. Visual problems are among the most common conditions following a TBI or CVA. It is essential that those individuals affected by visual dysfunction as mentioned above, as well as visual field loss due to injury to a region of the brain (which is very common), be seen by a rehabilitation team skilled in providing care for that person until dysfunction has been alleviated. This should involve an interdisciplinary rehabilitative team involving a neuro-optometrist and/or ophthalmologist, occupational, speech and/or physical therapist as indicated. Collaboration of these individuals will address the sensory and motor components of vision as well as the vestibular and kinesthetic process. Hopefully this will lead to your son obtaining improvement in all his activities of daily living. William L. Park, OD, FAAO is in private practice in Wichita, KS. He works exclusively with patients referred for low vision evaluation, low vision rehabilitation and neurological vision loss. He is a past Director of Low Vision Services, Lions Research & Rehabilitation Center, Wilmer Eye Institute-Johns Hopkins University. Dr. Park can be reached at William L. Park, OD, LLC, www.parklowvision.com, 610 N. Main, Suite 201, Wichita, KS 67203, (316) 440-1690 or drpark@parklowvision.com.