Vision Rehabilitation for Vision Problems Resulting From Head Injury or Stroke

By Anna Warren, Vision Therapist

You might have someone in mind while you read this, maybe it’s why you are looking into the link between head injuries and vision. If so, please feel free to connect with us to ask any specific questions about the individual’s symptoms. 

Concussions result from a direct blow to the head, or indirectly from injuries such as whiplash. The impact causes the brain to hit against the inside of the skull causing brain bruising. It is estimated that nearly 4 million concussions and more than 795,000 strokes occur each year in the United States.

Because more than half of the brain is involved in vision, there is a high probability that vision will be affected in some way after concussions and other brain injuries. Recent research suggests that over 50% of patients with concussion or post-concussion syndrome have visual problems that may include: 

  • light sensitivity
  • blurred vision
  • double vision
  • headaches
  • loss of place when reading
  • decreased peripheral vision
  • complete loss of vision in one or both eyes

Words blurred to show double vision

Concussions result in symptoms that can last weeks, months, or more, but vision therapy can bring relief. When symptoms persist, a condition known as post-concussion syndrome occurs. Up to 1/3 of symptoms are visual, meaning that treating visual problems is often the key to providing relief. One study found that vision therapy had the following success rates for vision problems that developed after a brain injury:

  • Patients treated for convergence insufficiency: 85% had a successful outcome and 15% were improved
  • Patients treated for accommodative insufficiency: 33% were successful and 67% were improved
  • Patients treated for saccadic dysfunction: 83% were successful and 5% were improved

Normal Vision vs Hemianopsia

The most common type of vision loss resulting from a stroke is called Hemianopsia. Hemianopsia is when a person loses half of their visual field, either on the right or left side (losing just the top or bottom half of vision is rare in brain injury). While completely restoring this lost vision is still not a possibility, treatments and therapies can be provided to help individuals better function with these visual changes. It is important to know which area of the brain is affected in order to identify likely visual issues that have arisen, and then train the brain and eyes more accurately during vision therapy.

Since each brain injury is unique, an interdisciplinary team is a matter of “more heads are better than one.” After a stroke some patients are only referred to an occupational therapist or a physical therapist to help address their post-stroke or post-brain injury symptoms. However, occupational and physical therapists do not have the same training and tools that a neuro-optometrist has to treat the visual system. A comprehensive team approach including these professions and others is needed to fully treat patients with post-concussion syndrome. 

Without vision rehabilitation, symptoms of TBI or stroke may worsen or create obstacles down the road. Vision is integrated into other problems that can occur after a brain injury including muscular imbalance and vestibular problems, such as, dizziness, imbalance, vertigo, etc. This means vision therapy is often indicated before many other therapies in order to maximize results in other areas.

Vision Rehabilitation for brain injury patients

How neuroplasticity works

How can vision rehabilitation help you? Vision rehabilitation is a customized treatment program for patients whose stroke, traumatic brain injury, concussion, neurological condition or disease has resulted in visual deficits. It applies the latest methods and knowledge of neuro-plasticity and visual function to help patients develop or regain the essential visual skills necessary for learning and optimal daily function. During a program of vision therapy, we address deficits in eye-teaming, focusing, visual tracking, visual processing problems, and other related visual problems. These problems are common with patients who have concussion and other forms of acquired brain injury. 

Read Ella’s story about how she found relief to her visual problems within a week, after suffering for more than two years:

“Every day that followed (my concussion), for two and a half years, I woke up with a headache. In addition, I experienced nausea, dizziness, fatigue, double vision, and shadowing, and had trouble focusing, concentrating, and remembering. It was so much to take in!

“[We] found a vision therapy clinic nearby. Here, finally I found hope! For the first time in the two long years after being kicked in the head, I honestly could see myself facing and conquering the giants ahead of me.

“I noticed improvements within the first week (of vision therapy), and things only kept getting better from then on. I went from a reading level of 1% to 88% in just five months. Not only that, but visual fields in both my left and right eyes increased.

“Along with my perseverance and my vision therapy team’s dedication, I can proudly say that my continued improvement has been possible. If I were to see myself a year ago, I would not recognize the person I was then. She was hopeless, confused, and tired, but now she is optimistic and thriving.”

Ella's story from her concussion to her successful treatment with vision therapy

Optometric Vision Rehabilitation is very effective in resolving a range of vision problems resulting from brain injuries and neurological disorders. Our highly trained North Charleston-based doctor can diagnose issues with eye-teaming, focusing, visual tracking, and visual information processing, and prescribe the most effective optometric vision rehabilitation program so that you can live your best life!

If you or someone you love is struggling after a stroke or concussion, please connect with us to see if we can help you.