Vision Problems Following Brain Injury

Out of all of our senses — seeing, hearing, smelling, tasting, feeling — vision is our most dominant sense. Researchers estimate that 80-85 percent of our perception, learning, and cognition are mediated through our eyes. So dealing with vision issues after a brain injury can be challenging.

Common forms of vision problems

In general, 20-40 percent of people with traumatic brain injury (TBI) experience related vision disorders. Some vision-related issues can be permanent; others resolve quickly. This depends on the individual and his unique brain injury.

Vision can be broken down into the following general categories:

• Visual motor abilities, including alignment, refer to “eye posture” — meaning the direction in which the eyes point. For example, if the eyes are straight and aligned, the eye posture is normal.
• Visual perception is the ability to interpret information and surroundings from visible light reaching the eye.
• Visual acuity refers to clarity of sight.
• Visual field is the complete central and peripheral range, or panorama of vision; picture a pie as your visual field. Here are the common types of visual field loss:
  • hemianopsia
  • quadranopsia
  • homonymous hemianopsia
  • bitemporal hemianopsia

What happens with change or loss of vision?

When we can’t see clearly or have lost part of our field of vision, everyday tasks can become more challenging, some even impossible.You might have trouble with reading, driving, dealing with bright lights, or doing activities that involve hand-eye coordination. In many cases, there are tools and strategies that can help.

Techniques and compensatory strategies

In rehab, there are various techniques and strategies to help people with vision problems after TBI. They can include:

• Wearing prescription glasses
• Using magnification
• Implementing better or varying lighting for different environments
• Using assistive technologies to help make reading and using a computer easier
• Learning to use scanning and head turning
• Re-teaching the eyes to move and look into missing areas in the vision field

Getting the right professional help

Someone with vision problems after a TBI should find a top-notch ophthalmologist or neurologist who can administer a comprehensive vision exam. From there, the ophthalmologist may suggest the patient work with an interdisciplinary rehabilitation team to integrate all the necessary treatments for optimal recovery.

Having vision problems after a TBI can definitely interfere with a person’s quality of life, but it doesn’t have to be that way. Vision expert Dr. Gregory Goodrich advises, “Even if your symptoms don’t seem that serious, try to find an optometrist or ophthalmologist who has experience working with people with TBI. And keep persisting until you get the help you need.”