Concussion Management

Concussions have become a common topic of medical and sports-related conversation.  Estimates as high as 3.8 million sports-related concussions occur each year.  Currently, between 6 and 10 percent of all sports injuries are concussions.  These injuries have become so prevalent that even the definition of a concussion has changed.  In the past, concussions were defined as a loss of consciousness due to trauma.  Now, concussions are defined as a temporary disruption of normal brain activity due to trauma.  Although most people are familiar with concussions in general, many do not realize the effects these “temporary disruptions in normal brain activity” can have on our vision.

Treatment of post-concussive visual dysfunction is a three-step process.  Initially, our doctors will identify the most common visual symptoms following concussion.  Secondly, it is necessary to connect the symptoms to the associated impaired visual skills and neuro-anatomy.  Lastly, our doctors will establish a management plan for addressing the symptoms of concussion.

In cases of concussion patients between the ages of 11 and 17 years old, 69% had one or more visual diagnosis.  The most common of these diagnoses are convergence insufficiency and accomodative disorder.  Both of these conditions affect our ability to perform near work.  In general, the most common visual symptoms following concussion are eye strain, double vision, reading accuracy and comprehension, photosensitivity and blurred vision.

Our doctors may treat visually-related concussion symptoms in multiple ways.  These may include prescription glasses, prismatic correction and tinted lenses.  Prescription glasses may be necessary to provide optimal acuity in general, or specifically for near tasks.  Prism may be prescribed to alleviate double vision due to misalignment or allow for greater focus at near.  In some cases, vision therapy may be necessary.  In these case, Dr. Mitchell Scheiman is on-staff and specializes in binocular vision disorders and vision therapy.

Additionally, our practice offers the most current equipment to assist in the diagnosis and treatment of post-concussion visual dysfunction.  Specifically, Visually Evoked Potential (VEP) testing may be used to analyze the brain wave function of the occipital cortex of the brain.  In many cases, the brain wave function of this area of the brain is affected following concussion.  Appropriate use of VEP testing may allow in the diagnosis stage, and assist in monitoring the healing process.

With the increasing prevalence of concussions, there are many good resources available to become better educated.  Below are some links to assist in your understanding of post-concussive visual dysfunction:

https://nora.cc/for-patients-mainmenu-34/vision-a-brain-injury-mainmenu-64.html

http://www.covd.org/?page=BrainInjury

http://padulainstitute.com/education/articles/visual-evoked-potentials-vep-evaluating-treatment-for-post-trauma-vision-syndrome-ptvs-in-patients-with-traumatic-brain-injuries-tbi