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Concussion and Vision

Posted by Ilena Di Toro | Posted on September 14, 2021

Imagine this: You are the goalie for your high school soccer team and a ball is headed towards you. Instead of stopping the with your hands, you stop it with your feet and in the process, you fall down. As you move to get up, the other player kicks you in the head and you end up with not only a concussion, you have post-concussive syndrome.

The above vignette isn’t made up. It actually happened to one teen who suffered for two years with nausea, dizziness, fatigue, double vision, as well as trouble focusing, concentrating, and remembering. What happened to this person is happening to many other concussion victims either through involvement in youth sports, auto accidents or veterans who experienced such an injury in the course of their military service.

How can optometrists help? More often than not, a concussion is preventable. That’s where patient education comes in. Encourage both pediatric patients and their parents to wear a helmet while riding a bike and if the patient is involved in a sport like soccer, hockey or football to follow concussion guidelines set by the Centers for Disease Control (CDC).

In addition, let the parent know that you have the results from baseline vision testing and that these results can be referred to if the child experiences a concussion. In fact, one optometrist, Maria Richman, OD, FAAO of Shore Family Eyecare in Manasquan, New Jersey, recommends that other optometrists let school nurses, pediatricians and school coaches know that they collect this information and to even send the information to the child’s primary care physician. Knowing what the baseline is can help in developing a plan of treatment, if the patient should experience a concussion.

All the more reason to involve an optometrist, in particular a neuro-optometrist, when someone has a concussion. A large part of the brain is dedicated to vision and 50 percent of those who experienced a traumatic brain injury, like a concussion, have eye tracking difficulties. Another optometrist, Tanya Polec, OD, FCOVD, a neuro-optometric concussion specialist working at VQ Learning Sports Rehab in Tucson, Arizona wants to see more primary eye care practices screen for brain injury, since many people don’t equate vision issues with brain injury. She recommends that practices use the Brain Injury Vision Symptom Survey (BIVSS). This survey is available on the Neuro-Optometric Rehabilitation Association (NORA) website and it is a symptom check list that a staff member can run through with a patient. A score of 31 out of 112 means that the patient should be referred to a neuro-optometrist.

A concussion isn’t just a hit on the head, it has wide reaching effects on visual processing. As more is learned about its effect on visual processing, more will need to be done to help those who experienced such an injury. That’s why there needs to be proactive testing of the visual function when someone experiences a concussion.

Sources:
https://covdblog.wordpress.com/2017/09/21/ella/

https://www.reviewofoptometry.com/wo/models-of-practice/atypical-practice/article/concussion-care-a-growing-part-of-practice/

https://modernod.com/articles/2019-sept/when-to-refer-to-a-neuro-optometrist?c4src=article:infinite-scroll

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