Signs and Severity of Concussion Eye Problems

Signs and Severity of Concussion Eye Problems

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The University of Pittsburgh’s Brain Trauma Research Centre estimates 300,000 incidences of sports-related concussions a year in the United States.

In Canada, hospitals diagnosed 39% of children and youth admitted because of a sports-related head injury with a concussion.

The prevalence of concussions is alarming as concussions can bring about a loss of consciousness, slower cognitive processing, amnesia, and problems with vision.

Concussions have received a lot of attention in recent years thanks to groundbreaking work, but it’s the visual problems brought on by concussions where we want to focus our discussion.

We’ll start with a general overview of what happens to the brain’s visual processing systems after a concussion.

Then move on to the mild symptoms of concussion eye problems before delving into the more severe symptoms.

What happens to the brain’s visual processing systems after a concussion?

Image by Max Andrews via via Wikimedia Commons

Cerebrospinal fluid cushions the brain from impact, but it doesn’t absorb all the force.

A sudden blow can cause the brain to make contact with the inside of the skull.

This trauma can lead to blood vessels tearing, pulled nerve fibers, and bruising to the brain.

The injury to the brain affects the visual processing systems which in turn can bring about concussion eye problems.

We have two modes of visual processing: focal and ambient.

The focal mode is concerned with “what” objects are perceived.

When you see an apple, that’s your focal mode at work.

Seeing the apple on the table across the room is the responsibility of your ambient visual processing.

This system provides information about “where” objects (and yourself) are in space.

It contributes to balance, movement, and coordination.

Suffering a concussion can cause these systems to misfire producing the symptoms associated with vision problems.

These symptoms vary in severity.

Some signs need more urgency than others but make no mistake, they all require proper care and attention from a medical professional.

Mild Symptoms of Concussion Eye Problems

Symptoms considered “yellow” flags require a referral to a specialist, but not with a high level of urgency.

These symptoms include:

Visual Dysfunction

This symptom presents itself as eyestrain, blurred vision, ocular fatigue, or impaired depth perception.

You may have difficulty sustaining vision tasks like reading or focusing.

Neurological Symptoms

Visual neglect or hemispatial neglect occurs when a person is unable to perceive stimuli on one side of the body or the environment.

Due to the effect on ambient vision processing, headaches, dizziness or vertigo are common symptoms of a concussion or traumatic brain injury.

If you find yourself experiencing recurring headaches, you can go to a specialist (like Image Optometry) to investigate and find treatment.

Findings from a Physical Exam

Seeking help from a professional right away can reveal other signs of concussion eye problems that are outside of your awareness.

Such as irregular head posture or movement which could be compensating for vision problems.

Severe Signs of Concussion Eye Problems

More severe signs and symptoms are potential signals for serious issues such as ocular, cranial nerve or structural brain injury. These can cause long term sight or even life threatening outcomes if they don’t receive treatment. Symptoms to look out for include:

Vision Loss or Decline

The impact that caused the concussion could lead to damage to the nerves that send messages to the brain.

This disconnect between the eyes and the brain may result in scotomas or partial vision loss.


Double vision (or diplopia) causes a person to see two images of a single object.

Eyes that are not aligned properly cause the double vision in Binocular Diplopia.

Nerve damage to the extraocular muscles causes the misaligned eyes.

Trauma to the muscles of the eye socket can also cause eyes to misalign.

Abnormal Pupils

Anisocoria, or having pupils that are not equal in size is usually harmless.

But it can also be an indicator of a more serious medical problem.

Other symptoms related to pupils you need to watch out for are irregularly shaped pupils and impaired reactivity.

Abnormal Eye Movements

Concussions can also lead to uncoupled eye movements where each eye moves independently of the other.

People who suffer concussions can also experience nystagmus.

With this condition, the eyes move rapidly and uncontrollably.

These abnormal eye movements can lead to difficulty in eye tracking, shifting gaze from one point to another, and focusing.

Abnormal Behaviour

Family and friends can be valuable resources in noticing odd or abnormal behaviour due to concussion eye problems.

They may be among the first to see you bumping into things around the house or struggling to recognize objects or people.

Acute Ocular Symptoms

People who have experienced a concussion need to be wary of acute ocular symptoms like sensitivity to light and glare.

And any eye pain needs to be addressed immediately.

It’s tough to diagnose concussion eye problems let alone suggest a treatment.

Each case presents a unique set of circumstances.

But in each case, the best course of action starts with consulting a medical professional if you experience any of the symptoms we’ve discussed.

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