The Hidden Vision Problems Caused by Concussions

Introduction to concussion and vision 0:00

In my practice, most concussion-related visual symptoms fall into four main categories. Let's walk through them each. One, trouble reading or using screens. This is one of the most common complaints I hear after a brain injury. Many patients may say, words move or blur when I'm trying to read. I lose my place when I'm reading. I can't read for long anymore. My endurance is very limited. Or screens give me headaches and light sensitivity. Now all of these symptoms happen because the brain is struggling to coordinate both eyes working together, especially up close.

So after a concussion, the neural pathways that control eye movement and focusing can be disrupted. Even if you have perfect vision on the eye chart, your eyes may not be working together efficiently when you read. Keep in mind, this is not a glasses problem. This is a brain eye connection problem. And once patients understand that, their symptoms finally start to make sense and we can deal with them. Hello and welcome to the IQ podcast. I'm your host Dr. Rani Banek also known as America's integrative eye doctor and in this podcast I share with you strategies that will help to support your vision from within.

Strategies that will help you to protect and preserve your precious vision for life but also strategies that will support your brain health, your cognitive function and also decrease headaches and migraines. The month of March happens to be brain injury awareness month. And in honor of that, in this episode, I'm going to be sharing with you insights into concussions and how they may affect vision. So stay tuned. You're going to definitely want to tune into this episode. Hello, I'm Dr. Rani and I'm here to talk about something we often take for granted, our vision.

In my book, Beyond Carrots, Best Foods for Eye Health A-Z, I delve into how crucial it is to be proactive about your vision health. Certain eye issues are quite common, such as dry eye and eye strain, while others frequently develop with age like cataracts, macular degeneration, diabetic retinopathy, and glaucoma. Some of these types of eye conditions can be debilitating and even lead to loss of vision. The good news is that many of these sight-stealing conditions are preventable if you take the right steps.

Your eyes are precious and they deserve the best care possible.

How concussions disrupt the brain-eye connection 2:34

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Let's embark on this journey together because your eyes deserve nothing but the best. The Ageless Eyes Bundle. See the world with clarity and confidence. I want to talk to you about something that surprises a lot of people, how concussions can affect vision. Now, when most people think about a concussion or traumatic brain injury, they often think about common symptoms like headaches, dizziness, or memory issues. But what many people don't realize is that vision problems are incredibly common after a head injury, as mild as it may be.

And here's the key reason why. It's because our vision doesn't just live in our eyes. It actually lives in our brain, in the visual centers in the brain. And as a neuro-ophthalmologist and integrative eye doctor, I see this eye-brain connection every single day.

Reading, screens, and visual endurance problems 5:00

In this episode, I want to explain why concussions so often disrupt vision, the most common visual symptoms I see after a head injury, why eye exams often look normal even when someone's vision feels off, and also how I support concussion patients from a whole-brain integrative perspective. So exactly how do concussions affect vision? It's important to first understand the brain's structural and functional connections to vision. More than half of the brain pathways are involved in visual processing.

This includes eye movements, focusing, depth perception, light tolerance, and how vision integrates with balance and our attention. So when the brain experiences even a mild injury, such as a concussion, vision is often affected, even if the eyes themselves are perfectly healthy. A concussion, fortunately, doesn't usually damage the eyeball. It disrupts the brain's control of our vision. And that's why patients oftentimes will say, something feels off, but it can't explain it. Or, my eye exam was normal but I still struggle with my vision.

And many of my patients will often describe that reading or screen time truly exhausts them. Now these experiences are very real and they have a neurologic explanation. So what are the four most common vision problems after concussion? In my practice, most concussion-related visual symptoms fall into four main categories. Let's walk through them each. One, trouble reading or using screens. This is one of the most common complaints I hear after a brain injury. Many patients may say words move or blur when I'm trying to read.

I lose my place when I'm reading. I can't read for long anymore. My endurance is very limited or screens give me headaches and light sensitivity. Now all of these symptoms happen because the brain is struggling to coordinate both eyes working together, especially up close. So after a concussion, the neural pathways that control eye movement and focusing can be disrupted.

Eye discomfort, double vision, and light sensitivity 7:11

Even if you have perfect vision on the eye chart, your eyes may not be working together efficiently when you read. Keep in mind, this is not a glasses problem. This is a brain-eye connection problem. And once patients understand that, their symptoms finally start to make sense and we can deal with them. Number two, eye discomfort, dryness, and visual irritation. Another commonly overlooked issue is eye discomfort or dryness after concussion. What's important to understand is that this isn't classic dry eye.

After a head injury, the brain's sensory pathways, especially the trigeminal nerve pathways that carry pain and irritation signals from the eyes and the face to the brain, these pathways can become overly sensitized, which leads to burning or a gritty eye sensation, eye discomfort that often feels out of proportion to the findings on the eye exam or worsening light sensitivity. So in other words, the eyes may feel irritated because the brain is amplifying sensory input, not because the eyes are severely damaged.

Now addressing this component is critical because untreated dry eye and eye discomfort can worsen all of the other visual symptoms. Number three, double vision. Now double vision after a concussion should always be taken seriously. It can occur when the eyes are misaligned, even slight misalignments can cause double vision, a cranial nerve like three, four, or six that controls eye movement is affected by the concussion, or a previously compensated eye alignment issue becomes symptomatic because it's decompensated.

Now even subtle eye misalignment can cause major visual symptoms, especially in busy or complex environments. As a neurophthalmologist, my role is to determine whether this represents a true neurologic emergency, whether further testing or neuroimaging like CT or MRI is needed, and also what their expected recovery looks like. Now double vision after concussion is a neurologic symptom. It's not something to ignore or simply push through. Symptom complex number four is light sensitivity. Light sensitivity is also called photophobia or fear of light and is one of the most distressing post concussion symptoms.

Patients often describe pain or pressure with bright lights. They need to wear sunglasses even indoors. Sometimes they even have nausea or dizziness that's triggered by screens or overhead lighting. Again, this is not an eye problem. It's a brain sensitivity problem. After concussion, the pathways that link light input to pain and the sensory centers in the brain can become overactive. And that's why even normal light levels can suddenly feel overwhelming. Now, avoiding light completely can sometimes prolong these visual symptoms.

So part of recovery involves gradually restoring tolerance in a thoughtful, guided way instead of wearing just really dark sunglasses.

Normal eye exams and the path to recovery 10:14

Next. Let's talk about what the eye exam may reveal after a concussion. One of the most frustrating things that concussion patients oftentimes hear is, well, your eye exam is normal. I don't know why you're having these symptoms. Structurally, yes, the eye exam may be normal, but concussion-related vision problems are usually functional, not necessarily structural. They involve how the brain processes and integrates visual information, not damage that you can see on an eye exam or an eye chart or even an OCT machine, which is optical coherence tomography.

And this is why a neuro-ophthalmic perspective is so important, because we can support concussion patient care in very profound ways. As an integrative neuro-ophthalmologist, I don't use a one-size-fits-all approach. I focus on identifying which visual symptoms are affected, then explaining why the symptoms are happening because understanding is one of the first steps in recovery for patients, then addressing the neurologic, the ocular, and the sensory contributors to a patient's symptoms. Really, we need to support recovery at the brain and cellular level.

I also remind my patients of something very important, that persistent visual symptoms do not mean permanent damage. They usually mean that the brain hasn't received the right kind of support yet. and recovery is often possible, even months or even years after injury. So if you've had a concussion and your vision hasn't felt right, even if your eye exams have been normal, you are not imagining it. Vision problems after a concussion are very common and very real, but the good news is that they are treatable when they're approached from a brain-based integrative perspective.

which is based in nutrition, stress modulation, sleep hygiene, and supplements when. If you'd like to learn more, I've written a detailed blog series on this topic of traumatic brain injury and vision that will walk you through these symptoms. You can find the link to my blog post in the show notes below. And I want to thank you for listening to this episode of the IQ podcast. I hope you've gained some important insights. Remember to write a review and please subscribe to the podcast. It's a no cost way to support me and my team as we continue to bring you useful information about your vision and brain health through the IQ podcast.

Again, thanks for watching and I'll see you soon in our next episode. Thank you for tuning in to the IQ Podcast. I hope you enjoyed today's episode and learned something new to help you boost your IQ. Leave us a review and share the podcast with your family and friends. Stay connected with me for more eye-opening insights on eye health, nutrition, and lifestyle. Until next time, keep your vision clear and your IQ sharp.