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A Brain Injury Can Damage Our Vision System

by Linda W. Arms

Brain injuries often cause problems with our vision system.   I’m not talking about a problem with the eye itself but about the work our brain does to allow us to see and interpret what we see.    According to the Neuro-Optometric Rehabilitation Society, around 50% of brain injuries result in problems with our vision system.     If you have had a brain injury, you have a good chance of having visual-related problems that in turn result in fatigue; and problems with cognition, balance, and coordination.    I have several issues with my visual system that I am still trying to resolve after 8 years and I can tell you these have had a major impact on my abilities to do things I was easily able to do before my injury.

You will most certainly have a variety of problems if your vision system is not functioning properly since we use nearly half of our brain for vision-related activities.    After a brain injury, our vision system is sometimes overlooked and as a result, we struggle to improve.   In my case, the problems with my vision system started being addressed after about 6 months and I was in some type of vision rehab therapy for nearly 4 years.    In the last several months, I started noticing problems again with vision and having that discombobulated sensation that I thought was gone.    I’ve had to start vision therapy again to help correct the problems that seem to have resurfaced although I suspect some of the problems never completely disappeared.

Damage to our visual systems cause problems such as:

  • Difficulty with eye movements
  • Double vision
  • Sensitivity to light
  • Reduction of visual field
  • Problems when shifting gaze from one thing to another
  • Difficulty focusing
  • Problems reading and comprehending what is read
  • Visual mid-line shift
  • Sensitivity to visually busy environments
  • Problems with walking and balance
  • Problems with motor skills
  • Dizziness

If you are having problems like these, your brain must work extra hard to get you through your tasks which then causes even more fatigue.    A full comprehensive vision exam is frequently not performed on people after a brain injury and these problems are not identified.   I know I had to be persistent to get my “eyes fixed”.   I went to 3 different specialists who each worked with different parts of my vision problems.

I believe it is very important to visit an optometrist or ophthalmologist who specializes in neurological vision care.    In recent years, I visited two optometrists that did not have this specialty since I thought things were under control although I still had some problems.    I didn’t return to either of them because I felt they did not understand the neurological issues.    In fact, one doctor became very impatient with me when I told him a number of times I could not do some of the visual tests he was asking me to do – it just didn’t work.    When I noticed more vision problems recently I made it a point to find a neuro-optometrist.    You can find a specialist in your area by visiting:

Neuro-Optometric Rehabilitation Association – Health Care Locator


North American Neuro-Opthamology Society – Find a Provider


The following chart, intended for children’s development, shows the components of the visual system and helps me see how they interrelate.     Source:

Click on image to view an enlarged image:

Developmental-model-color (1)


The Center for Neuro Skills also provides a good overview of visual problems associated with brain injury: