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
The following chart, intended for children’s development, shows the components of the visual system and helps me see how they interrelate. Source: http://lynnhellerstein.com/the-developmental-vision-model/
Click on image to view an enlarged image:
The Center for Neuro Skills also provides a good overview of visual problems associated with brain injury:
http://www.neuroskills.com/brain-injury/post-trauma-vision-syndrome-1.php
http://www.neuroskills.com/brain-injury/post-trauma-vision-syndrome-2.php
I have hemianopia following brain damage and am keen to learn about ways for possible improvement
Thank you so much for this information! After over 3 years of having 2 brain surgeries after my massive brain hemorrhage, no one could explain to me the after affects of these changes.
Please know I will send out links to my loved ones so they too will be informed of my “new changes and new normal!”
There is so much we don’t know about our brains, even the doctors and scientists. There are so many options for therapy that many of us never hear about after our brain is injured. Fortunately I was referred to vision therapy a few months after my accident but my problems were not completely resolved during the first years. I stopped the therapy thinking I had made as much progress as I could but I was wrong. I’m very happy I went back this year because I have made a lot of improvement AFTER NEARLY 9 YEARS.
Great points you make. thanks. I too had problems trying to get my ABI vision problems acknowledged and addressed. I was continually dismissed and the ongoing migraines (induced by light sensitivity) and fatigue meant i didnt push it very hard. It took 9 nine years to find a specialist optometrist so that I could once again wear glasses without immediate headaches (i am shortsighted) and thus see again and also exercises so I could tolerate a computer screen. i am still light sensitive and have occasional migraines and can’t wear my glasses for long periods of time, but at least it has been acknowledged as part of my brain injury, rather than ‘in my head’.
It can be hard to find a good optometrist. I am in Australia and i found mine via the Epilepsy Foundation!