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

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