Updated: Aug 22, 2021
A case series published in Optometry and Vision Science reviewed patient records during a time frame of 18 months from two private practices. Eighty percent of patients (175 out of 218) with a mean age of 20.5 years were recommended vision therapy after a concussion. Post-concussion vision problems were prevalent with the most common diagnoses being convergence insufficiency at 47% and accommodative insufficiency at 42%. Of the 95 patients who completed their vision therapy treatment, “Clinically and statistically significant changes were measured in symptoms, near point of convergence, positive fusional vergence, and accommodative amplitude.”
Convergence insufficiency (CI) is a binocular vision disorder in which the eyes do not work well together at near. Difficulty with convergence can cause frustrations and strain with reading and near-centered tasks including computers and tablets due to poorly developed or impaired eye teaming skills.
Accommodative insufficiency is a disorder in which there is insufficient flexibility of our focusing system. The focusing system in our eyes, when functioning efficiently, automatically adjusts in order to see clearly at different distances. Our eyes rapidly change focus when we look far away, up close, and back again. Impairments in this visual skill can lead to headaches, eye strain, and blurred vision.
As you can imagine, deficits in these visual skills can significantly impact one’s daily functioning and overall well-being in the workplace, at school, and at home. Given the high prevalence of concussion-related vision disorders, adequate testing of vergence, eye movement function, and accommodation by a developmental optometrist is essential for any individuals who have experienced a concussion. As a result of the information obtained during a comprehensive eye exam, appropriate treatment recommendations can be made. As supported by the case series previously referenced, measurable results can be achieved through participation in neuro-optometric rehab (vision therapy) to address these impairments. Often times neuro-optometric rehab will be performed in conjunction with other therapies that may be needed for post-concussion symptoms such as vestibular therapy and/or physical therapy. It’s this collaborative approach that helps achieve the best outcomes.
1. Gallaway, M., Scheiman, M., Mitchell, G.L. (2016). Vision Therapy for Post-Concussion Vision Disorders. Optometry and Vision Science. doi:10.1097/OPX.0000000000000935