Research Review, April 2024

We have three studies where the authors were looking to determine how involved the visual system is after concussion. They assessed the most common visual dysfunctions found after concussion, how often it happens, number of referrals to vision therapy and how well vision therapy worked.

Some stunning facts:
75% of the patients had 1 vision diagnosis!
42% had 2 or more vision diagnoses!

The most common dysfunctions were accommodative (our eyes’ ability to transition from looking far to near) and convergence (our brain’s ability to move our eyes inward to keep things in focus as they get closer). Several people also struggled with saccadic dysfunction (our eyes’ accuracy when looking from target to target). These commonly cause double vision, blurry vision, depth perception issues, disorientation, eye strain, headache, dizziness, fatigue and cognitive dysfunction.

80% of the participants in one study were referred to formal vision therapy based on their evaluation. EVERYONE who went to vision therapy had reduction of symptoms and improvement in function.

Unfortunately less than half of those referred attended vision therapy, possibly speaking to the challenges with access in the US - vision therapy is a specialty that isn’t always covered by insurance. To cover this gap, it’s vital that your concussion physical therapist or other provider is able to evaluate your vision after a concussion, guide you through foundational visual rehabilitation, and perhaps most importantly, know when and whom to refer complex visual cases to.

Keep in mind, these are broad generalizations - the important point is that vision dysfunction is VERY COMMON after concussion. Your vision should be thoroughly evaluated by your concussion physical therapist or other provider. The results of your vision evaluation should then guide your treatment plan, expedite referral to a vision specialist and guide school accommodations for students and work accommodations for workers.

431 patients, avg 14-20 years old, 55% female.

Study citations here:

Gallaway, Michael*; Scheiman, Mitchell; Mitchell, G. Lynn. Vision Therapy for Post-Concussion Vision Disorders. Optometry and Vision Science 94(1):p 68-73, January 2017. | DOI: 10.1097/OPX.0000000000000935

Master CL, Scheiman M, Gallaway M, et al. Vision Diagnoses Are Common After Concussion in Adolescents. Clinical Pediatrics. 2016;55(3):260-267. doi:10.1177/0009922815594367

Mitchell Scheiman, Matthew F. Grady, Erin Jenewein, Ruth Shoge, Olivia E. Podolak, David H. Howell, Christina L. Master, Frequency of oculomotor disorders in adolescents 11 to 17 years of age with concussion, 4 to 12 weeks post injury, Vision Research, Volume 183, 2021, Pages 73-80, ISSN 0042-6989,