Many people understand what traumatic brain injuries are, even if they don't know it by that term. These injuries are caused by some type of trauma to the brain, whether it be from an accident or a stroke. Common causes of a traumatic brain injury include sports injuries, motor vehicle accidents, strokes, whiplash, being struck by a hard object and falls. Most people are not aware that these types of injuries are closely related to vision problems. It is sometimes difficult for people with traumatic brain injuries to describe the symptoms they are experiencing, or they worry the doctor will think they are exaggerating.

Vision problems following a traumatic brain injury

• Sensitivity to light - Optometrists encounter patients with traumatic brain injuries who tend to be very sensitive to light. These patients wear dark glasses and hats whenever they are outdoors, as well as inside. Learn more about light sensitivity.
• Decreased peripheral vision - Traumatic brain injury patients are sensitive to movement, especially in their peripheral vision. These people can’t go to the grocery store and walk down the aisle because it makes them uncomfortable. This can cause them to become disoriented and limit their ability to get out and do what they have to do. Learn more about peripheral vision loss.
• Binocular vision problems - Traumatic brain injuries can also cause binocular vision problems. It is difficult for them to use both eyes as a team. Various manifestations of this problem exist. A person who hits their head hard can damage a particular nerve, the fourth nerve. Damage to the fourth nerve will cause one eye to aim higher than the other and they may experience double vision. Learn more about binocular vision dysfunction.
• Double vision - They may have difficulty aligning their eyes horizontally, which can lead to double vision, especially when they are concentrating on close-up tasks. Severe double vision does not always occur, and some people just get exhausted really fast or feel a pulling sensation around their eyes when they try to do near work such as reading. Learn more about double vision.
• Difficulty reading - Patients have trouble making accurate eye movements when reading. After traumatic brain injuries, saccadic eye movements may become less accurate, causing them to skip lines or lose their place when reading.
• Visual midline shifts - Traumatic brain injuries can also cause visual midline shifts. In this case, their perception of  the center is actually offset to the right or to the left. As they walk, these patients will lean sideways or veer to the right or left or they may need to hold on to the side of the wall in order to stay upright. One indication of a visual midline shift is a change in posture after a traumatic brain injury.

How are vision problems caused by traumatic brain injuries treated?

In the case of horizontal or vertical double vision, prisms are used in the glasses. In order to treat visual midline shifts, yoked prisms may be used. These prisms shift the whole world off the other way which changes the sense of center and helps them walk more upright. The usage of tinted glasses has become very common among light sensitive people. Vision therapy is done to try to rehabilitate the visual skills that are lost as a result of brain injury. Usually, a combination of these treatments is done to achieve the best results.