Concussions & Brain Injuries
You don't need a head injury to have a brain injury.
We have visual brains. More area of the brain is involved in processing vision than all of the other senses COMBINED.
The visual process is neurological. Vision and coordination of binocularity happens in the brain. When there is a closed head trauma the disruptions that affect the neurons and axons in the brain can affect the visual process as seen in Post Trauma Vision Syndrome (PTVS). The neurological conditions manifest in the ocular and visual symptoms.
Common Symptoms of Post Trauma Vision Syndrome include:
visual fatigue and overwhelm
problems with perceived movement and motion
computer vision syndrome
visual field loss
Common Vision Problems After Concussion & Brain Injury
Convergence insufficiency: the brain points the eyes out instead of inward when looking close up. Reduced convergence at near point is a common finding after concussion. It is found to be associated with neurocognitive impairment. It is found to cause visual discomfort which is reflected in a higher convergence insufficiency symptom score. It also causes vision mediated functional difficulties like slowed reading and compromised attention, which can impair work performance.
Oculomotor dysfunction: the brain doesn’t move the eyes smoothly or accurately when looking around or when reading. This can be a saccadic dysfunction which is a breakdown in the brain’s ability to control the eyes to make a saccadic eye movement from one place to another. This can also be a pursuit dysfunction where the brain loses the ability to make a smooth eye movement to follow an object as it moves.
Vergence dysfunction: the brain doesn’t coordinate the eyes together properly when moving between far and close range. This happens when the brain doesn’t move the eye muscles freely inward and outward to reposition the eyes to look at different distances. Vision can appear blurred and double at varied times, making it difficult to read or focus.
Accommodative dysfunction: the brain doesn’t focus vision clearly when looking close or when shifting between far and close. This can cause near or far vision to blur in and out and can take a prolonged time for vision to focus.
Visual midline shift: perceived vertical midline position is misaligned with the physical midline position of the body, resulting in Vertical Midline Shift Syndrome – VMSS. This indicates a mismatch and lack of communication between central and peripheral processing systems. Visual midline can be shifted left or right, up or down. When shifted, it can cause a person to posture their body weight to either side, front or back. The common symptoms of VMSS frequently include diplopia (double vision), perceived movement of print or stationary objects, headaches, and photophobia (light sensitivity). It can also affect balance and walking.
Ambient visual disturbance; Central/peripheral processing dysfunction: the brain is not using information from centre and side vision together. The central visual system, also known as the focal system, is processed in the ventral processing stream of the brain. The peripheral system, also known as the ambient system, is processed in the dorsal processing stream of the brain. Many of the binocular vision problems following a concussion are caused by a dysfunction in the ambient visual process – which is part of the neural sensorimotor feedback loop – rather than an oculomotor disturbance. Cortical binocular integration is influenced by dysfunction in ambient visual process.
Visual perception dysfunction: the brain is not interpreting visual information accurately. This happens when the brain is not making sense of the signals from the visual system. This can result in confusion and not understanding the world properly.
We assess and prescribe a treatment plan for rehabilitation for those
with any history of head trauma, whiplash, concussion, acquired
and traumatic brain injury of any severity, and stroke.
Our Concussion & Brain Injury Evaluation
There are 2 parts to this Evaluation:
1. Visual Perception Testing and Doctor Visual Skill Exam
this includes testing one on one with a therapist to determine deficiencies in understanding and interpreting visual information
the doctor will evaluate over a dozen areas of visual function and determine the source of vision related symptoms that are diagnostic for Post Trauma Vision Syndrome
This appointment is 2 hours.
2. Doctor Treatment Plan Assessment
the doctor will finalize the prescription for treatment, including therapeutic glasses and /or neurovision therapy.
This appointment is 2 hours.
Following your evaluation...
a full medicolegal report is provided for any school, work, or insurance purposes
we provide a detailed return to work or return to learn plan
we advise your school or employer as to necessary accommodations for your recovery
if you are a student in school we can arrange a meeting at your school with your educators and our therapist to review your case and accommodations
Please contact us for more information or to book your evaluation.
This evaluation can also be completed through virtual telemedicine, in the comfort of your own home, from anywhere in Ontario. Learn more here.
We work with insurance to get your evaluation covered.
If your injury is a result of an automotive or workplace accident, and you have a current claim, we work alongside Health Claims for Auto Insurance (HCAI) and the Workplace Safety and Insurance Board (WSIB) to get your assessment, eyewear, and therapy fees covered by your insurance claim.
A formal referral by another health care professional is not required, but helpful. Please contact us for more information and to get a treatment plan started.