Acquired Brain Injury (ABI) and Vision 

How are the brain and eyes linked? 

A concussion or traumatic brain injury is when a blow or jolt to the head happens and causes damage to the neural pathways. A non-traumatic brain injury is when damage results to the brain by an internal force. Diffuse axonal injury and release of neurotoxins from a brain injury may lead to many visual and nonvisual symptoms. There are so many connections in the brain related to vision. Any damage to the brain often results in difficulty with visual pathways such as eye teaming, tracking, and focusing. 

Examples of Traumatic Acquired Brain Injury (ABI): 

  • Sports-related concussion

  • Falls

  • Motor Vehicle Accidents 

Examples of Non-Traumatic Acquired Brain Injury (ABI): 

  • Stroke

  • Aneurysm

  • Infectious Disease (ex, COVID-19)

  • Tumor  

Common Visual Symptoms after ABI: 

  1. Blur

  2. Double Vision

  3. Skipping lines while reading 

  4. Light sensitivity

  5. Visual memory difficulties 

  6. Visual Field Deficits

  7. Visual overwhelm (“Grocery store syndrome”)

  8. Difficulty with depth perception (especially while driving)

Helpful Stats:

  1. According to the CDC, at least 1.5 million people in the United States sustain a “mild” traumatic brain injury (mTBI) each year. 

  2. Approximately 300,000 sports related injuries occur each year at the high school level alone (IMPACT). 

  3. About 15% or more of people with a single concussion will experience visual symptoms. 

  4. Having one concussion can make you more likely to have another concussion in the future. 

If you or a family member is concerned about visual changes related to a concussion or brain injury, you can fill out the BIVSS (Brain Injury Visual Symptom Survey) below. If you score a 31 or higher, a neuro-optometric evaluation is recommended. 

Additional Resources: 

  • Article Dr. Lettrick co-authored on concussion and vision: http://pubs.covd.org/VDR/issue10-3/?page=17

  • “About Mild TBI and Concussion.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/traumatic-brain-injury/about/index.html. Accessed 11 Dec. 2024

  • Ciuffreda, Kenneth J, and Preethi Thiagarajan. “Objectively-based vergence and accommodative dynamics in mild traumatic brain injury (mTBI): A mini review.” Vision research vol. 191 (2022): 107967. doi:10.1016/j.visres.2021.107967

  • Schatz, Philip et al. “Sensitivity and specificity of the ImPACT Test Battery for concussion in athletes.” Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists vol. 21,1 (2006): 91-9. doi:10.1016/j.acn.2005.08.001

  • Scheiman MM, Talasan H, Mitchell GL, Alvarez TL. Objective Assessment of Vergence after Treatment of Concussion-Related CI: A Pilot Study. Optom Vis Sci. 2017 Jan;94(1):74-88. doi: 10.1097/OPX.0000000000000936. PMID: 27464574; PMCID: PMC5182092.

  • Tannen, Barry & John, Jamie & Ciuffreda, Kenneth & Shelley-Tremblay, John. (2021). Assessment of Three Clinical Tests for Evaluation of Concussion/Mild Traumatic Brain Injury. Vision Development & Rehabilitation. 10.31707/VDR2021.7.1.p43.

  • Tannen, Barry & Tannen, Noah & Ciuffreda, Kenneth. (2018). Neuro-optometric rehabilitation of a post-concussion patient. https://cdn.ymaws.com/www.covd.org/resource/resmgr/vdr/vdr_2_4/vdr2-4_article_tannen_doi.pdf