Connecting visual symptoms and concussion

November 27, 2023


By Dayne Hopkins

With concussions occurring in around four million people every year, it’s no surprise that the types of symptoms experienced vary from patient to patient. Given that a significant portion of the brain’s connections is associated with eye control and vision, individuals affected by concussions often report symptoms such as blurred vision, dizziness, asthenopia, and reading difficulties. The Concussion Center was joined this semester by Dr. Meagan J Tucker from the Kellogg Eye Center and Wendy Carendar from Otolaryngology and NeuroSport for presentations and discussions on binocular vision dysfunction and vestibular physical therapy for athletes following concussion.

Dr. Tucker discussed the diverse visual impairments that concussion patients may encounter, including vergence dysfunction, accommodative dysfunction, photophobia, visual vertigo, and the frequency with which many of these impairments show up. Several evaluative measures can be used to diagnose symptoms including cover tests, where one of the eyes is covered up to assess alignment; red lens testing, which can help diagnose diplopia (seeing double); and midline shift testing, where the horizontal and vertical midline is evaluated. Early diagnosis of these symptoms post-injury is crucial for developing effective treatment plans and achieving positive patient outcomes.

Carendar discussed various post-concussion symptoms such as peripheral vestibular impairments and oculomotor abnormalities, which showed up in 82% of patients with a mean age of 20.5 (Gallaway et al, 2016). She went on to address the question of whether earlier vestibular therapy after a sport-related concussion leads to a faster recovery. The finding discussed (Ahluwalia 2021), suggests that initiating VRT within the first 30 days following SRC is associated with earlier RTP (31 days vs 110 days).

Both, Wendy and Dr. Tucker ended their presentations by reviewing some of the treatment and rehab options that patients may be recommended, depending on their specific needs. For example, if a patient experiences vergence dysfunction, barrel cards may help train the eyes to focus back on the same point together. The sessions concluded by opening the floor for questions and discussion over locally sourced hors d’oeuvres. Concussion & Cocktails is a member-only event and provides an exclusive opportunity for U-M clinicians and researchers to connect on current topics and emerging research areas related to concussion treatment and management.