December 8, 2015

Post Trauma Vision Syndrome

Following a neurological event such as a traumatic brain injury, concussion, cerebrovascular accident, multiple sclerosis, cerebral palsy, etc., it has been noted by clinicians that persons frequently will report visual problems such as seeing objects appearing to move that are known to be stationary; seeing words in print run together; and experiencing intermittent blurring.

More interesting symptoms are sometimes reported, such as attempting to walk on a floor that appears tilted and having significant difficulties with balance and spatial orientation when in crowded moving environments.

The visual process is part of a sensorimotor feedback loop, which includes kinesthetic, proprioceptive and vestibular processes. Insults to the cortex produced by an acquired brain injury or stroke cause stress or interference in the central and autonomic nervous systems. As a result, a brain-injured person may experience diplopia, binocular dysfunction, or concentration difficulties. In the past, these symptoms were diagnosed as individual eye problems or muscle imbalances.  We now know that these eye problems and other reported difficulties that result from a brain injury often occur because of the interference in the visual process. This, in turn, will cause sensorimotor spatial disorganization. The resulting binocular problems are characteristic of Post Trauma Vision Syndrome.

The Post Trauma Vision Syndrome is a disruption of the visual process, causing eye problems like difficulty with accommodative function, binocular fusion, and fixation ability. MRI findings are usually negative in post trauma vision syndrome. The injuries suffered are most often diffuse and are caused by shearing and stretching of the brain fibers, as well as the neurotoxic cascade induced by the injury.

Symptoms of Post Trauma Vision Syndrome:

  • Double vision
  • Headaches
  • Blurred vision
  • Dizziness or nausea
  • Light sensitivity
  • Attention or concentration difficulties
  • Staring behavior (low blink rate)
  • Spatial disorientation
  • Losing place when reading
  • Can’t find beginning of next line when reading
  • Comprehension problems when reading
  • Visual memory problems
  • Pulls away from objects when they are brought close to them
  • Exotropia or high exophoria
  • Accommodative insufficiency
  • Convergence insufficiency
  • Poor fixations and pursuits
  • Unstable peripheral vision
  • Associated neuromotor difficulties with balance, coordination and posture
  • Perceived movement of stationary objects