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Concussion can cause changes to vision that are sometimes overlooked during an initial medical evaluation. Vision experts stress that eye exams should be part of the diagnosis and treatment of mild traumatic brain injury. (U.S. Air Force photo by Senior Airman Daniel Hughes)

Concussion can cause changes to vision that are sometimes overlooked during an initial medical evaluation. Vision experts stress that eye exams should be part of the diagnosis and treatment of mild traumatic brain injury. (Image courtesy of U.S. Air Force photo/Senior Airman Daniel Hughes)

Concussion can cause changes to vision that are sometimes overlooked during an initial medical evaluation. Vision experts stress that eye exams should be part of the diagnosis and treatment of mild traumatic brain injury (TBI).

“Service members exposed to a blast [exposure] may have brain injury, which may affect eye coordination, even when vision is 20/20,” said Felix Barker, associate director of research for the Vision Center of Excellence in Bethesda, Maryland.

Because a patient’s vision may not be affected at first, and issues such as bumping into objects or having double vision may seem subtle, providers and patients may not realize vision is a problem, he said.

“Undiagnosed, such ‘invisible’ eye problems can interfere with near tasks such as reading, which, in turn, can be confused with TBI issues, such as cognitive dysfunction,” Barker said.

To help eye care providers diagnose and treat eye problems associated with a concussion, the Vision Center of Excellence created a clinical recommendation and support tools for eye problems following a TBI. This clinical tool offers a practical approach to help identify patients with mild TBI who may benefit from further assessment and care. There is also an educational brochure for patients.

Eye Problems Vary with Severity of TBI

Patients with moderate or severe TBI may have more serious vision injuries.

“Persons with a more severe TBI may experience central vision loss or loss of half of their visual field due to direct brain trauma,” he said.

In these cases, treatment may not restore vision back to what it was before the TBI. However, rehabilitation can help patients return to daily activities. Rehab specialists should work with eye care providers to support these individuals.

“Patients with vision impairment and or visual dysfunction usually respond well to adaptive technologies and devices designed to enhance their ability to function in as normal a way as possible,” Barker said.

The Vision Center of Excellence website has information for service members, families and health care providers to help recovery after an eye injury.

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