Vision therapy reverses concussion-related double and blurred vision
Vision therapy helped nearly 90 per cent of young concussion patients see normally after 12 weeks, compared with under 10 per cent who only monitored their symptoms in a recent study.
The study enrolled 106 patients aged 11 to 25 with one or more concussions and persistent symptoms lasting one to six months after their most recent injury.
The research team tested patients’ vision, assessed their ability to perform daily tasks such as reading, and collected eye movement data to measure how quickly and accurately they tracked moving targets on computer screens.
Through fMRI imaging, they measured changes in blood oxygen levels in different brain regions to determine how much energy was produced, an indicator of eye performance such as speed.
The team also measured how consistently neurons in eye-functioning regions fired, whether nearby cells were recruited to help, and whether connections between neurons improved.
Tara Alvarez is a distinguished professor of biomedical engineering at NJIT.
The researcher said: “These conditions make it hard to read books, work on a computer or even use a smartphone, and the impact on cognition and learning can be severe.
“They also delay the return to sports, work and driving for young people.”
The conditions treated included convergence insufficiency (CI), where the eyes fail to coordinate when focusing on near objects, causing double vision, and accommodation insufficiency (AI), which makes nearby objects appear blurred.
After 12 weeks of therapy involving exercises to strengthen and coordinate eye muscles, nearly 90 per cent of treated patients were able to see normally.
A small number required an extra four weeks of therapy to improve sufficiently.
Mitchell Scheiman is senior associate dean of research at the Pennsylvania College of Optometry at Drexel University, and the study’s lead optometrist.
She said: “A practical conclusion is that someone with a concussion-related vision issue really shouldn’t delay starting therapy if symptoms disrupt daily activities.
“People who have concussions and haven’t recovered are struggling with their lives.
“At first glance, six weeks might seem like a short time, but if you have a concussion, six weeks is a long time.”
The team also found that treatments already used for non-concussed patients worked just as well for those with head injuries.
Participants were under the care of sports medicine physicians Christina Master with the Minds Matter Concussion Program at Children’s Hospital of Philadelphia, and Arlene Goodman with the Somerset Paediatric Group.
“Eye problems are the biggest issue in the majority of patients who have persistent symptoms after a concussion,” Goodman said.
She noted that the majority of her concussion patients have convergence insufficiency.
Some recover within three weeks, but many still have symptoms a month later. T
hey are usually referred first to physical therapy, and if that fails, they move on to vision therapy.
“There are few providers who offer this type of therapy, and it’s not covered by insurance. Some patients can’t afford to pay for it and therefore are left with persistent headaches and eye problems,” she said.
Master added: “As someone who treats patients with concussion and often am consulted for second or third opinions, what I have found both clinically and in my research is that vision deficits after concussion are often missed.
“The American Academy of Pediatrics and the international Concussion in Sport Group recommend screening for vision disorders after concussion and the results of this study now provide very strong, high-quality evidence for recommending treatment with rehabilitation of the vision system to address these deficits.”
She continued: “I am very optimistic that the results of the study will inform standardised treatment protocols for concussion-related CI and prompt third party reimbursement for this treatment, which would improve the quality of life for millions of people suffering from this disorder.”
