Where Vision Goes Beyond Eyesight

Traumatic Brain Injury

Traumatic Brain Injury (TBI) can come in many different forms. TBI is a form of brain injury caused by sudden damage to the brain. Depending on the source of the trauma, TBIs can be either open or closed head injuries.

  • Open Head Injuries: Also called penetrating Injuries, these injuries occur when an object (a bullet for example) enters the brain and causes damage to specific brain parts. Symptoms vary depending on the part of the brain that is damaged.
  • Closed Head Injuries: These injuries result from a blow to the head (sports injury for example).

Irrespective of the cause of the trauma, TBIs result in two types of damage to the brain: primary brain damage, which is damage that occurs at the time of impact (e.g., skull fracture, bleeding, blood clots), and secondary brain damage, which is damage that evolves over time after the trauma (e.g., increased blood pressure within the skull, seizures, brain swelling).

Causes of TBI:

The Centers for Disease Control and Prevention has identified the leading causes of TBI to be

  • falls
  • motor vehicle and pedestrian-related accidents
  • collision-related (being struck by or against) events
  • violent assaults.

Sport-related injuries and explosive blasts/military combat injuries are other leading causes of TBI. Acquiring a brain injury may predispose an individual to additional brain injuries before the symptoms of the first one have resolved completely.


Dr. Maze has helped many patients through visual rehab necessary after TBI.

TBI can cause many visual symptoms including:

  • double vision
  • blurred vision
  • eye strain and fatigue
  • headaches that intensify with use of the eyes
  • dizziness or nausea
  • difficulty tracking moving objects or loss of place when reading
  • light sensitivity
  • motion sensitivity

The brain contains more neurons supporting the visual system than the rest of the senses combined.



A wide range of visual problems can result from concussion and brain injury. Due to the complexity of the brain networks that control vision can cause a significant amount of symptoms. These symptoms can be present even in cases deemed “mild.”

Fortunately, many visual problems after concussion will resolve with rest and allowing the brain to heal. Vision therapy, also referred to as neuro-optometric rehabilitation can be effective in cases where the visual symptoms persist, even when other symptoms such as dizziness or poor balance have resolved.


Stroke or more significant brain injury can also affect peripheral (side) vision and visual processing ability.


Optometry and Rehabilitation:

Very few in the health care professions, including head trauma rehabilitation centers, are adequately aware of visual problems resulting from Traumatic Brain Injury and the visual-perception consequences. Unfortunately, this creates a gap in rehabilitative services, resulting in incomplete treatment and frustration for the patient, family and treatment team.

The vision care professional can play an important role in the rehabilitation effort. Through vision therapy and the proper use of lenses, a behavioral or developmental optometrist specifically trained to work with Traumatic Brain Injury patients can help improve the flow and processing of information between the eyes and the brain.

Vision therapy can be a very practical and effective. After evaluation, examination and consultation, the optometrist determines how a person processes information after an injury and where that person’s strengths and weaknesses lie. The optometrist then prescribes a treatment regimen incorporating lenses, prisms, low vision aides and specific activities designed to improve control of a person’s visual system and increase vision efficiency. This in turn can help support many other activities in daily living.