A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.

Concussions Are Serious

Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious.

Children and teens who show or report one or more of the signs and symptoms listed below, or simply say they just “don’t feel right” after a bump, blow, or jolt to the head or body, may have a concussion or more serious brain injury.

Concussion Signs Observed

Can’t recall events prior to or after a hit or fall.
Appears dazed or stunned.
Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent.
Moves clumsily.
Answers questions slowly.
Loses consciousness (even briefly).
Shows mood, behavior, or personality changes.

Signs and symptoms generally show up soon after the injury. However, you may not know how serious the injury is at first and some symptoms may not show up for hours or days. For example, in the first few minutes your child or teen might be a little confused or a bit dazed, but an hour later your child might not be able to remember how he or she got hurt.

Dangerous Signs & Symptoms of a Concussion

One pupil larger than the other.
Drowsiness or inability to wake up.
A headache that gets worse and does not go away.
Slurred speech, weakness, numbness, or decreased coordination.
Repeated vomiting or nausea, convulsions or seizures (shaking or twitching).
Unusual behavior, increased confusion, restlessness, or agitation.
Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously.

There’s no specific cure for concussion. Rest and restricting activities allow the brain to recover. This means that one should temporarily reduce time spent on sports, video games, TV or too much socialising. Medication for headache pain or ondansetron or other anti-nausea medication can be used for symptoms.

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Common Post-Concussion Symptoms

Symptoms may vary among individuals post-concussion, but some typical symptoms include:

Dizziness
Nausea
Difficulty with balance, coordination
Difficulty reading
Difficulty focusing
Sensitivity to light
Poor depth perception
Headaches/migraines
Double vision

Unless treated effectively, vision problems associated with brain injuries can be disabling and lead to serious consequences, including additional concussions, especially while playing sports. Common vision problems that may occur following brain injury include:

Eye focusing – Your vision may become blurred or the ability to shift focus between objects between near and far distances may be imperiled.
Eye teaming – Your eyes may not work together as a team, causing double vision.
Eye movements – While reading or trying to follow a moving object you may experience difficulty with eye movements. A common complaint is losing your place while reading.
Motion sensitivity – It may be difficult to process motion properly due to a disruption between the visual and balance systems. Symptoms can include motion sickness, disorientation, and even dizziness when scrolling on a computer screen or phone, or when in busy environments such as grocery stores, malls, or stadiums.

Balance is achieved and maintained by a complex set of sensorimotor systems that include the vision (sight), proprioception (touch), and the vestibular system. When any of these systems are not functioning properly you can experience motion sensitivity symptoms.

Vision problems that occur after a concussion can range from subtle to dramatic.

How Can Neuro-Optometric Rehabilitation Help?

Since every injury is unique, treatments will vary by individual.

Below are some types of treatments:

Vision Therapy – This is a customized program that improves the communication between your eyes, brain, and body. The training focuses on improving visual skills such as depth perception, hand-eye coordination, eye tracking, focusing, and peripheral vision.
Specific Prescription Lenses (Glasses) – These lenses help compensate for the damage done to the neural system along with enhancing visual clarity and comfort. Lens filters provide help with glare and light sensitivity.
Prism Lenses – These specialized glasses change the way light enters the eye. Prisms are frequently prescribed as part of vision therapy for binocular vision problems to eliminate double vision. In addition, prisms are often used to treat poor balance, which is a common symptom post-concussion.
Patching – Placing a patch on one eye or part of the visual field of one eye helps eliminate double vision. The patch is often placed directly upon the surface of the lens.

What happens after a sports-related concussion?

Sports-related concussions often result in mental and physical symptoms (e.g., inability to concentrate, forgetfulness, headache, fatigue, dizziness). For many athletes, the symptoms disappear after about 10 days, and they typically do not last more than several months. In some cases though, concussions lead to persistent complaints of physical, mental, emotional, and behavioral symptoms, sometimes referred to as post-concussion syndrome. We do not know whether persistent post- concussive symptoms result from primarily medical or psychological causes. In rare cases, when repeated concussions occur over a brief interval, athletes may suffer from second impact syndrome, a pathological response of the brain that can be life-threatening if not treated promptly. Parents should seek careful evaluation and management of any sports-related concussion.

How should a sports-related concussion be evaluated?

Concussions are typically managed according to their severity. Immediately after a concussion, medical evaluation is needed to determine a child’s vital signs, level of consciousness, and to rule out any other injuries, such as those to the spine. Recent guidelines indicate that any child who loses consciousness as a result of trauma during a sporting event should be evaluated by a hospital emergency department immediately. In cases of less severe concussion, athletes are typically evaluated on site rather than in hospital emergency departments. There are a variety of approaches to the “sideline” concussion assessment. Guidelines are also available to assist in deciding when a child is ready to return to play after a concussion.