By: Dr. Christina L. Master, MD, FAAP, CAQSM, FACSM, FAMSSM
Concussions are a type of injury that happens when a jolt to the head causes nerve cells in the brain to stretch. These injuries send more than a million U.S. children to emergency departments or doctor's offices each year. It is important to recognize the symptoms of concussion in order to seek prompt medical care, which can improve recovery.
You may be aware of common concussion symptoms such as headaches, dizziness and balance issues. However, many parents don't realize that vision problems are also common after concussion. In fact, the majority of children with concussion will experience vision-related symptoms. Here's what to watch for and how to help your child get needed care and accommodations as they recover.
What kinds of vision symptoms can occur after concussion?
Vision issues children may experience after concussion include:
Considering how much reading and other visual activities take place at school, these symptoms can have a big effect on a child's return to learning. Recognizing vision problems after a concussion is an important first step in tailoring school accommodations to support your child's return to learning.
How are vision problems identified after concussion?
The doctor will ask specific questions about vision issues your child may be having and perform a physical exam that evaluates their eye movements. They may move their finger to have your child track a moving object or have them look back and forth between visual targets to see if it provokes concussion symptoms like headache, dizziness or eye fatigue. The doctor may also have your child move their head while trying to focus on a stationary target, since vision problems can be related to difficulty with motion sensitivity. Lastly, they may have your child focus on a visual target moving from far to near, with both eyes and with each eye individually.
How do we manage visual problems at school after concussion?
Early identification of vision issues after concussion makes it easier to tailor school accommodations. When returning back to the school setting, your child may need temporary supports such as:
regular visual breaks to prevent visual fatigue
larger font size when reading to help with difficulty focusing at near distance
preprinted notes to temporarily limit the need to repeatedly adjust focus from far to near and back again
preferred seating to make it easier to see what the teacher shows during lessons
How long do vision problems last after a concussion?
Most vision problems after a concussion resolve on their own within a few weeks. However, some kids may continue to have vision issues beyond a month. In these cases, referral to a specialist with experience managing patients with concussion-related vision disorders can help. Health care professionals who specialize in concussion-related vision problems vary by location but may include sports medicine doctors, ophthalmologists, rehabilitation specialists or even otorhinolaryngologists (ear, nose and throat specialists), since vision problems can be associated with vestibular (inner ear canal) problems, such as balance or motion sensitivity.
If you think your child may have a concussion, be sure to talk with your child's pediatrician about vision issues and how to address them after injury at your visit.
About Dr. Master
Christina L. Master, MD, FAAP, CAQSM, FACSM, FAMSSM is a pediatric sports medicine specialist and a general pediatrician at the Children’s Hospital of Philadelphia and is a Professor of Clinical Pediatrics at the University of Pennsylvania Perelman School of Medicine. She has almost 30 years of clinical experience and conducts translational clinical research in pediatric concussion. She is a Fellow of the American Academy of Pediatrics and is an active member of the AAP’s Committee on Sports Medicine and Fitness and School Health Committee. She is also a member of the Pennsylvania Chapter of the American Academy of Pediatrics and is Co-Chair of the PA AAP School Health Committee.