Blurred Vision and Eye Pain After Concussion: the Impact

After a concussion, symptoms such as blurred vision, eye pain, and astigmatism may occur?

Hello: In January of this year, I was involved in a car accident where the back of my head hit the ground.
After a while, I experienced a workplace accident that caused a concussion from a blow to the top of my head.
The neurosurgeon advised me to watch for any double vision, but at that time, I had astigmatism and couldn't distinguish between the double vision and my existing astigmatism.
A few days later, I felt pain and blurriness in my left eye, so I went to see an ophthalmologist.
The ophthalmologist said my optic nerve appeared normal and conducted a vision test (using a phoropter), which showed a result of two to three hundred degrees of astigmatism.
I previously only had over one hundred degrees of astigmatism! Could the double vision caused by the concussion be due to damage to the optic nerve? My ophthalmologist said my optic nerve is normal, so should I completely rule out the effects of the concussion regarding the blurriness, pain, and double vision in my left eye? Thank you for your guidance!

Xiao Hua, 40~49 year old female. Ask Date: 2016/02/05

Dr. Zhang Junwei reply Neurosurgery

It's difficult to provide an answer online; I recommend scheduling an outpatient appointment!

Reply Date: 2016/02/05

More Info

Hello! Thank you for your question regarding the blurred vision and eye pain you are experiencing after your concussions. It’s understandable to be concerned about these symptoms, especially after experiencing head trauma.

First, let’s clarify the potential effects of a concussion on vision. A concussion can lead to various visual disturbances, including blurred vision, double vision (diplopia), and difficulty focusing. These symptoms can arise from several factors, including the impact on the brain's visual processing centers, changes in eye muscle coordination, or even increased sensitivity to light. In your case, since you have a history of astigmatism, it can be challenging to differentiate between the effects of your existing condition and any new symptoms resulting from the concussion.

You mentioned that your eye doctor assessed your optic nerve and found it to be normal, which is a positive sign. This suggests that there is no significant damage to the optic nerve itself, which is crucial for transmitting visual information from the eye to the brain. However, normal optic nerve function does not entirely rule out the possibility of other visual disturbances caused by the concussion.

The increase in your astigmatism from a little over 100 degrees to around 200-300 degrees could be related to several factors. It’s possible that the trauma has temporarily altered the shape of your cornea or the way your eye focuses light. Additionally, stress and strain on your visual system due to pain or discomfort can exacerbate existing refractive errors.

Regarding your question about whether the blurred vision and eye pain could be entirely unrelated to the concussion, it’s essential to consider that while your optic nerve appears normal, the brain's processing of visual information can still be affected by the concussion. Symptoms like eye pain and blurred vision can also be attributed to other conditions, such as dry eye syndrome, muscle strain from overuse, or even tension headaches, which are common after head injuries.

To manage your symptoms, here are some recommendations:
1. Rest Your Eyes: Ensure you take regular breaks from screens and close-up work. The 20-20-20 rule is helpful: every 20 minutes, look at something 20 feet away for at least 20 seconds.

2. Consult with Specialists: If your symptoms persist, consider seeing a neuro-ophthalmologist, who specializes in vision problems related to the nervous system. They can provide a more comprehensive evaluation of your visual function post-concussion.

3. Vision Therapy: Depending on the assessment, vision therapy may help improve coordination and processing of visual information, especially if you are experiencing double vision.

4. Manage Pain: Over-the-counter pain relief may help with discomfort, but consult your doctor before taking any medication.

5. Follow-Up: Keep regular follow-up appointments with your eye doctor and neurologist to monitor your symptoms and adjust your treatment plan as necessary.

In conclusion, while your optic nerve appears normal, the effects of a concussion can still lead to visual disturbances. It’s essential to continue monitoring your symptoms and seek further evaluation if they do not improve. Your health and well-being are paramount, so do not hesitate to reach out for help as needed. Thank you for your question, and I hope you find relief soon!

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