Vision Problems Following Brain Injury

Tight shot of a woman's eye.

Out of all of our senses — seeing, hearing, smelling, tasting, feeling — vision is our most dominant sense. Researchers estimate that 80-85 percent of our perception, learning, and cognition are mediated through our eyes. So dealing with vision issues after a brain injury can be challenging.

Common forms of vision problems

In general, 20-40 percent of people with traumatic brain injury (TBI) experience related vision disorders. Some vision-related issues can be permanent; others resolve quickly. This depends on the individual and his unique brain injury.

Vision can be broken down into the following general categories:

  • Visual motor abilities, including alignment, refer to “eye posture” — meaning the direction in which the eyes point. For example, if the eyes are straight and aligned, the eye posture is normal.
  • Visual perception is the ability to interpret information and surroundings from visible light reaching the eye.
  • Visual acuity refers to clarity of sight.
  • Visual field is the complete central and peripheral range, or panorama of vision; picture a pie as your visual field. Here are the common types of visual field loss:
    • hemianopsia
    • quadranopsia
    • homonymous hemianopsia
    • bitemporal hemianopsia

What happens with change or loss of vision?

When we can’t see clearly or have lost part of our field of vision, everyday tasks can become more challenging, some even impossible.You might have trouble with reading, driving, dealing with bright lights, or doing activities that involve hand-eye coordination. In many cases, there are tools and strategies that can help.

Techniques and compensatory strategies

In rehab, there are various techniques and strategies to help people with vision problems after TBI. They can include:

  • Wearing prescription glasses
  • Using magnification
  • Implementing better or varying lighting for different environments
  • Using assistive technologies to help make reading and using a computer easier
  • Learning to use scanning and head turning
  • Re-teaching the eyes to move and look into missing areas in the vision field

Getting the right professional help

Someone with vision problems after a TBI should find a top-notch ophthalmologist or neurologist who can administer a comprehensive vision exam. From there, the ophthalmologist may suggest the patient work with an interdisciplinary rehabilitation team to integrate all the necessary treatments for optimal recovery.

Having vision problems after a TBI can definitely interfere with a person’s quality of life, but it doesn’t have to be that way. Vision expert Dr. Gregory Goodrich advises, “Even if your symptoms don’t seem that serious, try to find an optometrist or ophthalmologist who has experience working with people with TBI. And keep persisting until you get the help you need.”

Posted on BrainLine June 21, 2017.

Comments (11)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

Is it possible TBI can cause someone to see and hear things that are not real?

I visited a neuropthamologist that assisted my recovery.

I experienced occillascopia (spinning eyeballs). After twenty years it healed.

Sadly, in Alberta, the ophthalmologists don’t seem to have the ability to recognize the brain part of vision. As long as eye health and optical nerve are in good shape then “you should be fine”.

Same thing in Ontario. So frustrating. I finally found help with a chiropractor who does functional neurology - anti-inflammatory AIP eating plan and brain-based exercises. He created a personalized plan for me and I experienced a significant improvement in my "eye tracking."

And my vision is going

I lost my sense of smell about 4 years before my doctor retired and a new dr took over his practice. She sent me for a cat scan after I mentioned I have no smell. Well just days later got called in to see her and found out I have had a stroke ad or a brain tumor. Went for MRI and was called in to a neurologist who said we need to do surgery for tumor. Well after surgery was told it's terminal and have 5 is years from time tumors started to grow. Feb 24 2016. Last March I was told by oncologist I was gonna live. No smell still and sad and scared. My marriage of 28+ years is over and my family seems upset with me. Praying.


I lost my sense of taste and sense of smell after brain injury.

Sense of taste returned 21years after injury.

Sense of smell returned after, but not sticking yet.

and at first it was all wonky. milk would smell like blueberries.

some days it work well now, but other days sense of smell still doesn't work at all.

hope you recover your sense of smell soon and complete and accurately

There is so much information missing from this page. After sustaining a severe concussion a year ago, I have been diagnosed with post concussion vision syndrome which is so much more complicated than what is described above. A visit to a neuro optometrist at least is suggested. It is so much more complicated than just acuity!!!!

Not all Optometrist, Neurologists or Neuro-Ophthalmologists are familiar with how post concussion syndrome can effect the visual system.