We had the opportunity to ask Dr. Steve Jacobs about one of his specialties- Traumatic Brain Injury (also know as TBI) and Concussions.
Not many people know how important a role you local eye doctor can have in helping you recover from a head injury. This is the first of a 2 part series.
Q. – What’s the difference between a concussion and a traumatic brain injury (TBI)?
A. – A concussion is a type of TBI, particularly a type of mild TBI (mTBI), as opposed to a more dramatic injury, such as involving a skull fracture or extended loss of consciousness. Concussions are frequently, but not necessarily caused by direct impact to the head. From the Latin “concuss”, to shake violently, they result from the brain “bouncing” against the inside of the skull. This can damage the area directly involved, as well as the area on the opposite side as the brain rebounds from the initial impact (called coup-contrecoup injury). Additionally, parts of the brain may twist, causing shearing damage to nerve connections. Although considered “mild”, there is often nothing mild about them.
Q. - How does a concussion affect the eyes if the eyes aren’t actually hit?
A. - The visual system is very complex. Beyond the millions of nerves in the eyes themselves, many millions more are involved in getting information from the eyes to the brain, in keeping the eyes working together, and in allowing visual information to be coordinated with that from other senses. When pathways are disrupted, what had seemed very simple, like reading this paragraph, can become an unpleasant and difficult task.
Q.- What are some of the visual symptoms of a concussion?
A. - large majority of people who suffer a concussion will experience at least some visual symptoms. This makes sense since more of the brain is devoted to processing visual information than all the other senses combined. Common symptoms include blurred vision, especially when shifting from one object to another, feelings of strain with reading or computer work, and increased light sensitivity. Other symptoms (to name only a few) include double vision, the sensation of print jumping around when reading, and feeling overwhelmed in visually busy environments.
Q. – What can be done to help visual system recovery after a concussion?
A. – If visual issues are present, a comprehensive visual system examination is necessary to determine if the causes are structural, functional or both. Structural damage, such as a corneal abrasion, retinal tear, orbital fracture, etc… should be addressed ASAP. Once the eyes are physically healthy, various lenses, prisms and visual therapy can improve comfort and efficiency and allow the individual to better benefit from all other types of therapy. Concussions disrupt coordination within and between senses, so even mild prescriptions can often make a big difference. Also, as the eyes, brain and body are intertwined, what helps one helps the others. This is especially true regarding nutrition, hydration and well controlled exercise.
Q. - How can I tell if I (or my child) has had a concussion?
A. – Sometimes it’s obvious, for instance if there is a brief loss of consciousness and headache, confusion, etc… Hopefully, in such a situation, the incident will be noticed and referral for medical care will be available quickly (such as during a sporting event or at an accident scene). In less clear-cut episodes, the best way to tell is through timely assessment by a professional specifically knowledgeable regarding TBIs. This will evaluate subjective symptoms, mental alertness/memory, basic neurological status, and balance. There is no single, definitive test, but taken together these measures produce a high likelihood that a concussion has, or has not, occurred.
Part 2 of the Q&A will be posted in a few weeks. If you have any questions about TBI and how Dr. Jacobs- your local eye doctor in Blacksburg- can help you please click here to see more information on Traumatic Brain Injuries.