Mild TBI and Post Concussion Syndrome

A patient with mild TBI is one who has sustained traumatically induced physiological disruption of brain function as manifested by at least one of the following:

  • Any period of loss of consciousness
  • Any loss of memory for events immediately before or after the accident.
  • Any alteration in mental state at the time of the accident (e.g., feeling dazed, disoriented, or confused).

And where the severity of the injury does not exceed the following:

  • Loss of consciousness of approximately 30 min or less;
  • After 30 min an initial Glasgow Coma Scale (GCS) of 13–15;
  • Post-traumatic amnesia (PTA) not greater than 24h

Symptoms may include:

  • Persistent low-grade headache
  • Light headedness
  • Poor concentration / attention
  • Memory dysfunction
  • Easy fatigability
  • Irritability (low frustration tolerance)
  • Intolerance to light and sound
  • Anxiety / depression / mood imbalance
  • Sleep disturbance

80-90% of people who experience an mTBI will recover spontaneously. The time frame according to the Berlin Guidelines is 2 weeks for adults and 4 weeks for children.
The remaining 10-20% have post-concussion syndrome.

Post-concussion syndrome can have a significant impact on daily living. Patients may experience:

  • Balance issue
  • Fear of large spaces
  • Inability to drive
  • Disorientation in crowded environments
  • Sound and light sensitivity
  • Fatigue with computer use, reading and/or comprehension
  • A change in speed of reading and conversation

How can Optometry help?

Oculomotor Dysfunction is the brain’s inability to coordinate the eyes to move with accuracy and control. It is considered an objective biomarker of brain dysfunction in concussion. 9 out of 10 people with a concussion or other traumatic brain injury will have associated vision or oculomotor problems. For many with post-concussion symptoms, all they want to do is close their eyes.

Treatment is achieved by improving their oculomotor skills through lenses, filters and Neuro Optometric Vision Therapy. Such Vision Therapy is an interactive process that involves conscious attention and provides immediate feedback thereby stimulating new behaviour patterns in the brain.