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Neuro Optometry

Can Your Vision Change After a Concussion?

women rubbing her head from neuro vision problemsIf you’ve hit your head in a fall while playing sports or in any other type of accident, your vision may have been impacted.

Between 69% and 82% of people who’ve experienced concussions report visual problems, such as eyestrain and double or blurred vision.

Head trauma causes the brain to move within the skull. The movement can stretch the fragile cranial nerves and can even damage brain cells. Since vision relies on efficient communication between the eyes and the brain, a concussion can disrupt these neural pathways, affecting your vision.

The resulting condition is called post-trauma vision syndrome (PTVS).

How Does a Concussion Affect Vision?

Our vision depends on our brain’s ability to accurately receive and interpret the images sent by our eyes. Therefore, anything that impacts the brain can severely affect our ability to see clearly. When we suffer head injuries caused by a traffic accident or a serious fall, the resulting head injury can impact the communication between our eyes and brain.

Although your eyes may be healthy, your vision may be blurred, or you might start seeing double or experience eye strain due to post-trauma vision syndrome.

What Is Post Trauma Vision Syndrome?

Post-trauma vision syndrome refers to a number of visual problems that tend to occur following a severe head injury. If you have PTVS, you may have trouble with:

  • Focusing – changing focus from close to far or keeping your vision clear
  • Eye teaming or binocular vision – your eyes’ ability to coordinate
  • Depth perception – judging distance or the relationship of one object to another
  • Eye-tracking – visually following an object or text on a screen or page
  • Peripheral vision – seeing things from the side of the eyes
  • Eye alignment – the eyes aren’t aligned correctly or point in different directions

Any one of these visual problems can negatively affect your ability to perform day-to-day tasks and significantly lower your quality of life. Driving, reading, watching TV, participating in sports, enjoying hobbies and even socializing can become difficult.

Why You Need a Neuro-Optometrist

A neuro-optometrist is trained to diagnose and treat visual problems related to the nervous system caused by head injuries, strokes and neurological diseases. After assessing your visual system for any aberrations, your neuro-optometrist will prescribe a customized treatment plan to strengthen your visual system and improve your quality of life.

What Treatments Improve Vision Following a Concussion?

A neuro-optometrist may prescribe any of the following to relieve symptoms after a concussion and help you see and feel better:

  • Prescription lenses – especially for blurry vision
  • Prism lenses
  • Syntonic phototherapy – the use of light to create balance in the autonomous nervous system and restore vision
  • Neuro-optometric therapy – a customized eye exercise program designed to rehabilitate your visual skills

How Long Do Visual Problems Last After a Concussion?

Typically, visual problems caused by a concussion don’t become noticeable for some time. Symptoms of visual problems can appear or remain for weeks, months or even years after the original incident. Any person who has had a concussion should be assessed by a neuro-optometrist, even if they’re not experiencing any obvious visual problems.

If you’re still experiencing any visual symptoms of post-traumatic vision syndrome, even weeks or months after your head injury, it’s essential to see a neuro-optometrist for diagnosis and treatment. If this is your case, we invite you to schedule your appointment with Dr. Radhika Chawla at today.

Our practice serves patients from Richmond Hill, Markham, North York, and Vaughn, Ontario and surrounding communities.

Frequently Asked Questions with Dr. Radhika Chawla

Q: Can a concussion permanently change your vision?

  • A: In some cases, a concussion can permanently impact your vision, especially if your visual system or optic nerve has been damaged. The good news is that most visual problems caused by a head injury respond well to neuro-optometric rehabilitation therapy.

Q: Why can it take time for concussion-related vision problems to be diagnosed?

  • A: Diagnosis can depend on several factors. If someone has been in a serious accident, their physicians are focused on life-threatening injuries. As a result, all but the most obvious visual symptoms, such as vision loss, may be missed. In other cases, the signs of PTVS can be very subtle and undetectable in a routine eye exam. That’s why anyone who has experienced a concussion should have their vision thoroughly examined by a neuro-optometrist.

    Request A Neuro-Optometry Appointment Today
    Find Out If Neuro-Optometry Can Help You! 833-700-2133

    Do You See Better When You Tilt or Turn Your Head?

    blue eye tilted head to see betterDo you find that you need to tilt or turn your head to see better? This is known as an anomalous and compensatory gesture. Many people – including children – don’t even realize they’re doing this until their neck begins to feel really sore. Naturally, it’s hard to imagine that the source of their problem is their eyes or the optic nerves.

    Why Does My Vision Improve When I Tilt or Turn My Head?

    You may turn or tilt your head for any of the following reasons:

    Eye Misalignment (Strabismus)

    When your two eyes are misaligned or “crossed” (strabismus), they aren’t able to point in the same direction. The result: each eye sends a different image to your brain, which then struggles to merge the images to create one clear, unified 3D image. Moving your head compensates for this and may enable your brain to more comfortably combine the images to see more clearly.

    This misalignment can be caused by a malfunction of the nerve that controls the muscles surrounding the eyes. Depending on which nerves and muscles are affected, the head turn or tilt is essentially an adjustment to enhance the comfort and clarity of vision.

    Duane Syndrome

    Duane syndrome is a specific type of strabismus. It is a congenital disorder of the 6th cranial nerve that controls the lateral rectus muscle. As a result, the eyes may rotate inward and outward and can lead to compensatory head movements.


    Nystagmus, involuntary jerky or shaky eye movements, can cause you to tilt your head in a specific position when the nystagmus is slow or stops. This is called a “null point.” Nystagmus can have a neurological basis, as in cases of:

    • Stroke
    • Trauma to the head
    • Brain tumor
    • Central nervous system diseases, such as multiple sclerosis


    Ptosis is often called “droopy eyelid,” and can be caused by an injury to the muscles surrounding the eyelid or to the nerves controlling these muscles. People with ptosis will compensate by looking upward to see objects as if trying to see past the eyelid.

    Refractive Errors

    Refractive errors occur when the eye is either too long or the corneal focusing power is too high or too low. They aren’t a result of a neurological problem. However, refractive errors often cause a child or adult to tilt or move their head to compensate for their blurry vision.

    These are the refractive errors that affect eyesight:

    • Astigmatism
    • Myopia (nearsightedness)
    • Hyperopia (farsightedness)
    • Presbyopia (age-related farsightedness)

    In the event of a refractive error, you or your child may also squint your eyes in an attempt to see better. Having an eye exam can determine the type of refractive error and the best way to correct the problem.

    How Can I Stop By Head From Tilting or Turning to See Better?

    If you find that you’re tilting or turning your head to see objects or read better, it’s important to schedule an eye exam to identify the cause of the problem.

    Patients with ocular neurological problems may be experiencing some of these symptoms:

    • Eye strain, headaches or migraines
    • Eye turn or blurry vision
    • Reading or attention problems
    • Difficulty moving the eyes
    • Involuntary eye movements
    • Pressure in the eyes or head
    • Uneven pupils
    • Double vision
    • Droopy eyelids
    • Facial distortion

    If your eye doctor suspects that your eye condition may be rooted in the nerves or the brain, they may recommend an appointment with a neuro-ophthalmologist, who is trained to diagnose and treat eye irregularities with a neurological cause.

    Do you want to get rid of your head tilt and treat your eye problem? Schedule an appointment at Richmond Hill Optometric Clinic Neuro-Optometry Center today.

    Frequently Asked Questions with Dr. Radhika Chawla

    Q: What are some causes of neurological problems that affect the eyes?

    • A: – Inflammation of the optic nerve (optic neuritis)
      – Swelling of the optic nerve (papilledema) – commonly caused by increased pressure inside the brain
      – Nerve damage leading to paralysis of eye muscles – this leads to strabismus or misaligned eyes
      – Optic neuropathy – can be caused by toxic substances such as alcohol, tobacco or B12 deficiency
      – Stroke or brain tumor

    Q: How is strabismus treated?

    • A: Strabismus, characterized by crossed or misaligned eyes, is treated by:- Eyeglasses for milder cases
      – An eye patch placed over the stronger eye to help the weaker eye become stronger
      – Orthoptics – eye exercises
      – Botox – can temporarily weaken the overactive muscle
      – Surgery on the eye muscles


    Request A Vision Therapy Appointment Today
    Find Out If Vision Therapy Can Help You! 833-700-2133

    Double Vision After Brain Surgery

    Double Vision After Brain Surgery 640×350Double vision (diplopia) can occur after a traumatic brain injury, a stroke or certain types of surgery due to a disruption in the connection between the nerves and extraocular muscles that control the eyes’ position and movements.

    Diplopia following brain surgery is usually temporary and can take a few days or weeks to resolve, depending on the source of the problem. In the meantime, people who suffer from double vision after an operation can benefit from specific glasses and neuro-optometric rehabilitation through eye exercises that help restore single vision.

    If you are experiencing diplopia after brain surgery and want to know which treatment is right for you, make an appointment with Dr. Radhika Chawla at Richmond Hill Optometric Clinic Neuro-Optometry Center today.

    What Causes Double Vision After Brain Surgery?

    The brain is connected to the eyes through a network of nerves — including the optic nerve — that controls the movement and alignment of the eyes. These nerves can be impacted by brain disorders, tumors and strokes, or during brain cranial surgery. Brain surgeries can disrupt the connection between the brain and the eyes, resulting in the misalignment of the eyes and double vision.

    Alternatively, the muscles surrounding the eyes that keep the eyes aligned and focused can be damaged during surgery, affecting their ability to perform accurately and effectively.

    Ordinarily, having two eyes means the brain receives two images, which it converts into one single 3D image of the world. However, an injury to the eye muscles can cause an eye misalignment, making it impossible for the brain to fuse the two images into one single, clear image — resulting in double vision.

    What Are Other Symptoms of Damage to the Visual System?

    Although the most obvious sign of damage to the visual system after brain surgery is double vision, patients may experience any of the symptoms below:

    • Eyestrain
    • Crossed eyes
    • Headaches
    • Pain when moving the eye
    • Droopy eyelids
    • Nausea
    • Eye weakness

    How to Treat Diplopia After Brain Surgery

    There are several treatments for diplopia after brain surgery.

    Prism glasses

    After an eye exam your eye doctor may prescribe prism glasses that work by altering the path of light rays and compensate for any misalignment of the two eyes. These lenses allow the brain to fuse the two images from the eyes to create a clear and single 3D view of the world around us.

    Eye Patches

    Your eye doctor may recommend wearing an eye patch because it removes the second image from a weaker eye reaching the brain. Using a patch can temporarily remove the visual disturbance and prevent you from seeing double images, but is often not the best long-term solution. It is important to follow a precise regimen for eye patch wearing and not deviate from the instructions without first consulting your doctor.

    Neuro-Optometric Rehabilitation

    One effective way to regain clear and comfortable vision after brain surgery is through neuro-optometric rehabilitation, which is a personalized eye exercise program that will strengthen the connection between the brain and your eye muscles, with the goal of improving your quality of life by regaining your clear 3D vision.

    Following a functional vision evaluation to assess visual problems, your optometrist may prescribe customized exercises to re-establish the effective communication between your eyes and brain.

    How Long Will It Take to Recover from Diplopia?

    Usually, diplopia that develops following surgery is temporary, and with treatment, regular vision can be restored in days or weeks. In cases that persist, eye patching, prism glasses and neuro-optometric rehabilitation usually resolve diplopia within weeks or months. In rare cases, eye surgery may be required to correct diplopia.

    If you are experiencing double vision after brain surgery, schedule an appointment with Richmond Hill Optometric Clinic Neuro-Optometry Center today.

    Our practice serves patients from Richmond Hill, Markham, North York, and Vaughn, Ontario and surrounding communities.

    Frequently Asked Questions with Dr. Radhika Chawla

    Q: What are the different types of diplopia?

    A: All types of diplopia involve seeing two images, but there are different forms of diplopia, depending on the positioning.

    • – Horizontal diplopia – images are separated laterally
    • – Vertical diplopia – one image is higher than the other
    • – Monocular diplopia – diplopia continues in one eye when the other is closed.

    Monocular diplopia can be caused by conditions such as astigmatism, cataracts or keratoconus. Diplopia can be temporary, intermittent or constant.

    Q: What are the common causes of diplopia?

    A: Diplopia can be caused by the following: Brain trauma or brain tumor

    • – Stroke
    • – Eye problems like keratoconus, dry eye and cataracts
    • – Brain surgery
    • – Cranial nerve palsy
    • – Eyestrain

    Request A Neuro-Optometry Appointment Today
    Find Out If Neuro-Optometry Can Help You! 833-700-2133

    What’s an Ocular Migraine?

    Whats an Ocular Migraine 640×350Ocular migraines, also known as visual migraines, are sudden, temporary episodes of visual distortion — and can be quite scary if you’ve never experienced one before.

    There are two different types of ocular migraines: migraine auras and retinal migraines.

    What Is a Migraine Aura?

    Migraine auras are quite common, affecting 1 in 5 migraine sufferers.

    A migraine aura causes sudden, temporary vision distortions just prior to or during a migraine. It typically lasts around 30 minutes.

    These visual distortions may include:

    • Flashes of light
    • Blind spots
    • Glittering “stars”
    • Zigzagging lines
    • Psychedelic images

    A migraine aura can also result in physical symptoms, such as:

    • Numbness or tingling in the body
    • Changes in taste, smell or sense of touch
    • Brain fog

    If you experience a migraine aura, it is best to stop what you’re doing, sit down and close your eyes until it passes.

    What Is a Retinal Migraine?

    Retinal migraines are rare, affecting 1 in 200 migraine sufferers.

    Retinal migraines cause repeated temporary episodes of blindness in just one eye. Most people experiencing a retinal migraine report that their vision suddenly becomes very blurry, or that there is a partial or complete “blackening out” of their vision. These episodes can last anywhere from 5 to 20 minutes, and can occur prior to or during a migraine headache.

    Vision loss in one eye is always a sign that needs to be taken seriously and requires urgent medical care.

    What Causes Ocular Migraines?

    Unfortunately, though most agree that genetics play a significant role in predisposing some individuals to ocular migraines, researchers have yet to discover if any one specific stimulus directly causes them.

    Some researchers believe that changes within the retinal nerves or blood vessels in the back of the eye can stimulate an ocular migraine.

    However, most doctors believe that the same factors known to trigger classic migraines can also trigger ocular migraines:

    • Excessive loud noise
    • Bright lights
    • Strong [odors]
    • Prolonged periods of stress
    • Binocular vision problems
    • Eye strain
    • An increase in the estrogen hormone
    • Weather changes/fluctuations in barometer
    • Alcohol consumption
    • Caffeine or caffeine withdrawal
    • Artificial sweeteners
    • Foods containing nitrates, MSG or tyramine
    • Genetic predisposition

    How Can a Neuro-Optometrist Help?

    If you suffer from ocular migraines, we at Richmond Hill Optometric Clinic Vision Therapy Center can help you uncover what may be triggering your migraines and provide you with the most effective treatment plan.

    If a binocular vision problem such as binocular visual dysfunction (BVD), convergence insufficiency (CI) or difficulties with focusing, eye tracking or eye teaming is causing your ocular migraines, we can devise a customized program of neuro-optometric rehabilitation to improve your visual function and treat your symptoms at their source.

    We can also discuss different lifestyle changes that could help you reduce or prevent episodes of ocular migraines, thereby improving your quality of life.

    Contact Richmond Hill Optometric Clinic Vision Therapy Center today to schedule an appointment. Richmond Hill Optometric Clinic Vision Therapy Center offers neuro-optometric rehabilitation therapy to patients from Richmond Hill, Markham, North York, and Vaughn, Ontario and surrounding communities.

    Frequently Asked Questions with Dr. Radhika Chawla

    Q: Can a vision problem trigger headaches, including migraines?

    • A: Yes. A binocular vision problem caused by even the slightest misalignment of the eyes can place extra strain on the eye muscles in an effort to produce clear vision. This often leads to headaches, even migraines.Convergence insufficiency and accommodative dysfunction are two binocular vision problems that can have been shown to cause or exacerbate migraines and other headaches.

    Q: How do I know if my headaches are vision-related?

    • A: The only way to know with certainty that your headaches stem from a vision problem is through a comprehensive eye exam. Be sure to inform your eye doctor if you recently suffered a concussion or brain injury. Many vision problems caused by a brain injury can be effectively treated with neuro-optometric rehabilitation therapy.

    Request A Vision Therapy Appointment Today
    Find Out If Vision Therapy Can Help You! 833-700-2133