A study published in the Journal of the American Medical Association estimates that as many as 20% of children will be diagnosed with a concussion during their childhood years. Concussions occur more often in children and adolescents because of the sports in which they are involved, and are beginning to be taken more seriously by school coaches and medical staff. Concussion is an injury to the brain caused by a sudden bump or blow to the head which causes the brain to move rapidly back and forth within the skull. The effects are usually temporary, but severe or repeated concussions can have a lasting impact in a number of areas, including on visual functioning.
Signs and symptoms generally appear soon after the injury. However, some symptoms may not show up for hours or days and the severity of the injury may not be evident initially. It is important to continue to check for signs of concussion for a few days after the injury. Physical signs and symptoms of a concussion may include dizziness, headache, ringing in the ears, nausea, vomiting, fatigue or drowsiness, and blurry vision.
Although the eyes may appear to be healthy, a number of functional vision symptoms can occur. Visual symptoms occur more often with near than with distance vision. Blurry vision is a typical vision problem following concussion. There may also be double vision, which can be disorienting and may lead to dizziness, difficulty balancing or walking, and difficulty reading. The individual may experience accommodative dysfunction and struggle with switching focus from near to far and vice versa. A common problem after concussion is convergence insufficiency, a decreased ability to converge the eyes and maintain binocular vision while focusing on a near target such as a book or phone. This may lead to difficulty concentrating when reading and eye fatigue. There may be increased sensitivity to light and glare. Concussion can affect the smooth movement of the eyes, causing rapid jumpy eye movements which may result in problems with hand-eye coordination, eye teaming or eye tracking. Reading speed, fluency and comprehension may be affected.
Fortunately, most of the problems associated with concussion are temporary and will resolve on their own. Research has shown that a break from physical and mental activity will give the brain a chance to recover. Doctors sometimes recommend total rest with no brain stimulation, and a gradual return to normal activity. If symptoms persist, treatment or referral to a specialist may be indicated.
The visual problems resulting from concussion can have an impact on reading and learning activities, and many of these conditions respond well to vision therapy. Vision therapy consists of a unique programme of eye exercises designed by the optometrist for the child's specific difficulties and needs. It helps to retrain eye muscles in order to improve focusing, eye teaming, coordination and reaction time. Sometimes reading glasses, bifocals or progressive addition lenses are prescribed to help remedy and compensate for the effects of concussion.
With the concerns regarding concussions and their associated problems in children and adolescents, the question often asked is whether they can be prevented. Certain steps can be taken to minimise the risks and perhaps the severity of these injuries.
Know the rules - Schools, coaches, community organisations and parents should know the rules so that they can ensure that they are responsibly followed.
Don't put all of your faith in equipment - While a child should wear a helmet or other protective gear, just because a helmet was worn, doesn't mean that a concussion did not occur. Do not ignore injuries, take them seriously.
Talk to your children about symptoms - Keep the lines of communication open, so that the child feels comfortable talking about problems if an injury occurs.
Generally, the impact of concussion is temporary, but being vigilant and aware of problems that may emerge will help to spot these issues and seek timeous professional help.