Blurry Vision

Abstract

Blurry vision after concussion can mean different things. A loss of acuity in one eye is often due to direct injury to the eye, which happens frequently in concussion. Refer to ophthalmology right away. Intact acuity in each eye, but worse vision with both eyes open is often due to a subtle cranial nerve injury. Subtle third cranial nerve or fourth cranial injuries typically cause vision to be worse looking up or down, whereas sixth nerve injuries are typically worse looking to one side. Consider referral to neuro-ophthalmology and an ocular rehabilitation prescription. Visual attention deficit is sometimes described as blurry vision. Treat the attention deficit. Migraine auras often cause visual impairment of some kind: distorted vision, double vision, loss of central vision, loss of vision on one side of the visual world, sparkling lights, jagged lines, and so forth. Paroxysmal changes in vision after concussion should be treated as presumptive migraine, or migraine equivalent even if there is not a severe headache. Patients will benefit from best corrected vision when starting aggressive cognitive rehabilitation even if preexisting visual impairments didn’t impair them much in everyday life before the concussion.