August/September 2019 - 22
Depending on symptoms and presentation, we must help the athlete understand that
" pushing through " can make them worse. They must plan and pace their day.
* 40% of individuals will have ocular difficulties longer
* than three months.
Intervention is helpful in ensuring resolution of
ocular complaints and meeting the other pathways.
Here are some impairments we look out for:
√ Blurred or fluctuating vision. Deficits in eye focusing *
(accommodative dysfunction), or a reduced ability to
compensate for a minor prescription can result in blurred
or fluctuating vision.
√ Double vision. More than half of concussion patients
see double. Oftentimes, double vision is only present
intermittently, and patients may not realize that what they
are experiencing is double vision. One major cause of double
vision is convergence insufficiency, or a reduced ability
to use the eyes together during near activities.
√ Eye tracking deficits. Difficulties with reading or computer
work is extremely common after a concussion. This is one
reason why eye tracking tests are used to help diagnose
concussions.
√ Light sensitivity. Many concussion patients find that they
are bothered by certain types of light, even when indoors.
√ Reduced cognitive abilities. Feeling as if they're " in a fog "
may be a common occurrence. There also can be difficulties
with concentration, memory and thinking quickly.
√ Balance difficulties/dizziness. The visual system has a
strong influence on balance. When vision conditions are
present, it can affect balance and create dizziness and nausea.
√ Headaches. Evaluation of the eyes should be considered
when headaches are present, especially when they occur at
the end of the day or after visual activities, like reading or
computer work.
Vision is multimodal activity of the brain and body
The focal/central vision mode occurs primarily as a macular
function. Detail discrimination relates to visual acuity. Other
functions within this area include attention, concentration and
orientation to present consciousness. Slow speed of processing
is within the occipital cortex. Higher processing is primarily
under cortical interpretation/action.
The periphery/dorsal vision functions can be seen
individually and in complex combinations. This is not only
important in initial baseline determination, but also in the
ongoing evaluation and monitoring. Spatial orientation is
required for posture and balance, and the feedback loop of
maintaining aligned posture and balance.
Movement depends on visual perception and orientation
of space in relation to visual planes. Movement requires a
shifting or planning of the constant requirements of posture,
balance and orientation.
Anticipate change in the preconscious and rapid speed in
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