Vision symptoms after concussion: Review of diagnosis, pathophysiology, and treatment

Vision symptoms are frequent after concussion and can often persist and be disabling. Most studies on concussion with persisting concussion symptoms (PCS) provide limited attention to vision symptoms. Vision symptoms occur in 69-82% of patients with PCS and commonly include photophobia, blurred vision, and computer screen intolerance (CSI) - a syndrome induced by viewing electronic screens including computer, cell phone, tablet, or TV screens. We discuss the vision symptoms that may arise and persist after a concussion. Unfortunately, the pathophysiology of many of these symptoms is unknown, and we examine current views of the mechanisms potentially involved with a focus on CSI. We also evaluate the effectiveness of the currently available treatments. Our aim is to improve recognition and treatment of concussion induced vision symptoms through an understanding of their pathophysiology and the efficacy of available treatments. Enhanced recognition and understanding may facilitate improved treatment for these debilitating symptoms that compromise the quality of life and hinder return to school or work for many concussed individuals. We aim to aid ophthalmologists, optometrists, and other vision scientists who are frequently called upon to diagnose and treat patients with these symptoms.