From the Guidelines
Post traumatic vision syndrome (PTVS) is characterized by a range of visual and non-visual symptoms, including blurred or double vision, difficulty focusing, light sensitivity, headaches, and problems with reading or tracking moving objects, as a result of disrupted neural pathways involved in visual processing following head trauma or traumatic brain injury 1.
Signs and Symptoms
The signs and symptoms of PTVS can be diverse and impact various aspects of an individual's daily life. Some common symptoms include:
- Blurred or double vision
- Difficulty focusing
- Light sensitivity (photophobia)
- Headaches that worsen with visual tasks
- Problems with reading or tracking moving objects
- Visual midline shift where objects appear displaced from their actual position
- Spatial disorientation
- Balance problems
- Visual memory deficits
- Reduced peripheral vision awareness
- Difficulty with visual processing in busy environments
- Visual fatigue, with symptoms worsening after prolonged visual activities
- Dizziness, nausea, or anxiety when attempting visual tasks
Pathophysiology
These symptoms occur because brain injury disrupts the complex neural pathways involved in visual processing, affecting not just the eyes themselves but the brain's ability to interpret and integrate visual information 1. The visual and vestibular systems are closely connected, which explains why balance problems often accompany visual symptoms.
Treatment
Treatment typically involves specialized vision therapy, prism lenses, and other rehabilitative approaches tailored to the specific visual deficits present 1. It is essential to address these symptoms to improve the patient's quality of life and reduce morbidity associated with PTVS.
Predictive Factors
Several studies have identified predictive factors for postconcussive symptoms, including female gender, preinjury psychological issues, loss of consciousness, and acute pain scores 1. These factors can help identify patients at risk for prolonged symptoms and guide referral to appropriate follow-up care.
Outcome Measures
Outcome measures such as the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and the ImPACT Post-Concussion Symptom Inventory can be used to assess the presence and severity of postconcussive symptoms, including those related to vision 1. These measures can help monitor the patient's progress and adjust treatment accordingly.
From the Research
Signs and Symptoms of Post Traumatic Vision Syndrome
The signs and symptoms of post traumatic vision syndrome (PTVS) include:
- Diplopia (double vision) 2
- Blur 2, 3
- Seeing movement in the spatial environment 2
- Vertigo 2
- Hallucination-like experiences 2
- Vision imbalances affecting balance, posture, ambulation, reading, attention, concentration, and cognitive function in general 4
- Light intolerance 5
- Visual motion sensitivity 5
Characteristics of Post Traumatic Vision Syndrome
PTVS is characterized by binocular function problems, which may be caused by dysfunction of the ambient visual process rather than specific oculomotor disturbance 2. It can also be related to Visual Midline Shift Syndrome (VMSS) 4. Additionally, PTVS can be associated with post-traumatic stress disorder (PTSD), which can cause blurry vision due to the interconnections between the sensory vision system and the structures of the limbic system 3.