Many of us rely on our eyesight every day. It can be scary when our vision starts to change and we don’t see the same way anymore. This can be tough to manage, even if the effects only last for a little while.
It’s definitely not easy to adjust to, but there are ways to navigate vision changes so you can continue doing things that are important to you in your day-to-day.
Please note: If you are experiencing vision changes/loss, you should work with health care professionals to understand these changes and what supports you may need.
Let’s talk about:
How your brain & your eyesight are connected
In order for your vision to work properly, your brain must be able to::
- Move your eyes together and focus on objects
- Send messages along the optic nerve from the receptors at the back of your eyes
- Capture and process the messages in your occipital lobe
The occipital lobe is the area of the brain that has the most control over vision. It processes the images you see, including patterns, shapes, and colours. Damage to the occipital lobe can cause a range of vision problems, including blindness.
Who can help me with vision problems?
Depending on the cause of your vision changes, you may need to work with different specialists. These can include ophthalmologists (op-tha-mall–o-gists), neuro-ophthalmologists, optometrists, and/or neurologists.
What do these specialists do?
Optometrists are the first people you see for vision care. They can do eye exams, provide prescriptions, and manage eye conditions. They are not licensed doctors, but have completed years of school and training.
Ophthalmologists are medical doctors who specialize in eye and vision care. They can diagnose and treat a wide range of conditions.
Neurologists are doctors who can diagnose and treat disorders related to the brain, spinal cord, and nerves.
Neuro-ophthalmologists are also doctors who specialize in vision problems related to the brain, nervous system, or nerves. If you have vision problems related to a brain injury, you could see a neuro-ophthalmologist.
Possible vision problems after brain injury
The following are some of the more common vision problems people can experience after brain injury.
Remember: You may or may not experience vision problems after brain injury. You may also experience vision changes we haven’t listed here. It’s best to ask a medical professional if you have any questions.
Blurry vision can happen when there’s damage to the visual part(s) of your brain or your eye/nerve receptors. This is also called visual acuity loss. It’s a lot like what people who need glasses experience.
For example: Your vision may be similar to someone who is near-sighted, which means objects close up may be clear and easy to see, while objects that are further away are blurry. If you already have glasses, it might seem like your prescription has changed.
How blurred vision is treated depends on how much your vision has changed/been impacted, and if the cause means your vision is going to be affected long-term. In some cases, glasses or surgery can help correct the problem. You will need to work with professionals to determine the best treatment.
However, sometimes blurry vision isn’t connected specifically to your brain. It can also be a side effect of fatigue (being extremely tired). And that’s a very common effect of brain injury. If you’re really tired or looking at something for too long, objects may start to become blurred, your eyes may ache, or you may experience headaches. In this case, the solution will be giving yourself a break and resting your eyes.
Also known as photophobia or photosensitivity, sensitivity to light means you have trouble adjusting to changes in lighting and struggle with bright lights such as fluorescent light or even sunlight.
For example: You’ve been inside all morning, and the sun hasn’t been shining through your windows. When you step outside, the sunlight causes you a lot of discomfort and confusion because it’s too bright.
Sensitivity to light can make it hard to be in some environments (for example, if your school uses bright fluorescent lights). Some tips for managing light sensitivity include:
- Wear tinted sunglasses to help reduce light and glare.
- Set up lighting that has a low-impact on your eyes and brain.
- Avoid using technology with screens unless they have the proper backlighting and contrast. Using a screen in the dark can be hard on anyone’s eyes, and can be especially difficult for those with light sensitivity.
For additional tips or if you have specific questions, reach out to someone on your health care team.
Double vision (also known as diplopia) happens when your eyes don’t move together exactly the same way at the same time. When that happens, you see two of everything. This makes it hard to figure out exactly where objects are. If you have double vision, you might bump into furniture, spill things, or drop stuff. It’s disorienting and can cause you to feel dizzy or nauseous.
If you are experiencing double vision, sometimes an eye patch or glasses with prism lenses are prescribed. To reduce the risk of bumping into objects, it helps to keep things like furniture in the same place so you get used to where it is and the paths you can take around them. You can also try eye drops if you are experiencing dry eyes – sometimes that dryness causes strain which can lead to double vision.
Whatever the cause of double vision, you should see an ophthalmologist or optometrist if you are experiencing it, as they will be able to recommend the best course of treatment.
A drooping eyelid (also called ptosis, pronounced toe-sis) may block your vision in the affected eye. This changes how you see, and it may take a while for your vision to adjust even if the drooping is temporary.
You may experience the following challenges:
- Dizziness
- Miss seeing objects in your line of view
- Not know how fast objects are moving towards you, or how close they actually are
- Have trouble pouring
- Trouble judging distances
Drooping eyelids can sometimes be treated with special glasses or surgery – but again, this is something a specialist can talk to you about.
Headaches & eye pain from vision problems
Vision problems can sometimes lead to headaches and eye pain if you’re straining your eyes to see [1]. This includes eyes feeling dry, sore, and itchy. The muscles around your eyes may feel sore as well. This might be something you’ve felt before if you’ve spent a long time on a screen. You may also be experiencing headaches related to your vision problems when you are trying to focus on an object or task.
Some things you can try to help with this include:
- Taking breaks where you close your eyes
- Adjusting the lighting in your home
- Using saline/tear solutions for dryness and itchy eyes
Check out our page on headaches for more information about treating them.
Vision loss
In some cases, you may have lost part or all of your vision. This may be temporary or permanent depending on the factors affecting your vision (like brain injury).
Your vision is broken up into fields, and you might have some fields of vision but be missing others. A good analogy is that your eye is like a pie, and each slice is a field of vision. You may be missing some slices of pie, but still have others. This would be called partial vision loss.
If you are experiencing partial loss of vision, you may experience some of the following challenges:
- Suddenly notice objects that seem to appear or disappear as you can’t see that part of their environment.
- Bump into objects on the affected side.
- Not see the food on your plate where your vision is affected (i.e. if it’s on your left-hand side and you don’t have sight there).
- Lose track of the last place on a page you were reading or writing.
- Cut words in half when reading, which can make it hard to figure out what the word is.
- See black dots (sometimes called floaters) that always seem to be there.
An optometrist or ophthalmologist will be able to work with you to figure out what kinds of vision loss you’re experiencing and what steps to take going forward.
What is legally blind, and what does that mean for me?
In Canada, you are considered legally blind if you have 20/200 vision or less with the help of glasses or contact lenses, which means you can’t see more than 20 ft away from you. For comparison, a person with normal vision can see 200 ft away from them.
In Canada, you would also be considered legally blind if your visual field is 20 degrees or less, even with the help of glasses or contact lenses [2]. This means that you have trouble seeing to the side when you’re looking straight. This is your peripheral vision. You use it a lot to perceive what’s around you without looking directly at something (like when horror movies talk about seeing something “from the corner of your eye”).
Being legally blind means that there will be some activities you can’t do for safety reasons (such as driving). This definition of legal blindness is also used to figure out if you’re eligible for disability-related government programs and supports.
You can learn more about available programs and supports from organizations like the Canadian National Institute for the Blind (CNIB).
Disclaimer: There is no shortage of web-based online medical diagnostic tools, self-help or support groups, or sites that make unsubstantiated claims around diagnosis, treatment and recovery. Please note these sources may not be evidence-based, regulated or moderated properly and it is encouraged individuals seek advice and recommendations regarding diagnosis, treatment and symptom management from a regulated healthcare professional such as a physician or nurse practitioner. Individuals should be cautioned about sites that make any of the following statements or claims that:
- The product or service promises a quick fix
- Sound too good to be true
- Are dramatic or sweeping and are not supported by reputable medical and scientific organizations.
- Use of terminology such as “research is currently underway” or “preliminary research results” which indicate there is no current research.
- The results or recommendations of product or treatment are based on a single or small number of case studies and has not been peer-reviewed by external experts
- Use of testimonials from celebrities or previous clients/patients that are anecdotal and not evidence-based
Always proceed with caution and with the advice of your medical team.
