After-Concussion Care for Children


This underexplored area offers opportunities for eye doctors

Fall sports are starting back up, and that means doctors may be seeing more cases of concussions, especially in children. Concussion affects an estimated 1.4 million children and adolescents each year in the United States, according to the American Academy of Pediatrics (AAP). Most pediatric concussions occur during sports or recreation. Visual symptoms of concussion are common and can interfere with school or quality of life if untreated. Here’s what eye doctors should be on the lookout for. 


Why early post-concussion assessment is crucial

Most people with a concussion can recover safely at home following a medical check-up, notes the CDC. And most visual issues after concussion — blurry vision, difficulty reading and focusing, eye fatigue — will resolve on their own by four weeks. However, up to one-third of children with concussion may need to be referred to a specialist for further assessment and treatment, stated the AAP. 

Post-concussion visual symptoms can impact children’s school performance and quality of life. Early identification and accommodations from an eye doctor can help. 

Vision problems following a concussion can have a substantial impact on how children perform in school and in extra-curricular activities. A doctor can recommend academic accommodations such as larger font, preprinted notes, and temporary use of audio books. “Early identification and appropriate management of visual symptoms may help lessen the negative effects of concussion on children and adolescents and their quality of life while they recover from a concussion,” according to an AAP statement and clinical report.


Visual symptoms common but often overlooked 

More than half of the brain’s cortex is dedicated to visual processing, so it is not surprising that visual symptoms would be amongst the most common long-term effects of brain injury. However, many concussion-related vision problems are overlooked, James Deom, O.D. said in the Optometry Times. Eye doctors can help diagnose and treat concussion if they know what to look for. Often, symptoms of concussions include: being disoriented or slow to get up; irregular speech or gait; dizziness; nausea; and reading problems.

A comprehensive eye exam can identify concussion symptoms that are often overlooked.

“Sometimes the fix is an easy one, such as improving visual acuity with a change in a glasses or contact lens prescription or the addition of prism lenses,” Dr. Deom said. “However, a detailed evaluation of a patient’s eye movements can identify disorders that will not show up on a standard eye exam.”


The role of patient education and diagnostic tools

Doctors who are seeing patients for concussions may benefit by showing them videos / content on: strabismus, accommodation, convergence insufficiency, etc.

View Video

Dr. Deom’s practice performs vestibular ocular motor screening on patients with concussion to learn whether moving the eyes or stimulating the vestibular system causes symptoms. If so, the patient receives an ocular, vision, and vestibular work-up. He also recommends conducting a nearpoint of convergence test to measure the patient’s ability to bring the eyes together, which is often affected by concussions. This article by the California Optometric Association gives an in-depth look at further assessment and treatments for concussion.

Post-concussion vision care is not a one-size-fits-all treatment. But according to Dr. Deom, a “rewarding opportunity” exists for ODs who choose to pursue this underexplored area. 

Learn more about the importance of health literacy when it comes to having conversations with your patients by downloading our Understanding Health Literacy eBook!


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