Visual Disturbances After Concussion

Purpose of Review: Concussion frequently results in visual symptoms, necessitating careful neuro-ophthalmic examination. Both afferent and efferent visual systems are sensitive to brain injury. The present review focuses on the pathophysiology, clinical presentations, examinations, management, and future directions regarding visual disturbances after concussion. Recent Findings: Photophobia is common in both acute and chronic concussion. Abnormalities of accommodation, convergence, saccades, and smooth pursuits can result in blurred vision, double vision, and difficulty with near work. Vision-based testing is crucial in the detection of concussion. Retinal nerve fiber layer thickness measurement may elucidate the risk of structural and functional sequelae. Patients presented with visual field loss or cranial neuropathies require evaluation for structural lesions. Summary: Proper neuro-ophthalmic examination is instrumental in clinical decision-making for the diagnosis and management of concussion, as well as directing future investigations on preventing long-term complications.