Traumatic Brain Injury Patients - Equilibrium and Vision Problems

There have been instances where a traumatic brain injury lawyer has seen severe symptoms develop after a TBI accident. It's not uncommon for those stricken with traumatic brain injury (TBI) to be left with equilibrium and vision problems. The process of maintaining balance involves input not only from the visual system but also from the balance organs of the inner ear and the joint and muscle receptors. If a head injury patient complains of double vision, headaches, blurry vision, or dizziness, or if he has trouble concentrating, easily loses his place when reading, can't find the beginning of the next line when reading, or has trouble understanding or retaining what he reads, he may have Post Trauma Vision Syndrome

(PTVS). Other symptoms include low blink rate (staring behavior) and spatial disorientation.

Frequently, patients with PTVS also have what is called Visual Midline Shift Syndrome (VMSS). Correct processing of visual information requires an accurate sense of where the person's body is in space in relation to his surroundings. Those with a correct perception of midline know where the center of their body is, and their posture and sense of balance reflects this.

In VMSS, a person's perception of his own midline shifts. Walls may seem to lean in on him, and his horizon may slant right or left. This syndrome may cause dizziness or nausea, spatial disorientation, and poor balance or posture as the person unconsciously leans to one side or the other to adjust to his perceived midline or horizon tilt. The person with VMSS may bump into objects when walking or consistently stay to one side of a corridor or room. He might shift his posture or weight distribution on the balls of his feet to compensate for a perceived tilt in the horizon or walls.

After a comprehensive evaluation, doctors can often rehabilitate a person with VMSS by prescribing "yoked-prism" glasses, which shift the perceived midline and counter the effects of VMSS.

Most people are familiar with the optical effects that prisms produce. Prism lenses change the direction of light, rather than expanding or condensing it as regular lenses do. Yoked prism reorientation uses prism lenses of equal power with the prism bases aligned in the same direction. Prisms are placed in the patient's line of sight and rotated until the patient's sense of space and orientation is altered. The position of an object seen through a prism will appear to shift toward the thinner part, or the apex, of the prism, thus allowing the brain to compensate for the VMSS and counteracting the distortions in vision caused by the brain injury. The patient regains the ability to accurately judge where an object is in space in relation to himself. In addition, physical and occupation therapy, in conjunction with the use of yoked prisms, may reach a higher potential and proceed more quickly.(J.Bisnar)

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