Pediatricians often evaluate children after a head injury, but the adverse sequelae involving the visual system may not be readily apparent. Vision disorders after a concussion can have a major effect on children, delaying return to full-time learning activities. Neurologic pathways associated with the visual system are widely distributed throughout the brain, so it is not surprising that many children experience visual symptoms post-head injury. Concussions also can affect saccadic (“jump”) and pursuit (“smooth”) eye movements. These will affect reading speed and fluency.
While some visual disorders may resolve on their own, the presence of any vision issues after concussion should prompt referral to a specialist. It also is important for pediatricians to recommend academic modifications. The school system may not be aware of a concussion’s effects on the visual system, so it is critical for health care providers to detect these conditions and provide guidance to maximize the child’s ability to function in the classroom.