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Traumatic Brain Injury - Binocular Visual Dysfunction (BVD)

Robert Karns

A large percentage of people that suffer a traumatic brain injury have visual problems including binocular visual dysfunction (BVD).

When a traumatic brain injury occurs there is often an interruption to the neurological system which damages the extra ocular muscles and/or nerves that control eye movements as well as the system that regulates focusing.

One visual problem that can occur following a traumatic brain injury is binocular visual dysfunction. Binocular vision has to do with the alignment of the eyes. Binocular vision dysfunction is a visual condition where the line of sight from one eye tends to be slightly out of alignment with the line of sight from the other eye. This puts a heavy strain on eye muscles as they are constantly trying to correct the alignment to achieve single focus vision. This can occur during a traumatic brain injury that damages the muscles or nerves in the eye causing the imbalance and lack of alignment.

This strain on the eye muscles or nerves results in dizziness, headaches, disorientation and reading difficulties.

As the eye muscles strain in order to keep the lines of sight aligned so that vision is not blurred or double the eye muscles become overused and strained which results in many of the symptoms of BVD. Another corrective measure besides the muscle strain is for the head to tilt slightly resulting in neck pain and further BVD symptoms. The brain automatically attempts to compensate by the overuse of the eye muscles and head tilting.

Symptoms of BVD include:

  • Dizziness
  • Lightheadedness
  • Nausea
  • Unsteadiness
  • Clumsiness
  • Poor depth perception
  • Motion sickness
  • Headaches and face pain
  • Eye pain
  • Neck pain
  • Head tilt
  • Double vision
  • Fatigue
  • Difficulty reading

Binocular visual dysfunction can be treated by certain types of visual therapy and by realigning the eyes with prismatic lenses in glasses. Prism correction can be added as a component of eyeglass prescriptions.

As part of medical treatment of a victim of traumatic brain injury, visual problems must be diagnosed and treated by a physician with experience with the problem. Including an ophthalmologist or optometrist with experience with muscle and/or nerve damage to the area of the eyes caused by traumatic brain injury.


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