Optometry & Visual Performance 131 Volume 14 | Issue 2 | June 2026 Growing evidence demonstrates the efficacy of optometric interventions such as vision therapy in mitigating visual deficits and symptoms and enhancing functional vision and quality of life in individuals following head injury.12 Table 1 summarizes key studies that illustrate the range of positive outcomes associated with these interventions, including oculomotor control, convergence ability, and patient-reported quality of life. The publications encompass single-case reports, small case series, and one large retrospective study, demonstrating clinical benefits across diverse age groups and injuries. This case series presents the long-term follow-up of three patients recovering from one or two sportrelated concussions with concurrent vision disorders (1, 2, and 5 years since the last injury), demonstrating how optometric evaluation and intervention can effectively manage post-concussion syndrome and support sustained improvements in visual function. Case Reports Three female patients were seen by an optometrist (ZR) in Reykjavík, Iceland in 2023. All patients sustained one or more sport-related concussions and were referred by their physiotherapist or cognitive therapist for a binocular visual evaluation due to their visual symptoms, despite having previously been seen by an eye care practitioner. Case Report 1 A 27-year-old female sustained a concussion without loss of consciousness in December 2021 after falling backward while ice-skating. She immediately developed headaches and was advised to rest. During a seven-day follow-up phone consultation, she was prescribed citalopram, esomeprazole, Selexid, Norgesic, melatonin, Atarax, and Botox. In June 2022, she began physiotherapy, receiving acupuncture and cognitive therapy for persistent headaches, fatigue, reading difficulties, and photophobia, which worsened with computer use. She was referred to the optometry clinic by her cognitive therapist and was evaluated in September 2023. The patient was a compound myope who reported wearing spectacles for the past seven years. Her most recent eye examination was in 2022, with a prescription of -1.00-0.50x170 OD and -1.00 -0.25x010 OS. Examination findings are presented in Table 2. Unaided visual acuity was 0.52 logMAR OD and 0.40 logMAR OS, improving to 0.00 logMAR in both eyes with subjective refraction of -1.00 OD and -0.25-0.25x030 OS. Cycloplegic refraction with 1% cyclopentolate yielded plano-0.75x175 OD and -0.25 -0.50x030 OS, both achieving 0.00- logMAR acuity. At follow-up six days later, non-cycloplegic refraction was -0.50-0.25x165 OD and -0.25-0.50x010 OS, with 0.00- logMAR acuity in both eyes. This prescription was dispensed. As described in Table 2, cover testing revealed distance orthophoria and 2Δ esophoria at near. She was able to converge to the nose without reporting double vision but was unable to clear the +2.00 D lens during monocular and binocular accommodative facility (MAF/BAF). Her dynamic monocular estimation method (MEM) retinoscopy was plano. Her negative relative accommodation (NRA) was +1.00, often indicating accommodative excess. Due to the reported reading difficulties, the King Devick test was administered, and her score was equivalent to 10 years old. During the vestibuloocular motor screening (VOMS) test, she reported an increase in headaches. Her brain injury symptom survey (BIVSS) score was 75 (predictive score is > 31).13 The Maples oculomotor test findings included head movements, undershooting on saccades, and Author(s) Study Design Participant(s) Age (years) Key Findings / Takeaways Ciuffreda et al. 24 Single case report 55 Vision therapy (20 sessions) + prism glasses improved fixations and quality of life in a patient 6 years post-blunt head trauma. Kapoor et al. 25 Two case reports 40 and 50 Oculomotor rehabilitation improved oculomotor function in two middle-aged men with acquired brain injury. Simkhovich et al. 26 Single case report 36 Seven sessions of oculomotor auditory feedback therapy improved convergence from 45 cm to 2 cm in a patient with central scotoma. Gallaway et al. 27 Retrospective cohort study (n=218) mean age: 20.5 years Majority of concussed patients with CI and AI showed improved visual outcomes following vision therapy. Table 1. Summary of Studies Examining the Effect of Vision Therapy and Oculomotor Rehabilitation in Individuals Suffering from Head Injury
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