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Why do my glasses not seem right after a concussion?

Any glasses prescription from before a head injury is likely not going to be the ideal glasses prescription for after the head injury. This often is due to the imbalances that emerge among the accommodative (eye focusing) systems, vergence (eye teaming) systems, and ocular motor (tracking) systems after the injury. The intricate relationship that exists in our brains allows for these systems to function in synergy. But when a disruption in visual processing emerges after a concussion, often the eyes no longer work well together as a team as the brain attempts to adapt and resolve the new visual confusion. This causes blurry or distorted vision as potential symptoms, and often standard medical care is to treat the symptom with a stronger or adjusted glasses prescription. As so many of us know too well, this can bring you down a rabbit hole of adapting to the lens you are in, needing something stronger to maintain the same clarity, and then a downward cycle continuing. If you address the underlying route problem, then the symptom of blur for example is no longer an option.

The prevalence of myopia is dramatically increasing worldwide. In the United States the percentage of myopic individuals increased from 25% to 46% from 1972 to 2002 and is growing since then. Today, more than 40% of Americans are myopic and by the year 2050 over 50% of the world’s population is predicted to be myopic!  This drastic rate of increase is especially alarming considering so much of this is occurring in school-age children.  While this escalation is linked to both genetics and lifestyle, research has shown that spending more time on sustained visual concentration activities like reading and screen devices instead of spending time outdoors increases the likelihood of becoming myopic.  Kids are being introduced to technology at earlier and earlier ages, and many do not have the visual systems in place to meet these demands.  Of great concern is the fact that higher levels of myopia are increasing in prevalence at an even faster rate.  Research has shown that the higher the myopia, the higher the likelihood of developing a serious vision threatening condition.

More commonly known as “nearsightedness”, myopia is a refractive visual problem when you can see more clearly at near compared to far distances. In this condition, light rays that enter the eye incorrectly focus at a point in front of the back of the eye (retina), rather than on the retina. This results in poor vision where distant objects tend to be blurry without the aid of compensatory spectacle or contact lenses. Myopia occurs when the length of the eyeball (axial length) itself is slightly longer than normal, and elongation can occur as a child grows and/or as the amount of myopia increases. Additionally, myopia can be provoked by concussion and/or by specific functional vision problems that are risk factors associated with earlier onset or higher risk of progression. 

While myopia runs in families and often makes its first appearance in childhood, there are influences other than heredity and genetics that play a role in the development of nearsightedness. Environmental factors can contribute to the likelihood of needing assistance for far distances. Long periods of intense near work coupled with a more sedentary lifestyle, less outdoor activity, and a greater dependence on high tech devices have all been associated with increasing nearsightedness. Studies have shown that the more near work humans perform, the more likely they will become nearsighted. It’s no wonder that myopia has been associated with higher levels of education and has become an epidemic in those countries that value technology, education, and reading.