Dizziness and Balance Problems After Brain Injury Many people feel dizzy or have balance issues after a mild concussion or traumatic brain injury (TBI). These problems can often be due to vision defects, and a neuro-optometrist can help.

The Balance System Maintaining balance involves three systems in the body:

1. Vestibular System: Located in the inner ear, it provides the brain with information about head position, spatial orientation, and motion.
2. Visual System: The eyes send signals to the brain to help maintain balance and prevent dizziness.
3. Proprioceptors: Found in the legs and feet, they give the body a stable platform and information about movement.

How Vision Problems Cause Dizziness and Balance Disorders When the visual system is affected, it can cause dizziness. Common causes include:

• TBI
• Eyestrain
• Incorrect eyeglass/contact lens prescriptions
• Binocular vision disorder (eye misalignment)

TBI can misalign the eyes, causing conflicting signals to the brain, resulting in double vision, eye strain, and dizziness. Eye misalignment can be subtle and often missed in routine exams, so a thorough visual assessment is crucial for anyone with dizziness or balance issues.

Vision and Balance People with balance disorders may feel like they're moving even when still. Standing up quickly can make walking straight difficult. Vision problems can strain eye muscles, leading to headaches and balance disorders. Common causes of vision-related balance problems include:

• Blurry or double vision
• Binocular vision dysfunction
• Concussion
• Hemianopsia (blindness in one half of the visual field)
• Nystagmus (involuntary eye movements)
• Spatial disorientation
• Vertigo
• Visual midline shift syndrome

 Visually Induced Dizziness Visually induced dizziness occurs when visual stimuli cause a person to feel dizzy or unsteady. This can happen if the eyes send conflicting signals to the brain, often due to issues like eyestrain, incorrect prescriptions for glasses or contact lenses, or binocular vision disorders (where the eyes are not properly aligned). After a brain injury, conditions like visual midline shift syndrome can disrupt a person's perception of straight ahead, causing disorientation and balance problems. These visual disturbances can lead to symptoms of dizziness, especially when the brain struggles to reconcile mismatched visual information. Proper assessment and treatment by a neuro-optometrist (FNORA) can help alleviate these symptoms by correcting the visual dysfunctions causing the dizziness.

Treating Vision Problems That Cause Dizziness and Imbalance It's important to schedule a Neuro functional eye exam to check for vision functional problems if you're experiencing dizziness or balance issues. The expert will assess eye coordination and check for blurry or double vision. Once identified, a customized treatment plan will be created.

Neuro-Optometric Rehabilitation Therapy This therapy includes weekly sessions to improve or develop visual skills, involving techniques and exercises that enhance visual perception and processing. Vestibular therapy, a type of physical therapy for balance, may also be recommended.

When to Seek Treatment Seek evaluation by a neuro-optometrist as soon as possible after a TBI. Early treatment increases the chances of optimal results, but treatment can also help those with symptoms from older injuries.

Treatment Duration Treatment duration varies per individual. Some may need only a few weeks, while others require long-term plans. Improvements from neuro-optometric rehabilitation are generally long-lasting. Ensure your eye doctor is trained in neuro-optometric rehabilitation to provide the best care.