Interprofessional Care in Patients Post-Concussion: Vision and Vestibular Considerations

By Siva Meiyeppen and Bre Myers

This article is a part of the May/June 2022, Volume 34, Number 3, Audiology Today issue. 

The evaluation and management of patients with symptoms as a result of concussion crosses disciplines. This is especially true when assessing visual and vestibular disorder-related symptoms. Oftentimes, post-concussive syndrome can manifest itself with debilitating effects on daily life. 

Those with post-concussive syndrome are individuals whose symptoms last beyond the expected recovery time. According to Ryan and Warden (2003), post-concussive symptoms can include headache, dizziness, decreased concentration, memory problems, irritability, fatigue, visual disturbances, sensitivity to noise, judgment problems, depression, and anxiety. Some symptoms resolve while others persist. The heterogeneity of symptom severity between patients is also difficult to predict. Due to the overlapping and sometimes vague nature of the symptoms, it is difficult to identify an exact dysfunction in any particular system. 

Patients may make incorrect assumptions that their blurred vision post-concussion may best be handled by vision therapy in lieu of seeking a vestibular evaluation. Conversely, some of the motion sensitivity and skewed balance complaints they attribute to an inner ear problem may be more visual in nature. 

An interdisciplinary approach to care may lead to better outcomes. However, prior to forming a collaborative relationship with optometrists and visual therapists, audiologists need a clear understanding of common evaluations and treatments available in related medical subspecialties. In this article, a case study will be used to describe the roles of each professional in the evaluation and treatment of a patient post-concussion.