Neuro-Optometry and Vision Therapy for Concussion

Neuro-optometric rehabilitation treats the eye-movement problems a concussion leaves behind — most commonly convergence insufficiency, where the eyes stop working together comfortably at reading distance. These problems are invisible on a standard eye chart, which is why people are frequently told their vision is fine while screens remain unbearable.

The symptom that brings people here usually is not described as a vision problem. It is described as twenty minutes of reading producing a headache, or a screen at work becoming impossible by mid-afternoon, or a child who was a keen reader losing interest in books after a fall. The eyes are doing the work; the exhaustion is what gets reported.

This is common enough after concussion to be worth testing for routinely. In one 2024 study, roughly one in five patients with post-concussion syndrome had symptomatic convergence insufficiency — the eyes failing to converge properly at near distance. A routine acuity test will not find it, because acuity is not what is broken.

Vision therapy is the usual treatment: a program of oculomotor exercises, sometimes with prism or tinted lenses, run over weeks. It is widely offered and clinically well established, and the honest caveat is that the trial evidence is thinner than the adoption suggests — the protocol paper for the CONCUSS trial states that no scientifically validated treatment for concussion-related convergence insufficiency has been assessed. Commonly offered and proven are not the same claim.

One practical note before you book. Vision care is the thinnest widely-needed service in this directory, and vision and vestibular work are rarely in the same building. If you have both sets of symptoms, assume two appointments in two places unless the clinic tells you otherwise.