Youth: How Soccer Concussions Affect Vision

What’s the first sign of a concussion? Confusion? Unconsciousness? Headaches?

The answer is all of the above. But there’s another symptom that observers and victims sometimes overlook - vision changes. In fact, the eyes are one of the most susceptible bodily regions to the ravages of brain injuries, and they display telltale signs that someone has taken a hard hit to the head.

Some of the visual manifestations of a concussion may be minor, while others can be quite serious and long-lasting. That’s why it’s crucial to monitor the eyes immediately after a head injury and in the weeks following, and to adhere to concussion recovery protocols. 

In Focus - How Concussions Affect the Eyes

The impact from a head collision can damage the optic nerve. However, what’s more likely to happen is the impact disrupts communication between the brain and the eyes, leading to vision changes. A concussion may also reduce blood flow to the brain, meaning less available oxygen and as a result, slower processing of information received from the eyes. 

These problems may not show up immediately but they can appear over time. Unfortunately, daily use of the eyes, stress and other factors can worsen these symptoms. For the purpose of this article, we’ll focus on vision symptoms that affect young soccer players on the pitch and in their daily routines. 

Symptoms of Vision Changes Brought on by Concussions 

• Blurry vision
• Eye pain or eye strain
• Poor reading comprehension
• Inefficient performance at school 
• Fatigue
• Double vision
• Poor depth perception
• Clumsiness
• Inability to see three-dimensionally
• Difficulty driving a car or riding a bicycle
• Difficulty walking up or down steps
• Losing your place while reading
• Skipping small words while reading
• Difficulty copying words and information
• Problems with eye-hand coordination
• Difficulty following moving objects in sports
• Motion sensitivity
• Reduced visual field
• Inability to catch important details
• Difficulty with movement
• Increased chance of collision

Any one or combination of these symptoms could wreak havoc on a player’s performance on the field, in school and at home. Some of these symptoms are unmistakable, whereas others are more subtle. For example, blurry and double vision are obvious. However, symptoms such as poor depth perception may not stand out as much. A sufferer may notice a sudden difficulty judging distances between themselves and other players or the ball, but may not know that it’s due to reduced depth perception. 

Signs of Vision Changes Observers Can Notice

Apart from what the concussion victim feels, there are eye changes that an observer may notice. Brain function after a concussion can alter how the eyes move or appear to others. A coach or medical professional will often see these changes if they look carefully enough. They include:

• Dilated or unequal pupil size
• Crossed eyes
• Droopy eyelids 
• Staring into space/looking dazed (this could also be a sign of a seizure)
• Watery/red eyes

If any of these signs appear immediately after a concussion, then there’s a high likelihood that the brain-to-eye function has been compromised. The question at that point is to what extent the eyes have been affected and what treatment the victim will need. 

How to Manage Concussion-Related Vision Changes

Vision changes, like most concussion symptoms, can follow one of three paths. First and most ideal, the symptoms will gradually disappear over time (usually due to treatment and rest). Second, visual disturbances will stabilize - they won’t get better but they won’t get worse. Third and most concerningly, concussion-related vision symptoms will get worse and disrupt one’s performance on and off the pitch. 

Regardless of the outcome, an affected player will require assessments from various specialists. An optometrist will have to observe the eyes for structural changes, but also, to test its function. However, the victim will need more than an eye exam - concussion-related eye changes come from the brain, and the affected player will need to see a neurologist. They may require diagnostic testing such as a CT scan or a functional magnetic resonance imaging (fMRI) to monitor and detect changes in brain function. 

In terms of treatment, a concussion victim who shows eye symptoms will likely need some ocular intervention. That may include prescription glasses for blurred or double vision and sunglasses for light sensitivity. 

Concussion sufferers will need to follow the standard recovery protocol as well. For starters, that means an initial and mandatory rest period in the days following the concussion - not even practice sessions are allowed.

And don’t forget the brain itself - it will need plenty of rest. Mental tasks requiring lots of concentrating, memorizing and thinking will have to go on the backburner. As time progresses, the victim can gradually resume their normal activities and play, but only in stages and with clearance from their doctor. 

Concussion Risk Reduction is Paramount

Concussion management has improved over the years but the old adage still stands - “prevention is better than cure”. It’s true that no one can eliminate concussion risks altogether, but it’s possible to bring the risks down significantly. It takes a coordinated approach from coaches, players and organizers to make this happen. 

How to Safeguard Players from Concussion Risks

• Teach visual awareness - Closely related to the preceding point, players need to learn visual awareness - the ability to see and remember all movement on the field. A player with heightened visual awareness knows where their opponents are, and can step away from a collision more consciously. Fortunately, players can improve their visual awareness skills with routine vision exercises. 

Remember, concussion prevention is about risk mitigation, not 100% “immunization”. However, a combination of training and protective gear can make the game far safer for the most at-risk players. 

Keep an Eye on Concussion-Related Vision Changes 

The eyes are your greatest asset in soccer (or any sport for that matter) and in life. A concussion can weaken your eye function. That’s why players, parents, coaches and doctors should always monitor the eyes since they provide telltale signs of a concussion’s severity. With faster and proactive management of visual disturbances, a concussion victim will likely regain their previous eye health over time.