Vision Rehabilitation for Persisting Post-Concussion Vision Deficits

Overview

Persisting visual dysfunction is one of the most under-recognized barriers to concussion recovery, yet up to 90% of concussed patients experience vision-related symptoms at some point in their recovery trajectory. This course, presented by Sport Physiotherapy Canada (SPC) in partnership with the Canadian Physiotherapy Association, examines the assessment and management of post-concussion visual disorders, including convergence insufficiency, accommodative dysfunction, and photosensitivity, and why these deficits so often predict a prolonged road to recovery.

Clinicians will gain insight into the clinical presentation of these disorders (which is frequently more subtle than "blurry vision," showing up instead as headaches, poor concentration, and impaired visual tracking), the assessment tools used to identify them, and evidence-informed vision therapy approaches. The course also incorporates a first-person account of the vision rehabilitation journey, grounding the clinical material in lived patient experience.

Learning Objectives

By the end of this course, participants will be able to:

1. Identify the prevalence and common clinical presentations of post-concussion visual disorders, including ocular motility, accommodation, and vestibular-visual deficits.
2. Describe clinical assessment tools for post-concussion vision dysfunction, including near point of convergence (NPC) testing, accommodation testing, and advanced imaging/electrophysiological measures.
3. Explain the rationale and evidence base for vision therapy interventions, including sequencing, pacing, and symptom monitoring.
4. Recognize the value of a multidisciplinary, collaborative care model involving optometry, physiotherapy, and sports medicine.
5. Apply considerations for tailoring assessment and rehabilitation for athletes with pre-existing visual impairments, including those in parasport.

Audience

This course is designed for physiotherapists, sport physiotherapists, and other rehabilitation professionals involved in concussion management, particularly those working with athletes or active populations. It will also be of interest to clinicians collaborating with optometry and vestibular rehabilitation providers as part of a multidisciplinary concussion care team.

Why This Course Matters

Visual dysfunction after concussion is common, frequently overlooked, and closely tied to prolonged recovery — yet many rehabilitation professionals receive limited training in recognizing or screening for it. Because visual and vestibular symptoms so often overlap, physiotherapists are well positioned to catch early warning signs, but only if they know what to look for and when to refer. This course closes that gap by walking through the clinical reasoning behind vision-related concussion assessment, giving practitioners a clearer sense of what optometric collaborators are assessing and why, and where physiotherapy fits into a larger, multidisciplinary rehabilitation pathway.

About the Presenters

Dr. Kristine Dalton, OD, PhD is an Associate Professor at the School of Optometry & Vision Science and a leader in sports vision and concussion rehabilitation. She founded the Vision & Motor Performance Lab in 2013 and the Sports Vision Clinic at the University of Waterloo in 2014, which later expanded to include the Brain Injury Clinic in 2019. Her clinical work focuses on performance vision enhancement and vision rehabilitation for athletes and individuals with traumatic brain injury. Dr. Dalton is Co-Chair of the Concussion in Para Sport group, a Fellow of the American Academy of Optometry, and a Fellow of the British Contact Lens Association.

Anna Nickel, BSc, MSc Candidate is a second-year Master of Science student in Applied Health Sciences at Brock University and a member of the Injury Prevention, Clinical Intervention, and Implementation Science (I3) Lab. Her research focuses on concussion management for athletes with disabilities, with current work aimed at improving concussion assessment and rehabilitation for athletes with visual impairments — work informed by her own lived experience with persisting post-concussion symptoms.

Related Learning

• Vestibular on-demand courses
• Are Post-Traumatic Headaches and Concussions the Same Thing?
• Vestibular Therapy and Common Pitfalls to Avoid