Light sensitivity has been a big problem for me. I wore sunglasses initially and then for most of October-January, when I started seeing an ocular therapist. She shined a light in my eyes and could tell that my pupils didn't stabilize quickly afterwards and weren't necessarily the same size. This is a reflex so can't be addressed with exercises. She told me not to wear sunglasses constantly/to wear light sunglasses so that my eyes would have to work and either my eyes or brain will figure out how to deal with light again. I have improved and can tolerate indoor lighting most of the time but not sunlight without sunglasses.

I had trouble going between the board and my notes in school, as it would give me a headache and feel uncomfortable. Not dizzy but wrong. The physical therapist was able to address this problem back in Nov/Dec by having me do exercises where I would look at an object and move my head or look between two objects, which is how she discovered this problem. My neck/ability to know where my head is in space was also involved, which she tested using a headband with a laser and a target on the wall.

The rest of my eye problems are more discreet and I am not usually consciously aware of the specific problems. My eyes do often feel tired at the end of the day and I sometimes get 'headaches' behind my face which is due to the eye muscles behind my face hurting from over-exertion.

The ocular therapist found that I have difficulty sustaining convergence. Basically, if I look at a pen that is 4-5 inches from my face, I don't see double but my headache significantly increases within seconds. Also, if my eyes are really tired, I do see double at that distance. She also gave me a string with beads on it, where the goal is to look at each bead for 10 seconds and move to the next. My eyes have a hard time finding the next bead and I initially see double before the images converge. Sometimes the image wavers between single and double. This exercise also increases my headache. My left eye particularly tends to 'turn out' and look more to the left when tired so my eyes aren't looking at the same thing.

The ocular therapist sent me to the neuro-ophthalmologist to look at these symptoms more. She did a crazy number of tests (the appt was 2-2.5 hours, not including waits). She diagnosed me with fourth nerve palsy (nerve going from brain to an eye muscle, muscle doesn't work well now). She did so by having me but a red lens over my right eye and look at a light she held straight on and with my head tilted to the left and right. I saw two lights instead of one. Another symptom of fourth nerve palsy was my tendency to subconsciously tilt or turn my head instead of looking straight on to relieve some of the strain. Fourth nerve palsy causes vertical double vision, which in my case is pretty subtle but straining on my eyes and likely contributing to headaches because my eyes have to work harder. She prescribed prisms for my glasses to make my eyes work together better, so hopefully that works (Hopefully getting them next week). If they don't work, then I will likely end up going to an eye muscle specialist. The fourth nerve palsy is causing/contributing to the convergence problems as well. The ocular therapist told me that this is not a particularly common problem in her patients, and she sees a lot of people with concussions, just to give some context.

The neuro-ophthalmologist looked closely at my eyes using a dye and found that they had some dry patches so I now put artificial tears in at night.

She ran a bunch of other tests that didn't turn up anything. Those that I remember are: visual field test, eye dilation/retinal scan, depth perception check, a prism test to see when things got blurry/double, color vision test, a check to see if bifocals would help, and other stuff that I don't remember/don't know what it did. Likewise the ocular therapist ran tests on my visual response time using a board with lights that I pressed when they lit up, my ability to switch from something near to something far (I need to work on this though), ability to follow lines on a page with my eyes, and several other things that I can't remember.

For my neck, I saw a physical therapist who specializes in treating concussions. She assessed my neck by feeling around and seeing what spots were tender and regularly massaged them (not a comfortable type of massage!). I also didn't have good posture so she gave me exercises to strengthen those muscles as that could be contributing to my symptoms even though it hadn't been a problem before. She also told me to play with a laser pointer and follow it with my eyes to get better with saccadic motions were difficult. I got better with all of these exercises pretty steadily.

It's been a lot, so hopefully you don't need this much!