Hi all. I've been reading this site for several months and found it helpful to my situation. Fwiw, I appreciate seeing others take time to reply with their expertise to assist others. I feel blessed to be where I am compared to many of the accounts I have read -as at least I can work and battle through the headaches, eye strain/fatigue, short term memory issues, & poor sleep. Also manage to run 12 miles a week along with some cycling.

I am 52, and was struck in the temple with a large metal pole (heavy) while setting up a trade show booth in July of 2015. Wasn't knocked out, but like so many, didn't see the a lot of the effects of concussion until 5-6 weeks later.

I felt like my recovery was mostly completed until a particularly stressful time about 5 months later, which I believe, brought back many of the symptoms. However a new symptom had appeared and it was my eyes having issues with convergence. I noticed it when I would look at someone in the eyes, and somehow I couldn't focus on one general area like I always have.

Thus off to a vestibular therapist, who was new to this type of therapy. On day one she put me through the ringer and it almost wrecked me! I was exhausted and had a nearly constant 'whooshy' feeling in the back of my head. I continued with it thinking that I would get through this rough part and make it to the other side. Well, nearly a month later, and I continued with the same side effects. I had to stop because it was affecting my job performance.

Fast forward to yesterday when I went to see a Neuro Eye Dr. He did a lot of tracking tests on me and determined that vision therapy would likely benefit me. 10 weeks of this, going twice a week. (Also $1800 out of pocket as it is deemed not medically necessary). So with the liklihood of this therapy making me feel similar to the vestibular therapy, I am not sure this is what I need.

Is it reasonable to expect the vision/vestibular dysfunction from the concussion to repair itself over time? Other than the short term memory issues, I feel like this is the biggest contributor to PCS. If this would resolve itself, my quality of life gets much closer to where it was prior to the injury. Thanks in advance....

For me vision therapy was huge. I needed to do vision therapy and get my eye movements in order before I could handle doing more intensive vestibular rehab. It is not an overnight fix, and I view it just like working out. You just have to keep with it and do a little everyday as more is not always better. After a while you should be able to do most eye exercises at home.

Pcsblows,

Maybe the Neuro Eye Dr could contact your PCP who can request the eye therapy. Maybe then your insurance will help. Some insurance companies put large copays or annual limits on therapy but any money would be good.

The vestibular therapist may also be able to state the medical need for visual therapy.

You may be able to negotiate the price based on the Medicare allowable fee. Insurance companies often pay a discounted rate that gets close to the Medicare allowable fee. To see what that fee is, get the HPCPS or CPT codes from the Dr's office and check out Physician Fee Schedule Search
Click Accept to get to the fee look up page. Select All Modifiers and input a Single or List of HPCPS codes.

Often, providers will agree to 150% of the Medicare allowable fee for patients paying cash at the time of treatment.

The American Optometric Association has put a lot of effort into getting guidelines from insurance companies to cover these therapies. Here is an article that explains the fight, but not the guidelines.
Getting Insurance Companies to Pay for Vision Therapy Coverage << Optometry Cares – The AOA Foundation
If you doc contas AOA, maybe they can help.

There are some online guides to at-home therapy but getting professional diagnosis and assistance would be best. Google 'vision therapy at home exercises'

Thank you for the replies.

Mark - this is a workman's comp case - which is a total disaster as you know, so I highly doubt they will pay for anything. I may have to go a different route and have my current work insurance (which is a cadillac policy) pay for it as you suggest.
My thing with getting this sort of therapy is that it would likely wipe me out (Physically) and because I travel for work ( and work from home when not traveling), I don't know that I can make this sort of commitment. Thus - why I asked if it was reasonable to believe the vestibular issues would correct themselves over time - without therapy?!?!
I am probably asking a question that only God knows!

The Dr made the comment that this sort of eye issue needed to be addressed before an 18-24 month time period AFTER the incident occurred, which makes me think it wouldn't resolve by itself. There is obviously something to the vision therapy, but it seems like its similar to a back surgery where the Dr only gives you a 60% chance of it actually helping.

Pcsblows,

I have had 40 weeks of vision therapy, I have found it helpful. I have better ability to control my eye movements and the prisms in my glasses do help.

The sessions wipe me out for the next day. I have to travel an hour each way and am sure that contributes to the way I feel afterwards. After an assessment yesterday I have another 20 weeks in front of me. It is not a quick fix but improvements are measurable unlike so many of the other symptoms.

Good luck! I hope it goes well for you.

Thank you Almost. 'Wiped me out' is a relative term...does this mean you couldn't function at all the next day? Perhaps not even accomplish a work from home situation?
Trying to determine if the average Joe can still work while going through this therapy. Sure wish I could see into the future!

PCsblows,

I have been unable to work since my injury so it is hard to say. I know that I spend most of the evening being quiet and usually do not do much the next day. My eyes ache and I feel spent.

I practise the homework daily without much trouble so maybe it is the combination of the travel and eye exercise.

We are all different in what we can tolerate. I would not discourage you from trying it. I have been reassessed every 8 weeks and have had improvement.

I am not sure whether I should start a thread or join this since I have vision related questions. Vision (especially convergence issues) are one of the measurable and obvious post-concussion symptoms in my case.

- do you know if there are downsides to having a prism? Does that reduce the ability of the eye to recover? I feel my therapist was a bit hesitant and gave me reading glasses "with a little of prism". But I am unable to work now...

- Do you think getting a big screen would help. Large fonts, would they reduce eye strain and improve symptoms?

I would be grateful for your thoughts on these two issues.

I went to my vestibular therapist today to chat with her about vision therapy. She was thrilled that my eye dr did not want to put me in prism glasses mainly because she felt it was not a proven technology. I know I sure wouldn't want to wear them for a upwards of a year plus.

The more I read and talk to people, the more convinced I am to give Vision therapy a shot.

Also, for what it's worth, I did buy a larger 26" computer monitor and I know it has helped my eye strain (at the very least).

Why would you not want to wear prisms?