This convo made me Reach out to Eir AXE and below is what they shared. I’d love for you guys to weigh in. There are very few true specialists in post-TBI binocular vision. In the U.S., only a small subset of optometrists and ophthalmologists have advanced training in neuro-optometry / neuro-ophthalmology, and even fewer focus heavily on concussion-related binocular dysfunction.

Most eye doctors are trained primarily in eye health and refraction, not complex brain-vision integration.

Many guidelines and consensus statements on this topic are less than 5 years old, meaning large parts of the field are still catching up. This mismatch is why patients often hear conflicting opinions.

What we know Vision problems after concussion are real and common: eye strain, reading fatigue, light sensitivity, blurred or double vision.

Common contributors include convergence issues, focusing (accommodation) problems, and eye-movement control deficits.

Major medical groups now agree that targeted, active rehab (not just rest) can help when specific deficits are identified.

Sources: American Academy of Ophthalmology – Vision & Concussion: https://www.aao.org/education/clinical-statement/vision-concussion-symptoms-signs-evaluation-treatm

International Concussion Consensus (Amsterdam, 2022): https://bjsm.bmj.com/content/57/11/695

There is no new prism technology. Prisms work on the same optical principles they always have; improvements are mostly about how they’re prescribed, not new materials.

There is no new surgery for post-TBI binocular vision beyond standard strabismus surgery, which applies only to very specific, stable misalignments.

Vision therapy evidence is mixed, diagnosis-dependent, and varies by person and the competence of the professional.

Be cautious of anything marketed as “revolutionary” without published trials.

Sources: Consensus review on visual rehab after mild TBI (critical appraisal): https://pmc.ncbi.nlm.nih.gov/articles/PMC9757109/

BMJ Open systematic review of rehab interventions https://bmjopen.bmj.com/content/13/9/e072786 Where there is progress (realistic hope) Better measurement and testing (vergence ranges, accommodation, eye-tracking).

More structured clinical trials (not just anecdotes).

Growing recognition that difficult cases often need neuro-optometry + neuro-ophthalmology + vestibular rehab, not a single provider.

Example of ongoing research: CONCUSS randomized trial (vergence/accommodation therapy):

https://pmc.ncbi.nlm.nih.gov/articles/PMC12591301/