A Beachball Sized Baseball Following Interprofessional Treatment of Multiple Concussions in an Athlete

Purpose/Objective Multiple concussions in a short period of time can be disastrous for a young athlete. This athlete suffered from photophobia, headaches, blurry vision, night glare, and poor concentration following subsequent concussions in a short time span. The athlete’s recovery required interdisciplinary management with major improvements resulting from optometric care. Background/Rationale A 20-year-old male presented to NSU Sports Medicine Clinic seven days after suffering from a concussion secondary to a weightlifting accident. He was evaluated by the sports medicine physician for initial diagnosis and treatment. He was subsequently referred to the neuropsychologist and then to the optometric physician. Six months later he sustained a second concussion while colliding with another athlete on the field. Methods/Methodology A coordinated approach to his care and careful evaluation and communication amongst three interdisciplinary disciplines was conducted. Results/Findings His initial symptoms were relieved with the use of certain filters on his phone and tablet, tinted spectacles for prolonged near work indoors and use of artificial tears throughout the day. He had accommodative dysfunction which was resolved with neuro-optometric vision rehabilitation/therapy. Optometric care also included the use of a contact lens for sports specifically. As he made tremendous progress from his concussion he suffered another concussion. He momentarily lost consciousness during his subsequent concussion. He experienced headaches, glare, photosensitivity, convergence insufficiency and reported difficulty hitting and catching the ball. Symptoms resolved following use of a contact lens in the other eye, continuation of neuro-vision rehabilitation/therapy and medical management for intermittent headaches. Conclusions Fortunately, our athlete had made enough progress from his first concussion to not suffer a major setback after the second concussion. Over the course of 12 months our interdisciplinary team effectively treated the medical, visual, and neuropsychological sequelae of both of his concussions. He did so well that he reported the baseball was “jumping out to him like it was the size of a beachball.” Interprofessional Implications This case displays the importance of an interdisciplinary healthcare team in the treatment and management of subsequent sports-related concussions in an athlete. In this case three disciplines collaborated to resolve the effects of two concussions in the same patient. Keywords: Photophobia, concussion, accommodative dysfunction, convergence insufficiency References Abusamak, M., & Alrawashdeh, H. M. (2021). Post-concussion syndrome light sensitivity: A case report and review of the literature. Neuro-ophthalmology. Clark, J., Hasselfeld, K, Bigsby, K., & Divine, J. (2017). Colored glasses to mitigate photophobia symptoms posttraumatic brain injury. Journal of Athletic Training, 52(8), 725-729. Mares, C., Dagher, J. H., & Harissi-Dagher, M. (2018). Narrative review of the pathophysiology of headaches and photosensitivity in mild traumatic brain injury and concussion. Cambridge University Press, 46(1). Merritt, V. A., Meyer, J. E., Cadden, M. H., Roman, C. A. F., Ukueberuwa, D. M., Shapiro, M. D., & Arnett, P. A. (2017). Normative data for a comprehensive neuropsychological test battery used in the assessment of sports-related concussion. Archives of Clinical Neuropsychology. 32(2), 168-183. Papas, E. B. (2017). Contact lens technology to 2020 and beyond: A review of recent patent literature. Clinical and Experimental Optometry, 100(5), 529-536