One of the most difficult things to do is driving again after experiencing a major automobile accident that results in a traumatic brain injury.
Often, there is real fear and anxiety about what was previously a routine task, getting around. This short-term stress of getting back behind the wheel usually diminishes in time, and old driving instincts take over.
Some auto accident victims have more difficulty, and it’s not just about fear- head trauma can effect the many skills needed to drive. Traumatic brain injury (TBI) can make navigation tough and part of the problem is with the vision system, and that’s where the Ophthalmologist becomes a useful resource.
There are a variety of skills and reflexes that are needed to drive. One of the things that can be lost in TBI is the ability to judge distance. Depth perception is a visual process. Proper depth perception requires both eyes working together and a fully-functioning brain. I have discussed in previous blogs how TBI can disturb the coordination between the eyes as in double vision. The coordination between the eyes can be assessed and measured by an eye doctor familiar with treating head injury victims. Depth perception is obviously a critical capacity in safe driving. Safe driving is a survivor skill to function in the real world.
The real world is what I like to talk about in these blogs. Not the world of medicine or ophthalmology, but the place where eyesight makes a difference. Ask people with head injuries if they have trouble driving at night. My TBI patients almost always say yes, “yes, that’s become more difficult, I often run errands during the day instead.”
We all know night driving can be challenging, but real difficulty is a common manifestation of TBI. There is no easy cure, but if you have a job that requires you to drive home at night, that can become a barrier to making a living.
Bright lights tend to bother people more after a head injury- that is most apparent at night when the glare and contrast is greatest. Why do bright lights become more troubling? It’s partially the eyes and partially the brain. Anti-glare coatings on glasses may help- you obviously can’t safely wear sunglasses in the dark.
Getting in and out parking lots can also be stressful in patients with head injuries- the tight spaces, blind turns, and backing up. I’ve had TBI patients park on a street a half a mile from their destination to avoid the chaos of a crowded multi-level parking lot. These are the questions a TBI doctor needs to ask, these are the answers a TBI doctor needs to know.