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Post-Concussion Dizziness and Vision Problems: Causes, Testing and Treatment

Why dizziness, eye strain and visual sensitivity can linger after a concussion, and what the research shows helps.

Dizziness and vision problems are among the most common and most persistent post-concussion syndrome symptoms. A concussion can disrupt the inner ear, the eye-movement systems that keep vision steady and focused, the neck, and how the brain combines these signals, often all at once and usually without anything showing up on a CT or MRI.[3][5] Most people recover within a few weeks, but dizziness is linked to a slower recovery, and targeted rehabilitation for the specific problems found on exam has research support.[1][2][9]

Key Facts

  • Dizziness early on predicts a longer recovery. In high school football players, dizziness at the time of injury was linked to about 6 times higher odds of a prolonged recovery.[2]
  • Vestibular and eye-movement problems are common. In a pediatric concussion program, 29% of patients with a recent concussion and 63% of those with persistent symptoms had vestibulo-ocular dysfunction. Those with it took a median of 40 days to recover, versus 21 days without it.[3]
  • Vision problems often persist. Among adolescents with persistent post-concussion symptoms, 62% were diagnosed with a concussion-related vision disorder on a comprehensive vision exam.[6]
  • Positional vertigo can follow a head injury. In one study, 9% of adolescents seen soon after a concussion had BPPV, a treatable inner-ear problem.[7]
  • Strict rest is no longer recommended. The 2022 international consensus advises relative rest for the first 24 to 48 hours, then a gradual return to light activity.[1]

Common Causes of Lingering Symptoms

  • Vestibulo-ocular reflex problems. The reflex that keeps your vision steady when your head moves. When it’s disrupted, head turns can cause blurred vision, dizziness or nausea.[3][4]
  • Convergence and focusing problems. Trouble keeping both eyes aimed and focused at near distances, which can cause eye strain, double or blurred vision, headaches and trouble reading or using screens.[5][11]
  • Saccade and pursuit problems. Difficulty moving the eyes quickly and accurately between targets or smoothly following a moving object, which can make reading, scrolling and driving harder.[5][6]
  • Visual motion sensitivity. Dizziness or discomfort in busy visual environments such as stores, crowds, traffic and scrolling screens.[4]
  • BPPV. Brief spinning triggered by lying down, rolling over or looking up, caused by displaced inner-ear crystals.[7]
  • Neck injury. The same force that causes a concussion often strains the neck, which can add dizziness, neck pain and headaches.[8]
  • Exercise intolerance. Symptoms such as headache or dizziness that flare with physical exertion, which a carefully dosed exercise program can help address.[10]

Many people have more than one of these at the same time, which is why a broad exam matters.

Post-Concussion Syndrome Treatment: What the Research Shows

Cervicovestibular Rehabilitation

In a randomized trial of youth and young adults with dizziness, neck pain or headaches that persisted after a sport-related concussion, 73% of those who received combined neck and vestibular rehabilitation were medically cleared to return to sport within 8 weeks, compared with 7% of those who received standard care.[8] A 2023 systematic review for the international consensus recommends cervicovestibular rehabilitation for adolescents and adults with dizziness, neck pain or headaches lasting more than 10 days, and vestibular rehabilitation for adolescents with dizziness or vestibular problems lasting more than 5 days.[9]

Vision Therapy for Convergence and Focusing Problems

In the 2026 CONCUSS randomized trial of people with concussion-related convergence insufficiency, 88% of those who started office-based vergence and accommodative therapy right away were successful or improved after 12 sessions, compared with 8% of those who waited. Symptoms improved in 79% versus 13%.[11] A secondary analysis found that focusing (accommodative) problems resolved in 86% of the immediate-treatment group, versus 28% of those who waited.[12]

Aerobic Exercise

In a randomized trial of adolescents seen within the first week after a sport-related concussion, an individualized aerobic exercise program kept below the level that triggered symptoms led to recovery in a median of 13 days, versus 17 days with a stretching program.[10]

Testing

The Vestibular/Ocular Motor Screening (VOMS) identified concussed patients with high accuracy in its first study, with eye-movement reflex and visual motion sensitivity items the most predictive.[4] Objective eye-tracking measures can also help flag adolescents who may have a concussion-related vision disorder and need a full vision exam.[6]

Who Is a Good Candidate

  • People with dizziness, unsteadiness, blurred vision, eye strain or visual motion sensitivity that has lasted more than about 10 days after a concussion
  • People whose symptoms flare with reading, screens, head movement, exercise or busy environments
  • People with neck pain or headaches along with dizziness after a sports injury, fall or car accident
  • People who have been told their imaging is normal but still can’t return fully to school, work, sport or driving

When to See a Physician First

Call 911 or go to the emergency room after a head injury for a headache that gets worse, repeated vomiting, seizures, increasing confusion or drowsiness, slurred speech, weakness or numbness, unequal pupils, double vision that doesn’t go away, or loss of consciousness.

See your primary care doctor, an urgent care or a concussion physician before starting rehabilitation if:

  • You haven’t yet had a medical evaluation after your injury
  • Your symptoms are getting worse instead of better
  • You have a sudden change in vision, such as vision loss or a new curtain or shadow in your vision
  • You’re not sure whether it’s safe to return to sport or driving

If you come to us first and need one of these evaluations, we’ll refer you.

What Care Looks Like at Harcourt Brain Center

Your first visit includes a detailed history of your injury and symptoms, a functional neurological exam, and a vestibular and eye-movement screen. Depending on your symptoms, we may add:

Your plan targets what we find. It may include repositioning maneuvers for BPPV, vestibular rehabilitation, eye-movement, convergence and focusing exercises, visual-motion training on the Dynavision D2, cervical spine proprioceptive retraining, and a sub-symptom aerobic exercise program. We re-test at planned checkpoints so you can see measurable change. We don’t prescribe medication. If you need a neuro-optometry exam, imaging or another specialist, we’ll coordinate with your physician, and with your permission we share findings and progress reports with your doctors. Learn more on our Concussion and Auto Accident pages, our brief on dizziness after normal tests, and our Clinical Rationale & Evidence page. Clinicians can find referral details on our For Clinicians page.

Limitations

  • Most of this research was done in children, adolescents and young adults with sport-related concussions, so results may differ for adults injured in falls or car accidents.[9]
  • Many of the trials are small, and the 2023 systematic review found that the studies varied too much to combine in a meta-analysis.[9]
  • In a 2026 randomized trial in adults, a targeted multidomain treatment program improved overall symptoms no more than usual care did. It did lead to greater improvements in vestibular and eye-movement symptoms and test results.[13]
  • The vision therapy results come from people with confirmed convergence insufficiency, not all vision symptoms after concussion.[11]
  • Results vary. Some people improve a lot, some improve partly, and some need ongoing support. We set checkpoints at the start and adjust the plan or refer you if progress stalls.

Related Condition Briefs

Frequently Asked Questions

Why am I still dizzy weeks after my concussion?

Concussion can disrupt the inner ear, the eye-movement reflexes that keep vision steady, the neck and how the brain combines balance signals. These problems often don’t show up on imaging, and dizziness is linked to a longer recovery, so targeted testing and rehabilitation can help.

Why do screens, reading and stores make my symptoms worse?

Reading and screens demand precise eye teaming, focusing and quick eye movements, and busy environments challenge how the brain processes visual motion. After a concussion, these systems can tire easily or send mismatched signals, which causes eye strain, headaches and dizziness.

Should I rest in a dark room until I feel better?

No. Current international guidance recommends relative rest for the first 24 to 48 hours, then a gradual return to light activity. In research, a carefully dosed aerobic exercise program started in the first week helped adolescents recover sooner.

Can vision problems after a concussion be treated?

Yes. Problems with convergence and focusing respond well to targeted therapy. In a 2026 randomized trial, most people with concussion-related convergence insufficiency improved after 12 sessions of office-based vergence and accommodative therapy.

Do you treat adults, or only athletes?

We treat adults and adolescents after sports injuries, falls, car accidents and other head injuries. Much of the research comes from younger athletes, so we track your progress with re-tests to make sure the plan is working for you.

What are common post-concussion syndrome symptoms?

Common symptoms include headaches, dizziness, unsteadiness, blurred or double vision, eye strain, light and motion sensitivity, neck pain, trouble concentrating, fatigue and sleep changes. Dizziness, vision and neck symptoms often respond to targeted vestibular, eye-movement and neck rehabilitation.

This page is for education and doesn’t replace care from your physician. If you have a sudden severe headache, new weakness or numbness, trouble speaking, vision loss, fainting, or confusion after a head injury, call 911 or go to the nearest emergency room.

Medically reviewed by Dr. Adam Harcourt, DC, DACNB, FACFN, FABVR. Last reviewed October 2026.

References

  1. Patricios JS, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. Br J Sports Med. 2023;57(11):695-711. PubMed 37316210
  2. Lau BC, et al. Which on-field signs/symptoms predict protracted recovery from sport-related concussion among high school football players? Am J Sports Med. 2011;39(11):2311-8. PubMed 21712482
  3. Ellis MJ, et al. Vestibulo-ocular dysfunction in pediatric sports-related concussion. J Neurosurg Pediatr. 2015;16(3):248-55. PubMed 26031619
  4. Mucha A, et al. A Brief Vestibular/Ocular Motor Screening (VOMS) assessment to evaluate concussions: preliminary findings. Am J Sports Med. 2014;42(10):2479-86. PubMed 25106780
  5. Master CL, et al. Vision and Concussion: Symptoms, Signs, Evaluation, and Treatment. Pediatrics. 2022;150(2):e2021056047. PubMed 35843991
  6. Master CL, et al. Metrics of concussion-related vision disorders among children and adolescents with persisting post-concussive symptoms using an objective eye tracking device. J Sport Health Sci. 2025;14:101058. PubMed 40412714
  7. Covert K, et al. Risk Factors for Benign Paroxysmal Positional Vertigo in an Acutely Concussed Adolescent Population. J Head Trauma Rehabil. 2026. PubMed 42098907
  8. Schneider KJ, et al. Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial. Br J Sports Med. 2014;48(17):1294-8. PubMed 24855132
  9. Schneider KJ, et al. Targeted interventions and their effect on recovery in children, adolescents and adults who have sustained a sport-related concussion: a systematic review. Br J Sports Med. 2023;57(12):771-779. PubMed 37316188
  10. Leddy JJ, et al. Early Subthreshold Aerobic Exercise for Sport-Related Concussion: A Randomized Clinical Trial. JAMA Pediatr. 2019;173(4):319-325. PubMed 30715132
  11. Alvarez TL, et al. CONCUSS randomised clinical trial of vergence/accommodative therapy for concussion-related symptomatic convergence insufficiency. Br J Sports Med. 2026;60(5):340-354. PubMed 41033748
  12. Scheiman M, et al. Effectiveness of office-based vergence/accommodative therapy with movement for accommodative dysfunction in concussion-related convergence insufficiency: a secondary analysis of the CONCUSS randomised clinical trial. Br J Sports Med. 2026;60(19):1475-1485. PubMed 42392844
  13. Kontos AP, et al. Targeted Multidomain Treatment for Mild Traumatic Brain Injury: A Randomized Clinical Trial. JAMA Netw Open. 2026;9(3):e261317. PubMed 41817527

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