Could hearing, vision, or dizziness problems be making learning harder?
How eye, ear and balance changes can look like forgetting, and which checks help
You sit down to read a letter from your insurance company. By the bottom of the page, you cannot recall what the top said. You start again. The words begin to swim. An hour later you feel as tired as if you had run a race.
After a concussion, it is easy to blame memory for moments like this. Sometimes memory is part of the story. For some people, though, the first snag happens earlier. Your eyes may struggle to stay on a line of print. The room may tilt when you turn your head. Voices may blur together in a noisy place. When that happens, information may never arrive clearly enough to be stored.
Vision, balance and hearing changes can all affect learning after a concussion or other brain injury. You can learn to tell them apart from memory trouble, find out who checks them, and see what research says about treatment. Much of that research involves teens with sports concussions or military veterans, so we name who was studied as we go.
Information has to get in before you can remember it
Memory works in stages. First you take something in through your senses. Then your brain holds it for a moment, makes sense of it and files it away. Later you pull it back out. A weak link at any stage can leave you feeling forgetful.
The CDC lists vision problems, dizziness or balance problems, and being bothered by light or noise among the physical symptoms of concussion. The same list includes trouble with attention, concentration and memory [1]. These symptoms often travel together, which makes it hard to tell which one is behind a bad day.
A pediatric concussion guideline used across the United States and Canada makes a similar point about students. It notes that school and thinking difficulties may overlap with vision, balance, hearing, mental health and family issues. It asks health professionals to judge school problems with that overlap in mind [2].
Think of a phone call that keeps cutting out. You miss half of what the other person said because the connection failed. Straining to hear also burns energy you need for understanding and holding on to the message.
Clues that point to an access problem
Some patterns suggest the trouble starts with seeing, hearing or balance:
- Symptoms build the longer you read, look at a screen or sit in a noisy room.
- You do better with the same material when it comes in another form, such as audio in place of print, or a quiet room in place of a busy one.
- You feel dizzy, queasy or drained in places with a lot of movement and noise.
- Friends say you keep asking them to repeat things.
If you forget things even in a quiet room, with clear print and no dizziness, memory and attention are more likely to be the main issue. Many people have some of both.
When your eyes tire on the page
Reading asks a lot of your eyes. Both eyes must turn inward together to look at something close, which is called convergence. Each eye also adjusts its focus for near work, called accommodation. And the eyes make quick, accurate jumps from word to word and line to line, called saccades.
A concussion can upset any of these skills. In a 2016 study at the Children’s Hospital of Philadelphia, researchers examined adolescents ages 11 to 17 who came to a concussion program. Of them, 69% had at least one vision diagnosis. Focusing problems turned up in 51%, convergence problems in 49% and eye jump problems in 29% [3]. The study included 100 teens. Nearly half had more than one diagnosis [4].
Keep in mind who was studied. These teens were seen at a specialty clinic, where people with stubborn symptoms tend to end up, so the rates are probably higher than for all concussions. The lead researcher also pointed to the heavy visual load of a full school day, starting with something as basic as reading [4].
A 2022 statement from the American Academy of Ophthalmology and three partner groups describes what these problems feel like. Convergence insufficiency, when the eyes struggle to turn in and stay lined up at reading distance, can cause double vision, eye strain and tiring fast while reading. A focusing problem, called accommodative insufficiency, can blur close work and bring on headaches and fatigue. Both can make reading feel like a chore that people start to avoid [5].
The same statement gives a broader picture. Soon after a concussion, up to 40% of children and teens have blurry vision, double vision or trouble with bright light, based on reports the statement cites. Most young people with visual symptoms recover on their own by about four weeks [5]. The statement focuses on children and teens. Adults returning to office work, or drivers scanning mirrors and road signs, rely on the same eye skills.
Signs worth mentioning to your care team
- Words that blur, double or swim after a few minutes of reading.
- Losing your place, skipping lines or reading the same sentence again and again.
- Eye strain, headaches or sleepiness with close work.
- Avoiding reading you used to enjoy.
- Screens or bright lights that make symptoms worse.
Dizziness, busy places and screens
Your sense of balance draws on your inner ear, your eyes and signals from your neck and body. The inner ear part, along with its links to the brain, is called the vestibular system. After a head injury, these signals may stop agreeing with each other. You might feel unsteady in a crowd or queasy when scrolling on a phone.
Dizziness also drains attention. When part of your brain is working hard to keep you upright and your view steady, less is left for a lesson or a meeting. A busy store, with people moving and bright shelves, can feel like too much input at once.
The 2022 Amsterdam consensus on sport concussion comes from an international panel. It recommends rehabilitation aimed at the neck and balance system when dizziness, headaches or neck pain are still there after 10 days. It adds that vestibular rehabilitation may help children, teens and adults with dizziness or balance problems [6].
The Living Guideline for Pediatric Concussion Care, in its 2024 version, has advice for children and teens. A young person with dizziness, spinning or unsteadiness should get a medical check one to two weeks after the injury. The guideline lists screening by a team trained in balance problems, including a positional test. When that test is positive, a repositioning maneuver may be used as treatment. The guideline advises referral to a concussion team if balance symptoms have not gradually eased by four weeks, or sooner when a child has factors that can slow recovery [7].
Dizziness and driving
Checking mirrors, scanning an intersection and judging the speed of other cars all depend on steady eyes and good balance processing. If you feel dizzy, see double or lose focus, check with your care team about driving before you take the wheel again. Each state sets its own driving rules for people with medical conditions, so check yours.
Get emergency care right away
New or sudden symptoms after a head injury can signal an emergency. Call 911, or get to the closest emergency department right away, if anyone shows one of these danger signs following a head injury [8]:
- One pupil bigger than the other.
- A headache that keeps getting worse and will not go away.
- Weakness, numbness, poor coordination, seizures or convulsions.
- Vomiting again and again.
- Slurred speech or unusual behavior.
- Cannot recognize people or places, or seems confused, restless or agitated.
- Passing out, seeming very drowsy, or cannot be woken up.
Ringing ears, noisy rooms and listening fatigue
Much of the research on hearing after brain injury comes from military veterans. A 2007 review of VA medical records looked at 252 patients with TBI of varying severity. Among people injured before the start of Operation Iraqi Freedom, 28% complained of hearing loss and 11% of tinnitus, a ringing or buzzing in the ears. Among those hurt later in injuries not caused by blasts, the figures were 44% and 18%. In the blast group, they rose to 62% and 38% [9].
Those findings come from service members, many hurt by explosions. They cannot be applied directly to a concussion from a car crash or a fall.
Audiologists who see civilians after concussion describe a pattern that is easy to miss. People often have trouble filtering out background noise. Some develop tinnitus or hyperacusis, which means everyday sounds feel uncomfortably loud. Others describe deep tiredness after time with friends or family, sometimes called auditory or listening fatigue [10].
A standard hearing test can come back normal even when listening is hard. A 2025 column in Canadian Audiologist warns that a normal hearing test result does not promise normal listening [10]. An earlier report from a Dalhousie University audiology program made a similar point: a basic tone test alone cannot capture these listening problems [11].
If you keep asking people to repeat themselves, mishear names, or come home from gatherings drained, the trouble may start with listening. To the people around you, missed parts of a conversation look a lot like forgetting. A partner may think you forgot a plan that you never fully heard.
Who checks what, and how to get there
Start with the clinician who manages your concussion care, such as a primary care doctor, sports medicine doctor or rehabilitation doctor. Describe exactly what happens, when it happens and what makes it worse. They can look for other causes and point you to the right next step.
Comparison compiled by Safety Behind the Wheel Foundation
Memory problem or information access problem?
| What you notice | What it could point to | Who can check it |
|---|---|---|
| Words blur or double after a few minutes of reading | Eye focusing or eye teaming problem | Optometrist or ophthalmologist |
| You lose your place or skip lines | Eye movement problem | Optometrist or ophthalmologist |
| Crowds, screens or car rides make you dizzy | Balance (vestibular) problem | Physician, vestibular physical therapist |
| You hear people but cannot follow them in noise | Listening in noise or sound processing | Audiologist |
| Ringing ears, or normal sounds feel too loud | Tinnitus or sound sensitivity | Audiologist, physician |
| You forget even in quiet, clear settings | Memory or attention | Physician, neuropsychologist, speech language pathologist |
Sources: CDC [1]; eye care clinical statement [5]; Amsterdam consensus [6]; Canadian Audiologist [10]; physical therapy guideline [12].
Eye care
A basic screen of eye tracking, eye jumps, convergence and focusing can be part of a regular checkup. The 2022 eye care statement notes that general pediatricians may do this screening. For the smaller group whose symptoms continue, it supports referral to specialty care [5]. The Amsterdam consensus names both optometrists and ophthalmologists among the professionals on concussion care teams [6]. Ask whether the exam will test eye teaming and focusing at reading distance as well as the usual eye chart.
Balance
Physical therapists with extra training in vestibular rehabilitation treat dizziness and balance problems. A 2020 clinical practice guideline from academies of the American Physical Therapy Association sets out evidence based recommendations for how physical therapists assess and treat people after concussion [12]. Children whose dizziness lingers may also be referred to a concussion team [7].
Hearing
An audiologist can go beyond the standard booth test. Depending on your complaints, that may include a test of how well you follow speech in noise. It may also include a check of central auditory processing, meaning how the brain makes sense of sound [10]. Tell your doctor right away about any sudden change in your hearing.
Before your appointment, note
Checklist from Safety Behind the Wheel Foundation
- When each symptom started, and whether it is getting better, worse or staying the same.
- What sets it off: reading, screens, crowds, car rides, noise or turning your head.
- How long you can read or listen before symptoms start.
- Whether you wear glasses or hearing aids, and when they were last checked.
- Any vision or hearing problems you had before the injury.
- Which daily tasks it affects, such as driving, work, school or cooking.
What the treatment research shows
Vestibular rehabilitation
Vestibular rehabilitation is a program of guided exercises for dizziness and balance. A 2022 systematic review found seven randomized trials with 266 people aged 9 to 67 who had a concussion. When three of those trials were pooled, rehab lowered scores on a questionnaire that measures how much dizziness gets in the way of daily life, by about seven points. Results for balance and for general symptom checklists were mixed [13].
The review authors noted that the trials differed a great deal in methods and measures. They called for larger studies [13]. That places vestibular rehab in the promising group, with some trial support. It also fits the consensus advice to consider it when dizziness lasts beyond about 10 days [6].
Vision treatments
The evidence for vision treatment is thinner. The 2022 eye care statement found too little high quality research to show that vision therapy, used on its own, helps blurry or double vision after concussion. It did note that temporary prism lenses, paired with the right glasses for close work, can ease symptoms. It also pointed to early evidence from two randomized trials that active rehab for balance and eye movement problems helps. More research is needed on timing and best practice, the statement adds [5].
Many eye problems after concussion fade with time [5]. If someone offers a long or costly course of treatment, it is fair to ask about the evidence behind it, the goals, and how you will track progress.
Hearing and sound sensitivity
For listening problems, audiologists may suggest communication strategies, changes to your surroundings, structured listening training, or help for tinnitus [10]. The evidence for these tools in concussion is limited. The Dalhousie report described varied responses among patients and recommended advanced testing to guide a plan [11]. Ask what results to expect and how you will know if a treatment is working.
Easier ways to read, listen and learn while you recover
While you wait for an appointment or work through treatment, small changes can lower the load on your eyes, ears and balance. They do not replace a proper check.
Reading and screens
- Turn down screen brightness and cut back on glare. The eye care statement lists both as ways to reduce stress on the eyes [5].
- Read in short blocks and stop before symptoms build.
- Slide a card or ruler under the line you are reading.
- Make text bigger on your phone or computer, and print long documents in a larger font.
Conversations and noisy places
- Face the person speaking and sit with your back to the noise.
- Ask for plans, instructions and appointment details in writing or by text.
- Run errands at quiet times of day.
- Build in rest after social events, especially loud ones [10].
School and work
For students, temporary changes to the schedule, the classroom setting and the workload are part of a gradual return to school in the pediatric guideline [2]. The Amsterdam consensus lists options such as preprinted class notes, extra time for assignments and extra time on tests [6]. Adults can ask an employer for similar short term changes, such as printed agendas, a quieter desk, or more time for reading tasks.
Questions to ask your care team
Question checklist from Safety Behind the Wheel Foundation
- Could my eyes, balance or hearing be part of why reading and remembering feel so hard?
- Should I have an eye exam that checks eye teaming, focusing and eye movements, and who should do it?
- Would vestibular rehabilitation help my dizziness, and can you refer me to a physical therapist trained in it?
- My hearing test was normal, but I struggle in noisy places. Should I see an audiologist for more testing?
- Which of my symptoms are likely to ease on their own, and how long should we wait before looking further?
- What evidence supports the treatment you are suggesting, and how will we know if it is working?
- Should I be driving yet, given my vision or dizziness symptoms?
- What changes at school or work would make reading and listening easier for now?
Frequently asked questions
Can a concussion affect my hearing?
It can. In VA records of veterans with TBI, complaints of hearing loss and tinnitus were common, especially after blasts [9]. After civilian concussions, audiologists more often describe trouble listening in noise and sensitivity to sound, sometimes with a normal hearing test [10]. An audiologist can help sort out which problem you have.
Will my vision problems go away on their own?
Many do. The 2022 eye care statement says most children and teens with visual symptoms after a concussion recover on their own by about four weeks. It adds that focusing and convergence problems often fade with time [5]. If symptoms last longer or get in the way of reading, ask for a referral.
Is vision therapy proven to work after concussion?
The evidence is weak so far. The 2022 statement found too little high quality research to support vision therapy alone for blurry or double vision after concussion. It did say temporary prism lenses with glasses for close work can ease symptoms [5]. Ask what the plan is and how progress will be tracked.
The bottom line
Recommendation from Safety Behind the Wheel Foundation
If reading, listening or busy places leave you lost and drained after a concussion, look at how information is getting in, along with how well it is being stored. Eye focusing, balance and listening problems are common after these injuries, often improve with time, and can be checked by eye care professionals, vestibular physical therapists and audiologists.
Ask for the right tests, ask what the evidence says about any treatment, and make small changes to your reading, screens and surroundings in the meantime. A clearer picture of what is going on can make the memory side of recovery easier to manage.
Sources and further reading
- 1Centers for Disease Control and Prevention. Signs and symptoms of concussion. HEADS UP. Updated September 15, 2025. cdc.gov/heads-up/signs-symptoms/index.html
- 2Reed N, Zemek R, et al. Living Guideline for Pediatric Concussion Care. Domain 12: Return to school and work. Updated December 2024. pedsconcussion.com
- 3Master CL, Scheiman M, Gallaway M, Goodman A, Robinson RL, Master SR, Grady MF. Vision diagnoses are common after concussion in adolescents. Clinical Pediatrics. 2016;55(3):260-267. doi.org/10.1177/0009922815594367
- 4Master C. Vision disorders are common after concussion in adolescents. Research in Action, Center for Injury Research and Prevention, Children’s Hospital of Philadelphia. March 21, 2016. injury.research.chop.edu/…/vision-disorders-are-common…
- 5Master CL, et al. (AAP Section on Ophthalmology, American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Association of Certified Orthoptists). Vision and concussion: symptoms, signs, evaluation, and treatment. Clinical statement. August 2022. aao.org/…/vision-concussion-symptoms-…
- 6Patricios JS, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022. British Journal of Sports Medicine. 2023;57(11):695-711. doi.org/10.1136/bjsports-2023-106898
- 7American Speech-Language-Hearing Association. Evidence Maps summary: Living Guideline for Pediatric Concussion Care (Reed N, Zemek R, et al., Ontario Neurotrauma Foundation, 2024). apps.asha.org/…/2216f789-723b-47ae-9218-407…
- 8Centers for Disease Control and Prevention. Symptoms of Mild TBI and Concussion. Updated September 15, 2025. cdc.gov/…/index.html
- 9Lew HL, Jerger JF, Guillory SB, Henry JA. Auditory dysfunction in traumatic brain injury. Journal of Rehabilitation Research and Development. 2007;44(7):921-927. doi.org/10.1682/JRRD.2007.09.0140
- 10Jiwani S. Concussion and hearing: the hidden impact. Clinic Corner. Canadian Audiologist. 2025;12(5). canadianaudiologist.ca/…/clinic-corner
- 11Noel G. Concussion and its impact on the auditory system. Dalhousie University School of Communication Sciences and Disorders; Canadian Academy of Audiology. 2018. canadianaudiology.ca/…/Concussion-And-Its-Impact-O…
- 12Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, Landel R, Alsalaheen BA, Hanke TA, McCulloch KL. Physical therapy evaluation and treatment after concussion/mild traumatic brain injury. Journal of Orthopaedic and Sports Physical Therapy. 2020;50(4):CPG1-CPG73. doi.org/10.2519/jospt.2020.0301
- 13Galeno E, Pullano E, Mourad F, Galeoto G, Frontani F. Effectiveness of vestibular rehabilitation after concussion: a systematic review of randomised controlled trial. Healthcare (Basel). 2022;11(1):90. doi.org/10.3390/healthcare11010090
This article reflects the safety priorities of brain injury recovery and road safety education. It is general education and not medical advice. Symptoms, tests and treatments differ from person to person. Check official sources such as the CDC and talk with your own care team before making decisions about treatment, school, work or driving. Reviewed October 2026.
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