When reading and screens become difficult after a concussion
Track what makes reading and screens harder, plan your questions and test changes
The novel on your nightstand has not moved in a month. Your phone feels too bright even at its lowest setting, and an hour at the laptop leaves your eyes aching and your head pounding. You read the same paragraph three times and still lose your place.
Trouble with reading and screens can make work, school, bills and even texting friends harder. It can also be hard to explain, because your eyes may look fine and the eye chart may come back normal.
This guide gives you a reading and screen log, questions to ask about a vision evaluation and a list of adjustments to try with your care team. Our shorter page on vision strain after a crash concussion covers the basics. Our article on hearing, vision and dizziness explains how these problems can look like memory loss.
Why reading and screens can get harder
The Living Concussion Guidelines come from Canada and cover adults. They are called living guidelines because they are kept current as research comes in. A version written for patients lists vision problems that can follow a concussion [1]. They include blurred or double vision, sensitivity to light or to computer and TV screens, and headaches set off by visual tasks [1]. Some people also struggle to tell apart letters or shapes that look alike [1]. The same guide says these problems usually clear up on their own within a couple of weeks [1].
Reading up close puts two demands on your eyes. To stay on the page, the two eyes swing inward together, a skill called convergence. Each eye also has to keep near print sharp, which is called accommodation. A 2022 statement from eye care groups, including the American Academy of Ophthalmology, says weak convergence can cause double vision and eye strain during reading [2]. When focusing is weak, near print may blur, and headaches, tiredness and losing interest in reading can follow [2]. The statement is about children and teens, but adults use the same eye skills.
What studies in adults show
A Danish study examined 103 adults who still had symptoms two to six months after a concussion [3]. About 20 percent had symptomatic convergence insufficiency, meaning their eyes struggled to work as a team at reading distance and they felt the effects [3]. Those people also had a heavier load of symptoms that had nothing to do with vision [3]. Two vision questions on the Rivermead questionnaire, a common concussion symptom checklist, did not identify who had the problem [3]. The problem showed up on an eye exam.
Screens add their own strain. A Canadian study interviewed 31 workers recovering from concussion and 16 professionals who support them [4]. The authors note that concussion symptoms can briefly worsen with mental effort, such as looking at screens [4]. One registered nurse said she could manage only about 30 seconds on a website before her symptoms set in [4]. Another worker said reading on paper was far easier than reading on a screen [4].
Trouble focusing and fatigue can slow reading too, so the log below keeps eye symptoms and thinking symptoms apart.
Keep a reading and screen log
The patient guide asks you to tell your provider about the specific problems you are having [1]. Details are what turn “reading is hard” into something a clinician can act on. The adult guidelines use a 0 to 10 rating scale when they describe how to build up exposure slowly [5]. Ratings in your log fit the way such a plan is made.
Keep the log for one or two weeks. Fill in a line each time you read or use a screen for more than a few minutes, and any time symptoms start.
What to write down:
- The task, such as a paper book, phone, laptop, TV or printed form.
- The setting: time of day, lighting, text size and screen brightness.
- How many minutes passed before the first symptom.
- Which symptoms: blur, double vision, eye strain, headache, nausea, dizziness, losing your place or rereading.
- A rating from 0 to 10 before and after.
- How long it took to settle, and what helped.
Worksheet from Safety Behind the Wheel Foundation
Reading and screen log
| Task, setting and time | Minutes until symptoms | Symptoms and rating (0 to 10) | What helped and time to settle |
|---|---|---|---|
| Example: laptop email, bright office, 2 p.m. | 12 | Eye strain, headache from 2 to 5 | Break in a dim room, 45 minutes |
Ratings use the 0 to 10 scale found in the Living Concussion Guidelines [5]. Bring the log, or a photo of it, to your next appointment.
Imagine a 29 year old graphic designer who was hit by a car while cycling to work. After a week of logging, a pattern shows up. She can read a paper book for 25 minutes, but her laptop brings on eye strain in about 10, and close reading after 6 p.m. makes the lines double. Her log gives her care team three clear facts: near work is the main trigger, screens are worse than paper and symptoms build as the day goes on.
Patterns to look for in your log
Checklist from Safety Behind the Wheel Foundation
- Are symptoms worse with close work than with things far away?
- Are screens worse than paper, or one device worse than another?
- Do bright rooms, flicker or fast scrolling make things worse?
- Are symptoms worse late in the day or when you are tired?
- Do you lose your place or skip lines even when the words look clear?
- Do you see the words fine but forget them by the end of the page? That may point more to attention or memory than to your eyes.
- Do symptoms last into the next day after a long reading session?
Who checks reading and screen problems
Your first stop is usually the clinician already treating your concussion. The Living Concussion Guidelines say vision symptoms should be screened for and rechecked at follow up visits [5]. A full check starts with a detailed history [5]. It then tests sharpness of vision, the pupils, side vision, the back of the eye, and how the eyes move and work together [5]. An eye exam should also rule out an injury to the eye or an eye condition you already had [5]. The guidelines name simpler causes too, such as a glasses prescription that needs updating, and note that mental health can affect lasting vision symptoms [5].
The guidelines recommend a referral to someone with special training in vision or balance problems when symptoms still limit daily life more than a month after the injury [5]. That advice rests on lower level evidence. For significant symptoms that limit what you can do, they say referral to a licensed professional trained in vision assessment and rehabilitation should be considered [5]. People with complex symptoms, such as double vision or loss of vision, should see a neuro ophthalmologist [5]. That is a medical eye doctor with extra training in vision problems that start in the brain and nerves. The patient guide names ophthalmologists and optometrists with rehabilitation training as vision specialists who may help [1].
Comparison compiled by Safety Behind the Wheel Foundation
Who may check reading and screen problems
| Professional | What they may look at | Often involved when |
|---|---|---|
| Concussion or primary care clinician | Symptom screen, eye movements, overall plan | Symptoms linger after the first weeks |
| Optometrist with rehabilitation training | Eye teaming, focusing, glasses, vision rehabilitation | Symptoms limit daily life after about a month |
| Ophthalmologist | Eye health, eye injury, glasses | An eye injury or eye disease needs ruling out |
| Neuro ophthalmologist | Double vision, loss of vision | Symptoms are complex or unusual |
Based on the Living Concussion Guidelines and its patient version [1, 5]. Titles, training and referral rules differ by country, state and insurance plan.
What the treatment evidence shows
For lasting symptoms, the patient guide says treatment may include vision rehabilitation or special glasses, such as reading, prism or tinted lenses [1]. The adult guidelines say vision rehabilitation can help some patients [5]. Vision rehabilitation also appears on a 2025 review’s list of treatments that may help adults with concussion return to their jobs [6].
The evidence is thinner for some treatments than others. According to the 2022 eye care statement on children and teens, good quality studies are still lacking for vision therapy as a standalone treatment for visual symptoms [2]. Short term prism glasses, used with a correct prescription for near work, may relieve symptoms, the statement says [2]. It also notes early, encouraging results from two randomized trials of active rehabilitation in sport concussion, aimed at balance, eye movement and exercise problems [2]. More research is needed on timing and the best approach [2].
If someone suggests a long course of treatment, ask about the goal, the number of visits, the cost and how progress will be measured. Your log gives you a simple way to judge whether things are changing.
Screen time in the first days and months later
Advice about screens depends on timing. A U.S. trial studied adolescents and young adults, aged 12 to 25, seen in emergency departments soon after a concussion [7]. It randomly assigned 125 of them to avoid screens for 48 hours or use them freely [7]. Those who stayed off screens recovered in a median of 3.5 days, compared with 8 days for the others [7]. The authors called for a larger study across several centers [7]. A U.S. primary care guideline from 2025 supports cutting back on screens for the first 48 hours, then going back to moderate use [8]. It also notes that most guidelines do not address screen time directly [8]. An international consensus on sport concussion, from a 2022 meeting in Amsterdam, reached a similar view for athletes. Less screen use in the first two days is warranted, it says, but may not help after that [9].
For symptoms that linger, a Canadian return to work tool advises easing back into screen use at a pace your symptoms allow [10]. For people sensitive to light, the Living Concussion Guidelines recommend a graded exposure program, with symptoms going up by 2 points out of 10 at most [5]. They also suggest lower screen brightness as you return to daily tasks [5].
Adjustments to try with your care team's guidance
Text, layout and audio
The 2022 eye care statement, written for children and teens, lists supports for reading [2]. They include larger print, double spacing, blocking out parts of the page, printed notes, lower screen brightness and breaks from visual work as needed [2]. It says audiobooks or text to speech software may be needed for a while [2].
Workers in the Canadian study had similar ideas for health websites. They asked for audio options, a way to enlarge text, less visual clutter, color filter options, print options and prompts to take short breaks [4]. Many of the same settings are built into phones, tablets and computers.
Lighting and devices
A 2010 guide from the Job Accommodation Network (JAN) suggests a glare guard for computer monitors and more natural light [11]. The guide describes a worker with a brain injury who could not read past the middle of a line [11]. The suggested fixes included narrower page margins in his word processor and task lighting [11]. A Living Concussion Guidelines table on work limits lists less screen use for people bothered by light or noise [12].
A small Toronto study tested a different kind of screen. It included 29 adults with post concussion syndrome who could not tolerate computer screens and were sensitive to light [13]. Reading on a standard LCD screen raised their symptoms more than reading on a non LCD screen that refreshes far less often [13]. People read longer before symptoms started on the non LCD device, and their understanding of the text was about the same [13]. The study was small, and the authors called for larger ones. Ask your care team before buying special equipment.
Reading at work, at home and on paperwork
Work often brings the heaviest reading load. If your job keeps you on a screen, bring your log to any return to work meeting. It shows your employer how long you can read now and which changes help. Our article on returning to work with persistent concussion symptoms has a worksheet and scripts for that talk. The Living Concussion Guidelines table on work limits also lists no heavy equipment for people with vision or concentration problems [12].
At home, bills, insurance letters and medical forms can pile up. Ask companies whether they can send paper statements in larger print, or explain a letter over the phone. A trusted person can read important mail aloud while you listen and take short notes. Most phones and computers can also read text aloud.
Reading for pleasure counts too. Short sessions with a paper book, large print editions or an audiobook can keep a habit you enjoy alive while your eyes recover. Stop before your log says symptoms usually start, and stretch the time slowly.
Driving also depends on clear, steady vision. If you have blurred or double vision or lose your place easily, ask your care team whether it is safe to drive before you get behind the wheel. Our page on getting back to driving after a brain injury can help with that conversation.
When to get emergency care
Most reading and screen symptoms are not an emergency. If you or someone near you sees any of these signs, dial 911 right away or have someone drive you to the hospital emergency department [14]:
- A worsening headache that does not ease with time
- Weakness or numbness, loss of coordination, or a seizure
- Repeated vomiting
- Speech that is slurred, or behavior that is unusual for you
- Pupils that look uneven in size
- Trouble recognizing faces or familiar places, or agitation, restlessness or confusion
- Losing consciousness, being very hard to wake, or not waking at all
Questions to ask about a vision evaluation
Question checklist from Safety Behind the Wheel Foundation
- Could my eyes be part of why reading and screens are so hard right now?
- Will my eye teaming, focusing and eye movements be checked, along with the eye chart?
- Is my glasses prescription still right for close work and screens?
- Do my symptoms limit my daily life enough to see a vision specialist, and whom would you suggest?
- Should a neuro ophthalmologist look at my double vision or vision change?
- If you suggest vision therapy or special glasses, what is the goal, how many visits will it take and how will we measure progress?
- How much screen time should I aim for this week, and how should I add more?
- Which reading adjustments should I try first?
- Should I hold off on driving until these vision symptoms improve?
Frequently asked questions
My eye chart test was normal, so why is reading still hard?
The eye chart mainly checks how sharply you see. The 2022 eye care statement for children and teens describes a fuller screen that also looks at how the eyes track, jump and work together [2]. In the Danish study, a symptom checklist missed eye teaming problems that an exam found [3].
How long do reading and screen problems last?
For many people they fade within a couple of weeks [1]. The 2022 statement says most children and teens recover by about four weeks [2]. If symptoms still limit your daily life after a month, the Living Concussion Guidelines recommend a referral [5].
Is it all right to switch to audiobooks for now?
Yes, for many people it is a sensible short term step. The eye care statement for young people lists audiobooks and text to speech as options while symptoms settle [2]. Ask your care team how to mix listening with short, gradual reading practice.
The bottom line
Recommendation from Safety Behind the Wheel Foundation
Reading and screen trouble after a concussion is common and often improves, but lasting problems deserve a proper look [1, 5]. A simple log of what you read, for how long and what happened gives your care team the details they need.
Ask for an exam that goes beyond the eye chart, and ask what evidence supports any treatment. With your care team’s guidance, try larger text, lower brightness, breaks, print and audio. Referral rules and coverage vary by state and insurance plan, so check your own plan.
Sources and further reading
- 1Living Concussion Guidelines, patient version. Vestibular and vision problems. Ottawa Hospital Research Institute. Last updated July 2025. concussionsontario.org/…/vestibular_and_vision_problems
- 2Master CL, Bacal D, 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-signs-evaluation-treatm
- 3Nisted I, Hellemose LA, Eggertsen PP, Odgaard L, Bek T, Nielsen JF. Convergence insufficiency in patients with post-concussion syndrome is accompanied by a higher symptom load: a cross-sectional study. Brain Injury. 2024;38(8):645-651. doi.org/10.1080/02699052.2024.2334355
- 4Beaton MD, Hadly G, Babul S. Stakeholder recommendations to increase the accessibility of online health information for adults experiencing concussion symptoms. Frontiers in Public Health. 2021;8:557814. doi.org/10.3389/fpubh.2020.557814
- 5Living Concussion Guidelines. Guideline for Concussion and Prolonged Symptoms for Adults over 18 Years of Age, Section 10: Vestibular (balance and dizziness) and vision dysfunction. Ottawa Hospital Research Institute. Last updated May 2023. concussionsontario.org/…/vestibular-balance-dizziness-vision-dysfunction
- 6Ethier-Gagnon M, Lithopoulos A, Pattison M, et al. Interventions to help adults with concussion return to work: a systematic review. PM&R. 2025;17(7):830-849. pubmed.ncbi.nlm.nih.gov/40152151
- 7Macnow T, Curran T, Tolliday C, et al. Effect of screen time on recovery from concussion: a randomized clinical trial. JAMA Pediatrics. 2021;175(11):1124-1131. doi.org/10.1001/jamapediatrics.2021.2782
- 8Silverberg ND, Lee K, Mikolić A, et al. Action Collaborative on Traumatic Brain Injury Care: Adapted Clinical Practice Guideline. Annals of Family Medicine. 2025;23(6):552-569. doi.org/10.1370/afm.250352
- 9Patricios 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
- 10BC Injury Research and Prevention Unit. Concussion Awareness Training Tool: Return to Work tool (version 2, updated September 2023), in Concussion Resources for Workers and Workplaces (version 8, June 2024). concussionsontario.org/…/CATT%20Concussion%20Resources%20for%20Workers%20%26%20Workplaces%20V8.pdf
- 11Job Accommodation Network. Employees with Brain Injuries. Accommodation and Compliance Series. U.S. Department of Labor, Office of Disability Employment Policy. Updated March 22, 2010. govinfo.gov/…/GOVPUB-L41-PURL-gpo9207.pdf
- 12Living Concussion Guidelines. Table 12.1: Identifying workplace restrictions and limitations. Last updated April 2024. concussionsontario.org/…/Restrictions%20and%20limitations.pdf
- 13Mansur A, Hauer TM, Hussain MW, et al. A nonliquid crystal display screen computer for treatment of photosensitivity and computer screen intolerance in post-concussion syndrome. Journal of Neurotrauma. 2018;35(16):1886-1894. pmc.ncbi.nlm.nih.gov/articles/PMC6079648
- 14Centers for Disease Control and Prevention. Symptoms of Mild TBI and Concussion. Updated September 15, 2025. cdc.gov/…/signs-symptoms/index.html
This article reflects the safety priorities of concussion recovery, vision health and road safety education. It is general education and not medical advice. Vision symptoms, tests and treatments vary from person to person, so check official sources and talk with your own care team before changing glasses, equipment or how much you read or use screens. Reviewed October 2026.
Special thanks to our contributors
We appreciate the professionals, experts, and community members who share their knowledge and perspectives to help make this resource better. Your insights are always welcome and appreciated.
Have professional expertise, firsthand experience, or a perspective that could make this resource better?
We welcome your input. Your knowledge and experience can help us make this resource more useful, accurate, and meaningful to the people who rely on it.
Thank you. Your contribution is on its way.
We’re grateful you took the time to share your knowledge with us. Our team reviews every contribution with care. If it helps improve this resource, we’ll update the page and recognize you the way you chose.
Keep learning
Safe Driving Resource Center
Guides, self-checks and articles for drivers, parents of new drivers, and families recovering after a crash.
