The Peripheral Vision Challenge

by Kellie Pokrifka

Have you noticed how bothersome our peripheral vision becomes after brain injury? Anything out of the corner of our eyes suddenly sets off our TBI symptoms. Why is that?

After brain injury, our body tends to get stuck on sympathetic firing, or fight-or-flight mode. We know this as the mode designed to help us fend off attackers and flee for our safety back in our caveman days. Any kind of fright can set off this system—preparing us to fight. Our blood rushes away from any systems like digestion or sleep that are not immediately necessary for fleeing the scene. Our pupils dilate, our heart rate escalates, and our anxiety kicks in to get us out of danger. 

Okay, but how is this connected to peripheral vision? Dr. Deborah Zelinsky compares this situation to seeing a mouse. If you see a mouse directly in front of you, you are likely to be startled, but not quite as much as you are if you see it out of the corner of your eye, and then lose track of it. Where did it go? What do you do? Should you try to find it and attack, or run away?

After brain injury, our brains start reacting to any motion in our peripherals as if they are mice. We get the same panic from any movement. Our body feels like we do not have control over any of these things that are not in our direct line of sight. 

Ask yourself:

• Why does this suddenly occur so frequently after brain injury?
• Should we not react like this with healthy brains, too?

After brain injury, or any sort of physical or even emotional trauma, the body tends to experience overdrive in the sympathetic firing. Our body knows we are hurt—but does not know whether the danger has officially receded. We start to experience dysautonomia – a dysfunction of the normal regulation between sympathetic (fight or flight) and parasympathetic (rest and digest.) We are constantly running on sympathetic firing, which is not sustainable. We become “wired and tired” – and our fighting resources are still being cranked up, but they have been in continuous use for so long that we are now exhausted. Yes, we are anxious and restless, but we are also completely exhausted. 

The less we can regulate this system, the more likely it is that anything can trigger it. Our peripheral vision is not a trigger when our body is cool and in charge. Now that the system is so overworked and high-strung, anything out of the corner of our eyes sounds the alarms as being a threat. 

But, wait a minute. This seems counterproductive to healing. It is! Just like learning any new skill, the more we practice, the better we get. Unfortunately, this skill is now overreacting to benign stimuli. And we are becoming great at it! Obviously, we need to break this cycle. We need to rewire our brains to relax. How can we do this?

• You should consult with your doctor about all the therapies available. Meditation, Cognitive Behavioral Therapy, deep breathing, vagal nerve stimulation, and neuro-feedback are a few examples.
• Basically we need to try anything that will help rebalance our autonomic nervous system.
• Anything which helps with this task will free up enormous amounts of energy to help heal any other lingering symptom of brain injury.
• If we set our body up to heal, it will often do the rest!

So with that, deep breath in, deep breath out. 

Kellie is a TBI survivor and works as an intermediary between the experts and the patients with brain injuries.