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Concussion, Brain Injury and Vision Quiz

Take the quiz below to understand if a concussion may be impacting your vision.

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Total score greater than 20 indicates a higher risk for a vision problem. Further evaluation is recommended.

How often does this happen? Choose one.

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1. Do your eyes feel tired when reading or doing close work?

 
 
 
 
 

2. Do your eyes feel uncomfortable when reading or doing close work?

 
 
 
 
 

3. Do you have headaches when reading or doing close work?

 
 
 
 
 

4. Do you feel sleepy when reading or doing close work?

 
 
 
 
 

5. Do you lose concentration when reading or doing close work?

 
 
 
 
 

6. Do you have trouble remembering what you have read?

 
 
 
 
 

7. Do you have double vision when reading or doing close work?

 
 
 
 
 

8. Do you see the words move, jump, swim, or appear to float on the page when reading or doing close work?

 
 
 
 
 

9. Do you feel like you read slowly?

 
 
 
 
 

10. Do your eyes ever hurt when reading or doing close work?

 
 
 
 
 

11. Do your eyes ever feel sore when reading or doing close work?

 
 
 
 
 

12. Do you feel a “pulling” feeling around your eyes when reading or doing close work?

 
 
 
 
 

13. Do you notice the words blurring or coming in and out of focus when reading or doing close work?

 
 
 
 
 

14. Do you lose your place while reading or doing close work?

 
 
 
 
 

15. Do you have to re-read the same line of words when reading?

 
 
 
 
 

16. Do you have blurred vision when looking far away?

 
 
 
 
 

17. Do you have a loss of peripheral (or side) vision?

 
 
 
 
 

18. Do you feel dizzy or foggy?

 
 
 
 
 

19. Do lights bother you?

 
 
 
 
 

20. Do you cover or close one eye to see well?

 
 
 
 
 

21. Do you have to take a lot of breaks during reading and close work?

 
 
 
 
 

22. Are you bothered by riding in a car or walking down the aisle in a store?

 
 
 
 
 

23. Do you have any trouble with balance while walking or standing?

 
 
 
 
 

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