| Sumario: | Background: Visual midline shift syndrome (VMSS) is an uncommon sequela of mild traumatic brain injury (mTBI). Untreated, VMSS may contribute to vague complaints of visual discomfort and balance or postural dysfunction. Identifying and treating this condition may improve visual outcomes and quality of life for an mTBI patient. Case Report: A 24-year-old female Soldier with a history of at least one concussive event and complaints of drifting when walking, photophobia, asthenopia, and persistent visual blur presented to the optometry clinic via a referral from her nurse case manager. Her initial visit failed to yield any reliable information regarding her symptoms due to fatigue, over-medication, and distraction, so we delayed any treatment until she could return in a better state of mind. Over her next four visits, we conducted a full ocular health examination and an extensive neuro-optometric evaluation, and we diagnosed her with convergence insufficiency and VMSS. We then issued corrective lenses and yoked prism in a stepped fashion. She responded progressively better to each intervention, and one month after her final visit, she was largely visually asymptomatic. Conclusions: A deliberate approach to care and a thorough neuro-optometric examination is indicated for any patient manifesting visual sequelae of mTBI during their initial comprehensive ophthalmic examination. Proper treatment of subtle dysfunctions evident only upon careful evaluation and consideration of all of a patient’s concerns can have a positive impact on the patient’s quality of life.
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