Q and A: Can a Blow to the Head Render My Character Blind?

01 Jul

Q: My male character hits his head on a wall, rendering him blind. How long would he be blinded for, once the swelling that caused it goes down? Any long term effects, such as headaches and that?

Michelle Cunin, Alliance, Ohio

A: Blunt trauma to the head if it is severe enough to cause a cerebral contusion (brain bruise), where by definition there is some degree of bleeding into and swelling of the brain tissues as a result of the trauma, can easily cause a malfunction in that area of the brain. If it is the area of the brain that controls vision, your victim could easily have blindness. We call this cortical blindness since it arises from the cortex of the brain and not from the eye or from the optic nerve. In other words the loss of the ability to see comes from the brain itself. The visual cortex, the part of the brain that controls seeing, is in the very back of the brain in what we call the occipital lobe. In order for your victim to be completely blind both halves of the brain would have to be damaged otherwise he would only lose vision to his right side or his left side but not both. But this could easily happen with a blow to the back of the head or can occur after a fall where the back of the head strikes a wall, the floor, stairs, or almost anything else.




If the injury were severe enough to significantly damage the optical cortex then his blindness could be permanent but in most cases once the bleeding inside the brain stops and the swelling resolves, vision will return. This could take a few hours or many weeks so you have a broad range to consider when constructing your story. Any of these are possible.

The victim’s blindness might be complete or only partial in that he might be able to see shadows and shapes or one half of his visual field might be clearer than the other. This later situation would indicate that one side of the brain was damaged more severely than the other. If it were the left occipital lobe that was more severely damaged then the right half of his visual field would be the most affected. If he were struck in the left back side of the head, for example, he could lose vision of the entire right side of his visual field. It would appear as if a line had been drawn down the center of his visual field and everything to the right of the line would be black while to the left all would be normal. But since you want him completely blind it would require injuries to both occipital lobes.

Whether his vision returns or not, he could suffer from long-term headaches, dizziness, poor balance, and a few other symptoms but he could also return to complete normalcy. These symptoms could last a few days, months, or forever. All is possible.




Posted by on July 1, 2013 in Medical Issues, Q&A, Trauma


44 responses to “Q and A: Can a Blow to the Head Render My Character Blind?

  1. Fritz Strobl MD

    July 1, 2013 at 9:20 am

    Doug: Nice diagram and great explanation! I’ve seen it in closed head injuries as a contrecoup injury from frontal trauma, but normally the patient would have a lot of pre-frontal damage as well. Not necessarily a bad story line as it would also cloud his decision making.

    We bought your “Royal Pains” book, nice job.



    • D.P. Lyle, MD

      July 1, 2013 at 9:22 am

      Thanks, Fritz. It was a fun question. Hope you like the Royal Pains books.

      Are you coming to ThrillerFest next week?


      • Fritz Strobl MD

        July 1, 2013 at 10:14 am

        Yes. Bringing Debi who signed up for everything. Coming in Tuesday night. Kimberley asked me to help with security muscle, which I will. Looking forward to seeing you! Missed you since last year!


      • D.P. Lyle, MD

        July 1, 2013 at 10:28 am

        Great. See you there.


    • LeeAnn E. Gibson

      February 18, 2017 at 7:30 pm

      My ex husband put his foot behind my ankle and shoved my by my forehead onto a cement floor from a standing position. After this I was blind for about 12 hours. When my vision started to return, It looked like little points of light, two of them, one for each eye. Then the circle got a little bigger. Everything was so blurry, I couldn’t recognize anything for over 24 hours. After that, I had a terrible headache, but was able to drive a car. Using a phone was super stressfull, trying to figure out which button was which when really scared. I hope this helps your writing. Perhaps finally there was something good to come of it.


  2. Fritz Strobl MD

    July 1, 2013 at 9:21 am

    But the occipital trauma is probably the easiest. Fritz


  3. Fritz Strobl MD

    July 1, 2013 at 10:16 am

    Doug, here might be a fun topic.'s_syndrome
    Balint’s Syndrome.


    • D.P. Lyle, MD

      July 1, 2013 at 10:29 am

      Very cool. Never heard of this one. You brain guys are so smart. We heart guys are just plumbers.


      • Fritz Strobl MD

        July 1, 2013 at 10:41 am

        Since we don’t get to do the neat stuff you do, we have to think up syndromes that are unique.


      • D.P. Lyle, MD

        July 1, 2013 at 10:56 am

        Like this one.


  4. A. Michael Schwarz

    July 1, 2013 at 11:40 am

    You’ve always got hysterical blindness as a last resort.


  5. Elaine Goss

    July 1, 2013 at 12:17 pm

    A blow to the head can cause detached retinas in those who are very nearsighted.


    • D.P. Lyle, MD

      July 1, 2013 at 12:22 pm

      Near or far sighted has little to do with retinal detachments and they are only rarely bilateral. But this could easily lead to blindness or impaired vision in one eye.


  6. Susanne Alleyn

    July 1, 2013 at 2:31 pm

    This actually happened in my family — to a cat. She was (apparently) struck a glancing blow by a car, not visibly hurt, no marks, no wounds, no broken bones, but knocked unconscious. When she came to, she was at least partially blind. Poor thing walked around in tight circles, stumbling into things, for weeks. Gradually, after three or four months, she recovered. It was like watching a newborn kitten mature all over again, re-learning how to eat kibble, use the box, etc. She ended up completely healthy and apparently able to see normally.


  7. Cheryl B. Dale

    July 1, 2013 at 3:28 pm

    Your blog is always interesting and informative!


  8. Christine Kling

    July 2, 2013 at 4:51 am

    Doug – Great timing! I’d just figured out that a continuing character of mine was going to lose his eyesight in a fight. I wanted to go with cortical blindness because it means the undamaged eyes will still react to light and look “normal.” But I wanted him to only be partially blind because I wanted to include some neat tech in the way of assistive technologies, but I wasn’t sure whether cortical blindness was all or nothing. You’ve described it well – how he can be “legally blind” but still retain some vision. Thanks!


    • D.P. Lyle, MD

      July 2, 2013 at 7:55 am

      Christine–timing is everything. Glad it worked out and good luck with your story.


  9. marilynm

    July 2, 2013 at 5:48 am

    My son was severely beaten, hit in the head with bar stools and a table at Christmas time while working as a bouncer. (No one was arrested.) and he received brain trauma, his vision worsened enough he now wears glasses, he still has problems with his memory, balance, etc. Now when I see people in movies getting hit on the head with heavy objects and getting right up and fighting back it makes me wonder.


  10. Fritz Strobl MD

    July 2, 2013 at 8:47 am

    Doug – Looks like it was a great topic!



  11. jenniferklewis

    August 4, 2013 at 8:17 pm

    Can I jump in here too. I also want my character to be blind, but aesthetically fine, and I was wondering if blindness can be caused by radiant heat from a severe house fire? She jumps from a burning building with her baby sister in her arms, so the damage could be due to the fall, but I’m very keen on the fire being the cause.

    Your help would be much appreciated.


    • D.P. Lyle, MD

      August 5, 2013 at 6:02 am

      Trauma would still be your best bet but if the fire was intense it could damage her corneas, scaring them. This could reduce her vision to only shadows and vague light, lacking in detail. But for this to happen she would have to suffer at least some fire damage to her face. This could be first and second degree so there would be no residual scarring or she could have areas of third degree burning which would scar. Her vision could be repaired with a corneal transplant so this defect would not be permanent.


      • jenniferklewis

        August 5, 2013 at 8:55 am

        Perfect. Thanks so much for that. Cheers


  12. drshaywest

    January 2, 2014 at 5:15 pm

    This info will definitely help with my story line too 😀 I still can’t decide if I want my villain to lose his sight via an occipital blow or trauma to his eyes and face… *decisions decisions* 😉


  13. Kat

    May 1, 2015 at 8:02 am

    One of my characters received a blow to the left side of his head then fell down a cliff(but there I haven’t said if he actually fell down the entire cliff or was teleported to the island before he hit the bottom). I’m making him out to have everything be really hard to see as the blow did cut him. He didn’t have the best eyesight before he got hit. Could the blow make him go blind permanently or would it just be temporary?


    • D.P. Lyle, MD

      May 1, 2015 at 8:05 am

      Kat—I only answer story questions thru my website as I require certain information beforehand. Please visit my site and add the needed info and submit your questions that way—DPL


  14. Amber

    May 24, 2015 at 9:23 am

    Is it possible for chemicals or gas in the smoke during a fire to cause blindness?


    • D.P. Lyle, MD

      May 27, 2015 at 3:32 pm

      Depends on the gas/chemical. Usually not but things like chlorine gas can severely damage the eyes—the lungs and skin as well.


  15. Vanessa Grant Oltmann

    June 30, 2015 at 3:50 pm

    I found this very interesting discussion while searching for more medical details for my character. This has been of some help to me and I’m hoping some of the medical experts are still following this thread. If so, I’d welcome any suggestions, or comments on the realism of my scenario.

    My character is an adult woman in her 30s who is legally blind in her left eye from an untreated (until too late) retinal detachment doctors believe was caused during the sailing accident that killed her parents. She can now see only shadows and shapes through the left eye, and her right eye is fully sighted. In my story she loses consciousness in a downhill pedestrian-meets-bicycle collision (she was the pedestrian). What I want is for this accident to make her lose consciousness for some time, and to wake with severely impaired vision in her right eye from a retinal detachment. I’m hoping it’s realistic for an opthalmic surgeon to repair the detachment. I initially had this done using a schleral buckle to hold the detached bit in place, but I’m thinking I might use the “gas bubble” to hold things together, because my husband had this done some years ago and I know more about it. Also the “this side up” arrow that was marked on the eyepatch my husband wore for the first 24 hours could be an interesting story element.

    Following the present day injury I want the surgeon to operate and get the detached retina back in place, but when she comes back for her checkup, the surgeio will see that the surgery was a failure. What I want is a situation where she knows that she’s going blind in this eye as a result of this detachment. I want her “going blind” period to last a few weeks, and her eventual right eye blindness to be about the same degree as her left. She’s legally blind, but can see some shapes and shadows.

    I want her to be delivered to the hospital by ambulance from the accident consciousness. My thought is that she won’t be fully coherent for long enough that there’s a realistic chance the reatachment will fail.

    My questions are:
    1. Aside from the “what’s your name”, “what day is it” type of questions that nurses and doctors will ask in her initial confused waking states, what kind of medical questions will they ask? What would be the most likely trigger for the medics realizing there’s a vision problem.
    2. Is there a set of symptoms that might look like a brain injury and later be found to be vetrios bleeding retinal detachment (or whatever kind of detachment works for my scenario)? I’m trying to get an idea of the sequence of steps that might be involved while she’s in hospital after this. And what the logical sequence of “might be this, might be that” that might go on.
    3. What’s the name of the surgical process you would recommend, and what are the details/symptoms of its failure. I’d like it if she doesn’t know it’s failed until her followup visit (next day, or when?), and at that point the surgeon tells her that although she’s seeing fairly well right now, her vision will diminish as she loses her sight. It would ge good if there were a likely time frame that could have her functionally blind within two months.

    To summarize the scenario I need in my story:
    1. Injury has to result from the bicycle collission
    2. Treatment for the injury has to fail – she needs to know she is going blind, the time frame needs to be relatively short range – ideally between 6 weeks and a few months.

    Any suggestions, corrections of my assumptions here, or associated thoughts are welcome.



    • D.P. Lyle, MD

      June 30, 2015 at 5:50 pm

      Vanessa–I don’t answer such questions here on my blog as I require certain information before answering. If you visit my website you will find how to submit your questions and the needed info to supply–DPL

      Liked by 1 person

  16. Vanessa Grant Oltmann

    June 30, 2015 at 3:58 pm

    I see that I didn’t mention character’s current blindness occured when she was 12 years old.


  17. Bethy B

    March 1, 2016 at 3:32 pm

    Thanks for the info! This answers my question about my MC’s injury as well.


  18. Aisha B

    July 29, 2016 at 11:35 am

    Your explanation has helped a lot with my story. My character actually had a car accident and lost her sight. I want to know if this form of blindness is curable.


    • D.P. Lyle, MD

      July 29, 2016 at 3:43 pm

      Depends on the exact nature of the injury, the treatment given, and luck. So it’s unpredictable.


  19. Frederick Strobl

    August 4, 2016 at 2:30 pm

    One feature that one might weave into a story is that during the recovery process, at night or with fatigue, intercurrent illness, the (visual) deficit can temporarily worsen/fluctuate.


  20. Niqua

    October 2, 2016 at 6:24 pm

    Has any one had a gun shot wond to the head and re gaind eye sight back ever he 9yrs old


    • D.P. Lyle, MD

      October 3, 2016 at 7:19 am

      It depends on the exact nature of the injury and the health–and luck–of the victim, but if the injury caused blindness for 9 years it would be unlikely sight would return by itself. But in medicine essentially all is possible.


  21. Lina Crowe

    July 19, 2017 at 3:01 pm

    Thanks for this article!! It was really helpful! I’m not a crime writer; more of a romantic. But the story of my character is that she falls from a horse and hits her head and is rendered temporarily blind. She develops a romance with a young physician she has never seen. It’s a period piece so no modern medicine and this was really helpful to understand how the brain works in that situation! Thanks again and I’ll be bookmarking this blog for future reference!!
    ~Lina C.


  22. Richmond Thoma

    May 24, 2019 at 11:29 pm

    my 4 year old daughter was a normal child but on 2018 on february i forgot the exact date if 21, she run around with other kids when she got trip and bump her head on a parking motor bike stand, she cried but when she stand up call for mommy we saw that her left eye not normal i mean shes looking at us (parents) and her right eye looking straight at us while her left eye looking diffrent direction. after the accicident she ran into a wall or trip on anything lying around, i stop and ask her why she trip on things she said that the left eye only see black colour the right eye is ok on july her right eye got infected until now she cannot see anything. please is there any cure for her to get her sight back?


    • D.P. Lyle, MD

      May 25, 2019 at 7:05 am

      I’m sorry to hear about her injury but I never comment on real-life medical situations. Talk with your physician about this.



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