Vision Rehabilitation

Neuro-Optometric Vision Rehabilitation is a treatment protocol prescribed by, and performed under the direction of, an optometrist with residency training in neuro-optometry. Neuro-Optometric Vision Rehabilitation addresses many of the visual changes that result from a neurological event (trauma, stroke, neuro-degenerative condition, etc) that would not otherwise respond to treatment to refractive correction (glasses) or surgery.

For many patients, Neuro-Optometric Vision Rehabilitation is performed as part of a comprehensive rehabilitation process. Neuro-Optometric Vision Rehabilitation is often critical in the early stages of recovery as visual reorganization allows for improvement in several areas. Vision, for example, is a critical component in mobility, hand-eye coordination and visual-motor tasks. This means that vision deficits can negatively impact one's progress in physical therapy, occupational therapy and speech therapy. Additionally, vision deficits can prevent a person from re-gaining their ability to participate in hobbies, returning to work, or performing activities of daily living (including driving). Including Neuro-Optometric Vision Rehabilitation as part of your comprehensive recovery program improves success and allows you to achieve higher levels of success.

It was once thought that once a skill was lost it was impossible to gain it back. This lead to fairly disheartening conversations with patients who has suffered an acquired brain injury. They were told that they had to give up hobbies, stop working and were going to be severely limited for the rest of their life. With time, health care provides began to realize that some level of recovery was possible with time. This lead to a 'wait and see' approach to care where health care providers acknowledged that deficits were present but told the patient that they would have to see if anything got better.

More current research has shown that change can be actively influenced. The concept of neuroplasticity enables anyone of any age to actually change the way they use their brain. There are obviously limitations to what can be accomplished, however neuroplasticity allows someone to regain abilities that were once thought to be forever lost following a brain injury.

For several decades we have known that the visual system is affected by a brain injury. Acquired brain injury, which includes concussion, traumatic brain injury, stroke and neuro-degenerative conditions, can have several effects on the visual system. These conditions include:

• Accommodative dysfunction (impaired eye focusing)
• Binocular vision dysfunction (impaired eye teaming, including convergence palsy)
• Dry eye syndrome
• Impaired visual working memory
• Oculomotor dysfunction (impaired eye movement or tracking)
• Prolonged visual processing speed
• Ptosis (sagging or drooping eye lid)
• Pupil anomalies
• Strabismus (eye turn, wandering eye, crossed eye)
• Visual field loss (peripheral vision or 'side vision' loss)
• Visual attentional neglect (inability to attend to information on one side of the body)
• Visual perceptual deficits or visual agnosia – including visual-spatial deficits

These conditions in turn result in several symptoms. Some symptoms are easily related to the visual system, while others may not initially be associated with vision by the patient or their health care provider. Symptoms due to post-trauma vision conditions include:

• Abnormal posture (head posture, leans to one side, forward or backwards)
• Asthenopia (eyes feel strained, uncomfortable, or sore)
• Attention or concentration difficulties
• Balance difficulties
• Blurred or fluctuating vision
• Bumps into objects or walls
• Difficulties moving through crowded spaces
• Difficulties with reading fluency or comprehension
• Diplopia (double vision)
• Dizziness or nausea
• Fatigues easily (especially with near work, reading, computer)
• Glare sensitivity
• Headaches
• Motion sickness or difficulties with mobility
• Photophobia (light sensitivity)
• Poor depth perception or 3D vision

We have also known that recovery is possible following an injury through the use of therapy (such as Neuro-Optometric Vision Rehabilitation). Recovering from an acquired brain injury is a long process that involves several professionals working as a collaborative team. More importantly, it requires a great deal of work by you, the patient.

Neuro-Optometric Vision Rehabilitation is a sub-specialty of optometry that treats a range of visual disorders that occur as a result of systemic disease, brain injury (ABI or TBI), stroke, developmental delay, and other neurological conditions. Neuro-Optometric Vision Rehabilitation is an individualized therapy program prescribed by a residency trained neuro-optometrist. This differs from other types of vision exercises that teach compensatory skills in order to “adapt” to the symptoms. In other words, they teach you to deal with the symptoms rather than treating and eliminating the underlying cause for the symptoms.

A Neuro-Optometric Vision Rehabilitation program is prescribed following an in-depth, comprehensive Neuro-Optomeric Assessment. This assessment, which is performed by a Residency-Trained Neuro-Optometrist, diagnoses the specific vision conditions that require treatment. Accurate diagnosis allows for appropriate treatment and greater recovery. If you have experienced an acquired brain injury, schedule a Neuro-Optometric Assessment to see if Neuro-Optometric Vision Rehabilitation should be incorporated into your recovery plan.