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In Part 1 of this blog series we discussed vision therapy – a great treatment option for children and adults who have struggled through a life of eye tracking, teaming, focusing or visual perceptual, processing and working memory deficits. In Part 2 of this blog series we are going to discuss Neuro-Optometric Vision Rehabilitation – a treatment that often serves as the foundation for someone's entire rehabilitative process after an acquired brain injury.

An acquired brain injury is often life-altering. Whether you experience a concussion, a stroke, or a head injury, it is probable that vision changes will result. For some, these vision changes are temporary and resolve in a short amount of time. For others, persistent vision problems can last months or even years. Vision problems can sometimes be quite obvious – such as seeing double. Often times, however, vision challenges can be more vague – such as difficulties with balance or mobility, reading difficulties, or challenges interpreting what you see. The complex nature of post-trauma vision changes is why every patient who experiences a traumatic brain injury should be under the care of an optometrist who is residency-trained in neuro-optometry.

During a Neuro-Optometric Assessment, the doctor will evaluate the several aspects of vision that can be affected by an acquired brain injury and prescribe a treatment plan based on your specific needs. Treatment can consist of an updated glasses prescription, a prism prescription to modify eye teaming, or a fully customized vision rehabilitation program. Without a residency-trained neuro-optometrist on your care team it is likely that your vision conditions will go undiagnosed or mis-treated.

NEURO-OPTOMETRIC VISION REHABILITATION

Neuro-Optometric Vision Rehabilitation is the foundation of your visual recovery; and arguably your overall recovery as well. Think about it – if you are not seeing correctly what will it impact? Yes things could be blurry, or even double, but visual deficits will impact your balance and mobility, your ability to perform visual-motor tasks (coordination), your return to driving, your ability to work and your ability to engage in many of your hobbies.

Neuro-Optometric Vision Rehabilitation is an in-office program prescribed by, and performed under the direction of, an optometrist with residency-training in neuro-optometry. The results of the Neuro-Optometric Assessment are used by the doctor to develop a treatment program to address post-trauma vision changes – such as deficits in eye tracking, eye teaming, eye focusing, visual perception, visual processing speed and visual working memory. Specialized techniques and equipment are used to re-develop the neural-visual network that is deficient following an acquired brain injury. By re-establishing a stable visual system, Neuro-Optometric Vision Rehabilitation prepares you to return to your life.

Many of the most common visual changes that are experienced as the result of an acquired brain injury are best-managed with Neuro-Optometric Vision Rehabilitation. By using a treatment program that is developed by a residency-trained neuro-optometrist, it ensures that the right treatment is being used to address the right visual deficit. As an example, if you engage in 'eye tracking exercises' with a therapist outside of Neuro-Optometric Vision Rehabilitation, you may be embedding poor visual habits that prevent you from getting better. Yes difficulties with eye tracking may be a symptom, but what is the underlying condition? Do you have ocular-motor dysfunction or do you have binocular vision dysfunction or a mis-alignment of the eyes that makes it difficult to track? These three examples of vision conditions are quite common after an acquired brain injury, all result in 'difficulties with eye tracking', but they are treated in very different ways. The diagnoses from the Neuro-Optometric Assessment guide your future treatment program and allow you to be as successful as possible in your recovery. This is one of many advantages to performing Neuro-Optometric Vision Rehabilitation early in your recovery rather than including a few eye exercises along the way.

HOW TO GET THE MOST OUT OF YOUR VISUAL RECOVERY

You will have several people on your recovery team. It is important that an optometrist who is residency-trained in neuro-optometry is included in this team. This doctor has the knowledge and expertise to develop a recovery program for your visual system. When adding vision rehabilitation to your care program, here are a few things to keep in mind.

• WORK WITH AN OPTOMETRIST WHO HAS COMPLETED A RESIDENCY IN NEURO-OPTOMETRY

  A residency is a formal, advanced training program completed after graduation from optometry school. Every residency program is accredited through a school of optometry and must meet strict guidelines. Residency-training is a great way to ensure that the doctor has both the knowledge and advanced training to care for you.

• ENROLL IN A NEURO-OPTOMETRIC VISION REHABILITATION PROGRAM PERFORMED UNDER THE DIRECTION OF A RESIDENCY-TRAINED NEURO-OPTOMETRIST

  Anyone can ask you to perform a few eye exercises and hope that things get better. But how do you know that you are working with someone who has the training to safely modify your visual system? Do you want to waste a year or more of your recovery attempting to put a patch on a damaged visual system? Vision is a complex process that needs to be managed by a doctor with specialized training in post-trauma vision changes.

• PARTICIPATE IN A PROGRAM THAT IS PERFORMED IN-OFFICE AND ONE-ON-ONE WITH A VISION THERAPIST

  The complexities of vision rehabilitation require close, one-on-one supervision. The only way to accomplish this is through an in-office (out patient) program that is designed to be one-on-one. It is impossible to make the necessary improvement if you are stuck in front of a computer or put in a group. Even a small group is inappropriate for Neuro-Optometric Vision Rehabilitation. Each person is affected differently by an acquired brain injury and recovery occurs at different rates for different people. This is why you need an individualized program.

• DON'T CONFUSE EYE EXERCISES FOR NEURO-OPTOMETRIC VISION REHABILITATION

  Several rehabilitation centers may offer physical therapy, speech therapy and occupational therapy, but they may not offer Neuro-Optometric Vision Rehabilitation. You should not start any type of eye exercise or vision training without a Neuro-Optometric Assessment (which is very different than a visit to your primary eye care provider). You should not have a therapist who is trained in handwriting, daily grooming or gait rehabilitation perform vision training with you. This is best left to a professional within vision care.

If you have experienced vision changes after an acquired brain injury, your next step is to find an optometrist who is residency-trained in neuro-optometry. A Neuro-Optometric Assessment will tell both you and your care team which visual barriers are present and how to resolve those barriers.

Check out Part 1: Vision Therapy to learn more about vision therapy.

Join us next time when we discuss eye exercises – time consuming yet ineffective attempts to improve visual function.