What is neuro-optometric vision rehabilitation?
Neuro-optometric vision rehabilitation is the term used to describe the individualized treatment regimen for a patient with visual deficits as a direct result of neurological injury and disease. This treatment plan is based off of the results of a comprehensive neuro-optometric examination and may include patient education on adaptive techniques to cope with neurologic vision loss, tinted lenses to improve contrast sensitivity/glare/light sensitivity, prism lenses to alleviate double vision or help with spatial orientation and neurologic visual field loss, and vision therapy.
Vision therapy is a very broad term that can encompass a variety of types of treatment. This can be frustrating for patients who are told they need post-concussion or traumatic brain injury"vision therapy" but don't know what type. At Virginia Neuro-Optometry we perform orthoptics vision therapy which is scientifically evidence-based and shown to remediate both developmental and acquired (brain injury/concussion/stroke) oculomotor dysfunction (convergence and accommodative disorders). For more information on neuro-optometric rehabilitation we recommend you visit the NORA (Neuro-Optometric Rehabilitation Association) website (click here).
Additionally, we can offer guidance on adaptations for higher order visual processing deficits like reduced visual processing speed, difficulty with spatial orientation, and adaptation to neurological visual field loss.
What is orthoptics vision therapy?
Orthoptics is an evidence-based type of vision therapy/rehabilitation for oculomotor dysfunction and disorders including convergence insufficiency and accommodative disorders. It has been shown in clinical trials to be helpful for certain patients with certain types of presentations of oculomotor dysfunction - this means, that not everyone is a candidate for orthoptics. However, for those patients who ARE a candidate (Ex: post-concussion convergence insufficiency), this specific type of vision therapy is available and helpful to remediate symptoms.
How many orthoptics vision therapy visits will a typical patient with a concussion or brain injury need?
Every patient is different and there is no definitive answer to this question. However, Dr. Theis' goal is to get you better as soon as possible in the fewest number of office follow up visits!
In her extensive clinical experience, the majority of orthoptics vision therapy can be successfully performed in a home-based daily vision therapy program with telemedicine/office follow-up visits to help guide the patient's success every 1-2 weeks. This methodology is not only cost-effective for the patient, but reduces the burden on the patient/family to acquire transportation and take time off of work for weekly/biweekly in-office visits. Additionally, this method reduces triggering symptoms in patients who are unable to tolerate vehicle transportation due to their brain injury.
Dr. Theis will monitor the patient's on-going progress and tailor the rehabilitation program to the patient's oculomotor system to expedite recovery. This is helpful for patients with brain injury as it allows for flexibility in rehabilitation and recovery.
Ciuffreda KJ, Rutner D, Kapoor N, Suchoff I, Craid S, Han ME. Vision therapy for oculomotor dysfunctions in acquired brain injury: A retrospective analysis. Optom 2008: 79: 18-22.
Collins M, Kontos A, Okonkwo D. et al. Statements of Agreement from the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015. Neurosurgery. Dec 2016;79(6):912-929.
McGregor ML. Convergence insufficiency and vision therapy. Pediatr Clin N Am. 2014; 61:621-630